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Break free from overthinking.
If you’ve ever felt stuck in your thoughts, replaying conversations, overanalyzing decisions, or unable to “turn your brain off,” you’re not alone. While it can feel like problem-solving, this kind of thinking often keeps you stuck rather than helping you move forward.
Rumination-Focused Cognitive Behavioral Therapy (RF-CBT) is an evidence-based approach designed to help you break these patterns. Instead of focusing only on what you think, it targets the habits of thinking that keep you looping, helping you recognize rumination, understand what drives it, and shift toward more grounded, effective ways of thinking and living.
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RF-CBT is an evidence-based therapy designed to help people reduce rumination, or repetitive overthinking. While it is grounded in cognitive behavioral therapy, it works differently than traditional CBT.
Instead of focusing only on the content of thoughts, RF-CBT targets habitual thinking patterns—the automatic mental loops people get stuck in. These patterns often happen outside of awareness and can be difficult to interrupt without specific strategies.
As Dr. Sheila Crowell explains, “What it is really targeting is habitual thought… and habitual thought is tricky to target.”
Because of this, RF-CBT is more experiential and practice-based, helping you learn how to notice and shift these patterns in real time.
Rumination is, “Recurrent dwelling on feelings, problems, upsetting events, and negative aspects of the self.”
It can include:
While it can feel like problem-solving, rumination is different because it tends to be:
RF-CBT focuses on shifting away from this style of thinking toward more concrete, active, and present-focused processing.
RF-CBT views rumination as a learned habit, similar to behaviors like nail biting.
Dr. Crowell uses this comparison: You may start the habit without noticing.
It runs in the background automatically. You only become aware when it becomes painful.
In the same way, rumination often builds gradually until it reaches a more intense or distressing thought.
It also frequently serves a purpose. As Dr. Crowell says, “rumination often serves an avoidance function.”
For example, instead of starting a difficult task, your mind drifts into overthinking
Instead of addressing a problem, you mentally replay it.
This makes rumination feel compelling, even when it isn’t helpful.
RF-CBT is used to treat a range of concerns where overthinking plays a central role, including:
One important insight from the training is that rumination may actually develop earlier than these conditions and persist even after treatment.
According to Dr. Crowell, “Rumination emerges before these disorders… and even after we do a successful treatment… the rumination will stay.”
This is why targeting rumination directly can help with both treatment and prevention of relapse.
RF-CBT is a strong fit for people who:
It may not be the best fit if:
Because RF-CBT involves actively stepping into your thinking patterns, a willingness to engage is important.
RF-CBT is typically a 12–14 session structured therapy.
Treatment follows a clear progression:
A key principle is that rumination is a habit, and habits require repetition to change.
RF-CBT helps you map out the full cycle:
Triggers (external):
Warning signs (internal):
Rumination:
Consequences:
This cycle shows how rumination both starts and reinforces itself over time.
The first sessions focus on building a clear understanding of your specific patterns.
You and your therapist will explore:
You’ll also connect this pattern to your goals and determine whether it is a core problem worth targeting.
Therapists often use your language (like “overthinking” or “worry”) rather than clinical terms to keep things relatable.
A rumination log is a structured tool used to help you notice patterns in real time.
You’ll briefly track:
Importantly, the goal is not to write a detailed story, just enough to recognize the pattern and revisit it in session. “Awareness is the beginning.”
Yes. RF-CBT is a skills-based therapy, and practice between sessions is essential.
The rumination log is one of the primary tools used outside of sessions, helping you:
Because rumination is a habit, Dr. Crowell says, “the only way to change habits is through repetition and practice.”
RF-CBT is active and experiential, not just discussion-based.
Sessions typically include:
Dr. Crowell emphasizes, “If we haven’t tried it in session… there’s a very low probability that the person will try it in their actual life.”
This approach helps ensure the work translates into real change.
Functional analysis is one of the most important parts of RF-CBT.
In this process, you:
It is done in the present tense, almost like re-experiencing the moment rather than just describing it.
This can feel intense. People often notice:
Dr. Crowell notes that this can be one of the hardest parts of therapy, but it’s also essential. She says, “If you can’t catch your rumination, you can’t do anything about it.”
With support, this awareness becomes the foundation for meaningful and lasting change.
Gain clarity, build resilience, and create meaningful change. Let’s work together to help you thrive and achieve the life you envision.
The unique mission of UCEBT is to improve the quality of mental health care by enhancing access to comprehensive evidence-based treatments, evaluations, and testing.
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