If you’ve ever felt like life has lost its colour – where even simple things like eating, sleeping, or getting out of bed feel hard – you’re not alone. In Canada, over 14% of individuals will experience at least one major depressive episode in their lifetime. That’s over 4 million people navigating the weight of depression. Fortunately, many talk therapies effectively treat depression and its symptoms (Cuijpers et al., 2020). One of the most well-known and widely researched treatments is cognitive behavioural therapy (CBT).
Understanding Depression
Depression isn’t just “feeling sad.” It can show up as emptiness, loss of motivation, irritability, or feeling disconnected from things and people you care about. Some common experiences include:
- Persistent sadness or hopelessness
- Loss of interest in activities that once brought joy
- Trouble concentrating
- Changes in sleep or appetite
- Low energy or fatigue
- Feelings of guilt or worthlessness
- Thoughts of death or suicide
Depression looks different for everyone – and it can vary by age, culture, and life experiences. For some, it feels like a fog that slowly lifts and returns. For others, it can be a deep, ongoing struggle.
What Is Cognitive Behavioural Therapy (CBT)?
Cognitive Behavioural Therapy, or CBT, is one of the most well-researched and effective treatments for depression. It’s also widely used for individuals struggling in Toronto with anxiety, stress and burnout.
At its core, CBT looks at how our thoughts, emotions, and behaviours influence one another.
Here’s how it works:
- Thoughts: Sometimes, our minds get stuck in unhelpful or distorted thinking patterns – like “I’m a failure” or “Nothing will ever get better.”
- Emotions: These thoughts can trigger painful feelings such as sadness, shame, or fear.
- Behaviours: When we feel low, we might withdraw, avoid, or lose motivation – which can reinforce those painful emotions.
CBT helps break this cycle. It invites you to gently challenge unhelpful thoughts and make small, meaningful changes in behaviour that support healing and self-compassion.
What Cognitive Behavioural Therapy (CBT) Looks Like in Therapy
CBT is a structured, practical, and collaborative form of therapy. Here’s what you might expect when working with a therapist:
1. Understanding the problem together: you and your therapist will work together and explore the thoughts, emotions, and habits connected to your challenges.
2. Setting goals: you will decide what “better” looks like – whether that’s feeling less anxious, improving motivation, reconnecting with meaning, or another growth area important to you.
3. Recognizing thought patterns: you will learn to identify and reframe unhelpful thoughts, often called ‘cognitive distortions’, so they have less power over you.
4. Taking action: as therapy progresses, you’ll focus on the importance of engaging in positive behaviours, commonly referred to as ‘behavioural activation’ that align with your personal goals and values.
5. Skill building: you’ll also develop skills and coping strategies to manage your thoughts, emotions, and behaviours more effectively. These may include relaxation techniques, problem solving strategies, assertiveness training, and stress management – skills you can use long after therapy ends.
6. Home practice: CBT is typically an active therapy approach, where you will be encouraged to practice the skills and techniques learned during therapy sessions in your daily life. This homework reinforces the therapy work and allows for ongoing practice and progress.
What the Research Says About CBT and Depression
CBT has been studied for decades and remains one of the gold-standard treatments for depression. A recent review published in the Journal of Affective Disorders (2025) found that CBT – in both its traditional and newer forms like Mindfulness-based Therapy and Acceptance and Commitment Therapy (ACT) – significantly improves not just mood, but also sleep, daily functioning, and overall quality of life. Interestingly, the number of sessions didn’t determine success – meaning even shorter therapy programs can be highly effective when the work feels meaningful and consistent.
FAQ about CBT for Depression
Here are a few alternative therapies that can help with depression which can be used on their own, or in conjunction with CBT!
Acceptance and Commitment Therapy (ACT): ACT encourages individuals to accept their thoughts and emotions while focusing on taking action aligned with their values. It incorporates mindfulness and acceptance techniques and aims to enhance psychological flexibility.
ACT Therapy, Toronto
Dialectical Behaviour Therapy (DBT): DBT is a specialized form of therapy that combines elements of CBT and mindfulness. It focuses on developing skills for emotion regulation, distress tolerance, and interpersonal effectiveness.
