The cognitive behavioural tradition represents an important approach to counselling, with its own distinctive methods and concepts. This approach has evolved out of behavioural psychology and has three key features: a problem-solving, change-focused approach to working with clients; a respect for scientific values; and close attention to the cognitive processes through which people monitor and control their behaviour.

The practice of cognitive-behavioural counselling unlike the psychodynamic and person-centred approaches to counselling, which place a great deal of emphasis on exploration and understanding, the cognitive-behavioural approach is less concerned with insight and more oriented towards client action to produce change. Although different practitioners may have different styles, the tendency in cognitive-behavioural work is to operate within a structured stage-by-stage programme, in which the problem behaviour that has been troubling the client is identified and then modified in a systematic, step-by-step manner. The attraction of CBT, for many clients, is that it is experienced as purposeful and that it makes sense – it is made clear to the client what is expected from him or her, and how his or her efforts will lead to desired outcomes. The main areas of focus within cognitive-behavioural work are:

1. The therapeutic relationship: establishing rapport and creating a working alliance between counsellor and client; explaining the rationale for treatment.
2. Assessment: identifying and quantifying the frequency, intensity and appropriateness of problem behaviours and cognitions.
3. Case formulation: arriving at an agreed conceptualization of the origins and maintenance of current problems and setting goals or targets for change that are specific and attainable.
4. Intervention: application of cognitive and behavioural techniques.
5. Monitoring: using ongoing assessment of target behaviours to evaluate the effectiveness of interventions.
6. Relapse prevention: attention to termination and planned follow-up to reinforce generalization of gains.