In Cognitive Behavioral Therapy, the interplay of which elements is central?

• A. thinking-believing-doing
• B. seeing-doing-expressing
• C. thinking-feeling-behaving
• D. behaving-doing-imitating

Answer: (A)

In Cognitive Behavioral Therapy, change comes from how we interpret events (our thinking and beliefs) and what we do in response (our actions). The way thoughts and beliefs shape behavior—and, in turn, how behaving can reinforce or challenge those thoughts—drives distress and recovery. This interplay between cognitive content (thinking and beliefs) and action (doing) is the engine therapists work on: by challenging distorted beliefs and testing new approaches to behavior, emotions shift as a consequence of those cognitive-behavioral changes.

Feelings are important, but they’re often the result of how we think and what we do. That’s why focusing on thinking and believing alongside doing best captures how CBT targets the mechanisms of change. The other formulations either emphasize feelings too much, or mix in elements that aren’t the core cognitive-behavioral loop, making them less aligned with the central process CBT targets.