Is CBT Only “Surface” Level? Understanding the Depths (and Limits) of Cognitive Behavioural Therapy

What CBT Really Is and Isn’t

CBT focuses on the connection between thoughts, emotions and behaviours. It teaches you to identify unhelpful thinking patterns and replace them with more balanced, realistic ones. For example, if you often think, “I’m a failure”, CBT helps you notice this automatic thought, challenge its accuracy, and reframe it into something more compassionate, such as “I’m struggling right now, but that doesn’t mean I’m a failure.”

This can be life-changing. For many, CBT provides immediate relief, structure and practical tools to manage anxiety, depression, or stress. It empowers people to feel more in control of their emotional world. However, many people feel that CBT does not sufficiently examine the origins of these thoughts or the emotional, relational, and spiritual experiences that shape our inner dialogue.

Why People Call CBT “Surface Level”

The criticism that CBT is “surface level” often comes from real experiences of frustration, particularly when therapy feels rushed or overly focused on changing thoughts without first understanding where they come from. However, this is not an inherent flaw in CBT itself. When practised well, CBT can explore core beliefs, those deep-rooted ideas about ourselves and the world (“I’m unworthy,” “People will always leave”), which often stem from earlier emotional or relational experiences. The issue is not that CBT can’t go deep, but that it isn’t always given the time or space to do so.

Some common limitations include:

• Limited emotional depth
• Less focus on past experiences
• A short-term model within NHS delivery
• Not always culturally or spiritually aware

When delivered with flexibility and sensitivity, CBT can move beyond symptom management and into deeper layers of belief, emotion, and meaning.

The Depth Within CBT: When It’s Done Well

CBT can be much deeper than many people realise. Skilled therapists often integrate emotional processing, compassion-focused work, and schema therapy within a CBT framework. When practised holistically, CBT can help clients explore:

• Core beliefs
• Emotional roots of shame, anxiety, or guilt
• The spiritual meaning of experiences
• Relational patterns that reinforce negative thinking

Research supports that integrated CBT approaches improve long-term wellbeing and resilience.

Integrating Depth: Beyond CBT

Healing is not one-size-fits-all. Many people find that combining CBT with other therapeutic approaches allows for both structure and depth. For example:

• Person-Centred Therapy offers emotional exploration
• Trauma-informed work helps the body and nervous system feel safe
• Faith-integrated therapy invites meaning, surrender, reflection, and connection to God

For Muslim clients, Islamically integrated CBT can be especially powerful.

How to Know If You Need “More Than” CBT

You may need a deeper or more integrative approach if:

• You understand your thoughts but still feel emotionally heavy
• Patterns return during stress
• Grief, trauma, or spiritual concerns feel unaddressed
• You want therapy that acknowledges your identity and faith

Finding the Right Support

When seeking therapy, consider asking:

• Do you integrate other approaches alongside CBT?
• How do you take culture or faith into account?
• Are you open to including spiritual reflection if meaningful to me?

A Personal Note

As a therapist, I value CBT for its clarity and structure, but I have also seen how true healing often lies beneath the surface. Our minds are powerful, but so are our hearts, bodies, and souls. For me, true healing means supporting all parts of a person. Healing often takes time. And you deserve support that sees the whole of you. If you feel ready to take the next step, I’m here to walk with you. You’re welcome to reach out whenever you’re ready. I offer online therapy across the UK or in-person in Telford and Wolverhampton.