DBT Therapy, Toronto
Mindfulness-Based Therapies: Therapies such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) incorporate mindfulness practices to help individuals cultivate present-moment awareness and reduce distress.
Mindfulness Therapy, Toronto
Solution-Focused Brief Therapy (SFBT): SFBT focuses on identifying and amplifying individual strengths and resources to create solutions. It is future-oriented, goal-directed, and emphasizes small steps towards positive change.
Psychodynamic Relational Therapy: Psychodynamic therapy explores the unconscious mind and past experiences to gain insight into current emotional and behavioural patterns. It focuses on understanding the root causes of psychological difficulties and working through them.
Psychodynamic & Relational Therapy, Toronto
The duration of Cognitive Behavioural Therapy (CBT) can vary depending on several factors, including the nature and severity of your depression, goals, and individual progress. In general, CBT is considered a shorter-term therapy compared to other therapeutic approaches.
Standard CBT treatment typically consists of a structured and time-limited course of therapy, lasting anywhere from 12 to 20 sessions. Sessions are usually conducted on a weekly or bi-weekly basis. However, it’s important to note that the number of sessions can be adjusted based on individual needs and progress.
CBT follows a collaborative and goal-oriented approach, with a focus on developing specific skills and strategies to address a person’s difficulties. The timeframe allows you to work on targeted goals, learn and practice new techniques, and make meaningful changes in your thoughts, behaviours, and emotions.
The exact duration of CBT is determined between you and your therapist, based on your needs and goals.
Because children, especially teens, are still developing their understanding of how the world works and how they fit in it, their emotions are already difficult to control. Add a dash of hormones and puberty and this can be quite overwhelming, to say the least, at times!
It’s important to pay attention to your child or teen and keep an eye out for the depressive symptoms listed above, as well as the following key symptoms in children and teens:
– Poor performance or attendance at school
– Use or abuse of recreational drugs
– Refusing to go to school
– Clinginess to a parent
– Overly sensitive
– Self-harm
If you are concerned, it is best to speak with your child in an open and non judgmental way to promote a spacious environment for them to feel comfortable to share what is going on for them. And if you are still concerned after speaking with them, to follow up with a health care professional such as a psychotherapist or family physician to discuss your concerns further and explore whether depression therapy in Toronto could be helpful.
Moving Forward
Depression can make it hard to believe that change is possible. But with the right support, small shifts in thinking and behaviour can open the door to relief and hope. At Horizon Therapy, our therapists are trained in Cognitive Behavioural Therapy and other evidence-based approaches like Acceptance and Commitment Therapy, Psychodynamic Relational Therapy, and Mindfulness Therapy that helps you understand your emotions, challenge unhelpful thought patterns, and rediscover what feels meaningful.
If you’re ready to take the next step – whether you’re looking for in-person therapy in Toronto or online therapy across Ontario – we’re here to help.
👉 Book a free consultation for Toronto or online therapy to connect with a therapist who can support your healing journey.
About the Author
Tammy Marcus is the owner of Horizon Therapy. She has a Masters of Social Work from the University of Toronto (1996), a certificate from the Toronto Institute for Relational Psychotherapy’s four year training program (2001), and is a Registered Social Worker and Clinical Supervisor with the OCSWSSW.
References
O’Toole, M. S., Ramsdal, N. B., Nørskov, C. S., Roepstorff, I. T., Buskbjerg, C. D., & Elkjær, E. (2025). Cognitive behavioral therapies are evidence-based–based on what? A systematic review and meta-analysis of recent randomized controlled trials of cognitive behavioral therapies for depression. Journal of Affective Disorders, 119791.
Cuijpers, P., Karyotaki, E., de Wit, L., Ebert, D.D., 2020. The effects of fifteen evidence-supported therapies for adult depression: a meta-analytic review. Psychother. Res. 30, 279–293. https://doi.org/10.1080/10503307.2019.1649732.
Depression in adults: treatment and management. London: National Institute for Health and Care Excellence (NICE); 2022 Jun 29. PMID: 35977056.
Kunorubwe T. Cultural adaptations of group CBT for depressed clients from diverse backgrounds: A systematic review. The Cognitive Behaviour Therapist. 2023;16:e35. doi:10.1017/S1754470X23000302
