A review in American Family Physician maps where cognitive behaviour therapy (CBT) belongs in everyday practice. It is a primary treatment — alone or with medication — for insomnia, anxiety, depressive and obsessive-compulsive disorders, PTSD, somatic symptom disorder and tinnitus, among others, and a useful adjunct for chronic pain, irritable bowel syndrome, weight management and more.
The practical shift for a busy clinic is to treat CBT as a specific prescription rather than a vague referral. Telehealth and digital CBT show clinical benefit, and brief CBT-based interventions can be delivered within primary care by integrated behavioural health, which matters where therapist access is limited.
In India, trained CBT therapists are scarce, but task-shared and lay-counsellor-delivered models have a track record, and digital programmes extend reach — so the gap is one of delivery, not of evidence. Reaching for CBT first in insomnia or mild-to-moderate anxiety can spare a prescription.
- Offer CBT as a first-line option for insomnia, anxiety, depression, OCD and PTSD, not only medication.
- Use it as an adjunct in chronic pain, irritable bowel syndrome and weight management.
- Digital and telehealth CBT show benefit where in-person therapists are scarce.
- Make the referral specific — name the target condition rather than referring for generic counselling.
Why it matters
It reframes CBT from a vague referral to a targeted treatment with defined first-line indications a GP can act on.
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