Two Concepts to Listen For
Quick Overview: The National Institute of Mental Health describes a cognitive behavioral therapy element as noticing automatic thoughts that may be inaccurate or harmful and considering how they relate to emotions and behavior. The National Center for Complementary and Integrative Health defines mindfulness as maintaining awareness of the present moment without judgment. These descriptions can help you ask whether a therapist uses either concept. They do not establish what a particular therapy approach will include, whether it fits you, or what results to expect.
When comparing individual therapy approaches, it can help to separate a definition from an assumption. A term such as automatic thoughts has a specific description in the NIMH material. Mindfulness also has a specific definition in the NCCIH material. Neither definition, by itself, explains how a particular therapist will use these ideas in therapy.
NIMH states that therapists may use one primary approach or incorporate elements from multiple approaches depending on their training, the disorder being treated, and the needs of the person receiving treatment. NIMH also notes that a preliminary conversation can help someone understand how treatment will proceed.
Automatic Thoughts in the NIMH Description of CBT
NIMH identifies several possible elements of psychotherapy. One element it names as cognitive behavioral therapy involves helping a person become aware of automatic ways of thinking that may be inaccurate or harmful. The description also includes questioning those thoughts, understanding how they affect emotions and behavior, and changing self-defeating behavior patterns.
This is a limited description of a CBT element, not a description of every therapy conversation or every person’s experience. It does not say that all thoughts are inaccurate or harmful. It also does not determine whether CBT, or any approach that includes cognitive elements, is the right choice for a particular person.
Questions That Clarify a Focus on Thoughts
If you hear a therapist use the phrase automatic thoughts, you might ask what they mean by it. You can also ask whether they use the NIMH-described process of considering links among thoughts, emotions, and behavior.
Questions can keep the discussion specific without assuming that one approach is better than another. For example, you may want to know whether a therapist primarily uses one approach or incorporates elements from multiple approaches. That question reflects NIMH’s description of how therapists may work rather than making assumptions from an approach name alone.
Mindfulness and Present-Moment Awareness
NCCIH defines mindfulness as maintaining awareness of the present moment without judgment. NCCIH discusses mindfulness in its information about meditation and mindfulness practices, including mindfulness-based programs that may combine mindfulness practices with other activities.
NCCIH also notes that mindfulness-based cognitive therapy integrates mindfulness practices with aspects of cognitive behavioral therapy. This means that the two concepts may appear together in some programs, but the cited descriptions do not establish how any particular therapist or service uses them.
What the Mindfulness Definition Does Not Establish
The NCCIH definition identifies present-moment awareness without judgment as part of mindfulness. It does not define every use of the phrase present-moment awareness in therapy. It does not establish that a therapist who discusses mindfulness will use a particular format, exercise, or pace.
The definition also does not determine personal fit or expected outcomes. NCCIH describes research on meditation and mindfulness across different practices and study designs, and it notes limitations in portions of that research. A general definition should not be treated as a prediction about what will happen for an individual.
A Careful Comparison of the Two Descriptions
The NIMH description of a CBT element addresses automatic ways of thinking that may be inaccurate or harmful and their relationship with emotions and behavior. The NCCIH definition of mindfulness addresses maintaining awareness of the present moment without judgment.
Those are different source descriptions. They provide a useful basis for questions, but they do not settle whether two therapy approaches are opposites, whether they can be combined, or which approach is preferable. NCCIH explicitly describes mindfulness-based cognitive therapy as integrating mindfulness practices with aspects of CBT.
Reflection Questions for Comparing Language
Use the following questions to identify what you would like clarified in a conversation with a therapist.
| Reflection question | What it may help you ask about |
|---|---|
| “When you use the term automatic thoughts, what do you mean?” | Whether the therapist is referring to thoughts that may be inaccurate or harmful and their relationship with emotions and behavior. |
| “Do you use elements of cognitive behavioral therapy?” | Whether CBT is one approach or one of several elements the therapist may incorporate. |
| “What do you mean by mindfulness?” | Whether the therapist is using the NCCIH definition of present-moment awareness without judgment or a different description. |
| “Do you incorporate mindfulness practices with other approaches?” | Whether mindfulness is discussed alongside other therapeutic elements. |
| “How would treatment proceed?” | Information NIMH identifies as appropriate to explore in a preliminary conversation. |
Practice Note: Definitions of automatic thoughts and mindfulness can clarify terminology, but they do not determine personal fit, a particular session’s content, or an expected outcome.
Questions to Bring to a Consultation
NIMH states that a preliminary conversation can help a person understand how treatment will proceed and whether they feel comfortable with a therapist. Consider bringing questions such as:
- “What approach or approaches do you use in individual therapy?”
- “How do you describe automatic thoughts in your work?”
- “Do you use mindfulness practices, and what do you mean by mindfulness?”
- “How do you decide whether to use one approach or incorporate elements from multiple approaches?”
- “What are the goals of therapy, and how is progress assessed?”
- “What information can you share about fees, insurance, or appointment details?”
At Rooted Integrative Therapy, Alina Hovsoyan, LCSW, offers individual therapy, couples therapy, group therapy, and therapy intensives. The practice offers in-person therapy near Orem and Provo, with virtual therapy across Utah. Its FAQs describe scheduling a consultation call as a first step, with an opportunity to ask questions and consider fit.
For an inquiry or appointment request, visit the Connect page.
Please do not include urgent or highly sensitive clinical information in a general inquiry.
FAQs
What are automatic thoughts in therapy?
NIMH describes a CBT element as noticing automatic thoughts that may be inaccurate or harmful and considering how they relate to emotions and behavior. This description does not determine what a particular therapist will do or what fits an individual person.
What does mindfulness mean?
NCCIH defines mindfulness as maintaining awareness of the present moment without judgment. NCCIH describes mindfulness practices and mindfulness-based programs, but the definition does not establish a specific therapy format or outcome.
Can CBT and mindfulness appear together?
NCCIH states that mindfulness-based cognitive therapy integrates mindfulness practices with aspects of cognitive behavioral therapy. That information does not establish how any particular therapist combines, or does not combine, these elements.
Can a consultation help me ask about an approach?
NIMH states that a preliminary conversation can help someone understand how treatment will proceed. Rooted Integrative Therapy describes a consultation call as an opportunity to ask questions and consider fit.
Sources and Further Reading
Sources used for this article:
- National Institute of Mental Health: Psychotherapies
- nccih.nih.gov: Meditation And Mindfulness Effectiveness And Safety
A Grounded Next Step
If you are considering individual therapy approaches, you can ask a therapist to explain the terms they use, the approach or approaches they may use, and how treatment would proceed. Rooted Integrative Therapy’s Connect page invites inquiries and appointment requests using its contact details or form.
This article is for general education only. It is not a diagnosis, treatment plan, or substitute for individualized mental-health care. A qualified mental-health professional can help you consider what fits your circumstances.