CBT Lesson


Why This Works

There’s evidence to show that setting specific, measurable goals around incorporating healthy behaviors into our lives can actually help us reduce our depressive or anxious symptoms.

If you’re struggling with depressive symptoms…
Let’s start by learning a little more about how goal-setting can help us work through depressive symptoms. There’s evidence to show that depression represents the absence of positive reinforcers in our lives. What might a positive reinforcer look like? Think about an activity you truly enjoy or find rewarding that elevates your mood. Perhaps that’s a workout, spending time with family, or practicing a favorite hobby.

If you’ve had to pause or reimagine how we engage with those positive reinforcers in our lives, and that can have an impact on your mood. The good news? We can set goals to help us get back to those activities we find rewarding, or even identify new ones.

Start by making a list of activities that you may not have done in a while, but used to be part of your typical weekly or monthly schedule that you found rewarding. Pay attention to what has dropped off of your list recently.

If you’re struggling with anxious symptoms…
And for those of us who struggle with anxious symptoms, we should acknowledge that research shows that anxious symptoms are maintained by avoidance, or the kinds of actions we take to avoid difficult thoughts, feelings, or situations. This is another area where we can set some goals to re-engage with situations that we may have been avoiding.

In this module, we’ll walk you through some ways to set goals to support healthy behaviors. Many of your daily choices directly impact your emotional and physical health, including what/when/how much you eat and drink, your physical activity, your sleep habits, your social interactions, and how you manage stress. We want you to choose to do things that are healthy but also that make you feel good. Think for a second: What gives you a sense of peace or makes you feel lighter?

Learn a Skill:
Setting a SMART Goal

Of course, trying something new can be easier said than done. Building healthy habits and changing our behaviors is hard. A SMART goal is a simple tool to help us out. SMART goals are Specific, Measurable, Achievable, Realistic, and Timely.

S - Specific | concrete, clear, salient
M - Measurable | you can actually track whether or not you’ve done the activity
A - Achievable | you can actually do the goal given time, resources, ability, and other constraints
R - Realistic | feasible, practical, impactful
T - Timely | it’s clear when to do the action and you can accomplish it at a specific time

Image illustrating 'Learn a Skill: Setting a SMART Goal'

Examples of SMART Goals

We suggest starting with movement goals. The evidence shows that light movement, such as taking a daily walk, is one of the most effective strategies you can do to reduce your stress level. It also might feel really good to stretch your legs after you’ve been sitting all day or as a way to spend quality time with your spouse, partner, roommate or pet.

Old Goal SMART Goal
“Get more exercise this week” “Take a 20-minute walk every day after I eat dinner”
“Drink water instead of soda” “Drink a full glass of water with lemon at lunch and dinner"
“Wind down before bedtime” “Set a reminder on my phone for 30 minutes before my bedtime. When my phone buzzes, turn off my computer and change into pajamas”

*Please check your insurance coverage; the final medication price may vary based on your insurance, so this estimated pricing is not guaranteed.

**Our medical team can prescribe Tretinoin Cream 20g for $60 or $30/month if needed.


Can you set your own SMART goal for a behavior that will help you manage depressive or anxious symptoms? This should be something that’s healthy and makes you feel good.

One of your SMART goals might be focused on reincorporating some of those rewarding or enjoyable activities we discussed above back into your schedule if they’ve dropped off.

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SMART Goal Steps

1. Choose a behavior from one of these categories: Diet, Movement, Sleep, Stress Management. Is there a stress trigger that you want to manage better? Is there a new healthy behavior you want to adopt?

2. Pick one activity you’d like to do and write it down on a piece of paper.

3. Turn that into a SMART goal: Write out your goal for actually doing that activity. Make sure it’s Specific, Measurable, Achievable, Realistic, and Timely!

4. Think about all the steps you’ll need to take to actually do this action. What obstacles do you think might get in your way? What can you do right now to remove or reduce them? Do you need to put seven glasses and a lemon on your counter right now so you don’t forget to drink water at dinner? Do you need to create a calendar reminder for your 20-minute walk?

5. Post your SMART goal somewhere where you’ll see it or create a reminder on your phone.

This is about modifying what you can.
Don’t overwhelm yourself with too big of a change! Progress is a process. So, if you wrote down “Stop drinking coffee,” we recommend a smaller step such as “Drink a cup of green tea after lunch.”

Bonus Step:

Consider how you could make achieving your SMART goal easier to do. Can you make it fun? Can it be social? Could you pair the activity with something that you already do without much thought, like walking your dog or making your bed in the morning?

Next Step:
Find a Provider

Engaging with a therapist can significantly improve your treatment results as studies suggest patients who take medication see better outcomes if therapy is part of the treatment plan. Websites which may be helpful in finding a local therapist are Psychology Today: Health, Help, Happiness + Find a Therapist and the Psychologist Locator from the American Psychological Association, to find a psychologist in your area.

You can also try internet based self help cognitive behavioral therapy. Nurx has a great list of therapy resources available.

Image illustrating 'Next Step:Find a Provider'

Please note: Nurx does not provide therapy or counseling. Nurx is not available for crisis response. If you are experiencing a mental health crisis, please contact 911 or go to your nearest emergency department. IF YOU ARE CONTEMPLATING SUICIDE, CONTACT 911 OR THE NATIONAL SUICIDE PREVENTION LINE AT 1-800-273-TALK (8255).

Take Control Today

Nurx also offers prescription medication for anxiety and depression. Connect with a medical provider online, from anywhere, for a personalized treatment plan, medication delivered, if medically appropriate, and ongoing support on your schedule.

Image illustrating 'Take Control Today'

More Resources

Congrats! You completed this section. Click on the link below for more cognitive behavioral therapy lessons.

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