Usually cognitive therapy is a short-term treatment lasting from 10-20 sessions. Therapists are more active than in many other types of treatment for emotional disorders. A strong therapeutic relationship is encouraged between clinician and patient. This relationship has been termed collaborative empiricism because therapist and patient work together as a team to examine: 1) the validity of cognitions and 2) the effectiveness of behavior patterns.

In the early phase of cognitive therapy, emphasis is placed on establishing a good working relationship and on teaching the patient the basic principles of this treatment approach. Usually, examples from the patient's current life situation are used to demonstrate the effects of automatic thoughts and cognitive errors. Therapy is most often focused on the "here and now" and is directed at specific problems or areas of concern. Homework assignments are used from the beginning of treatment to reinforce learning and to encourage behavioral change.

The middle portion of therapy is devoted to modifying dysfunctional patterns of information processing and behavior. Frequently used cognitive interventions include thought recording, identifying cognitive errors, examining the evidence, and developing rational alternatives. A number of behavioral techniques may also be employed, such as activity scheduling, graded task assignments, or desensitization procedures. The therapist asks frequent questions designed to stimulate a more rational cognitive style. Also, self-help is encouraged by in vivo therapeutic exercises and continued homework assignments.

The final phase of treatment is concerned with reinforcing skills learned earlier in therapy and in preparing patients for managing problems on their own. One of the goals of cognitive therapy is to learn methods that will have positive effects in reducing the risk of relapse. Thus, many cognitive therapists help their patients prepare for stressful situations that might trigger the return of symptoms. During the later portions of therapy, more intensive work may be needed to revise deeply held schemas. Change in these underlying attitudes is thought to be an important factor in the long-term effects of cognitive therapy.