cognitive therapy

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Cognitive Therapy (CT) is a type of psychotherapy developed by American psychiatrist Aaron T. Beck. CT is one of the therapeutic approaches within the larger group of Cognitive Behavioral Therapies (CBT) and was first expounded by Beck in the 1960s.

Overview

Cognitive therapy seeks to help the client overcome difficulties by identifying and changing dysfunctional thinking, behavior, and emotional responses. This involves helping clients develop skills for modifying beliefs, identifying distorted thinking, relating to others in different ways, and changing behaviors^[1]. Treatment is based on collaboration between client and therapist and on testing beliefs. Therapy may consist of testing the assumptions which one makes and identifying how certain of one's usually-unquestioned thoughts are distorted, unrealistic and unhelpful. Once those thoughts have been challenged, one's feelings about the subject matter of those thoughts are more easily subject to change. Beck initially focused on depression and developed a list of "errors" in thinking that he proposed could maintain depression, including arbitrary inference, selective abstraction, over-generalization, and magnification (of negatives) and minimization (of positives).

A simple example may illustrate the principle of how CT works: Having made a mistake at work, a person may believe, "I'm useless and can't do anything right at work." Strongly believing this then tends to worsen his mood. The problem may be worsened further if the individual reacts by avoiding activities and then behaviorally confirming the negative belief to himself. As a result, any adaptive response and further constructive consequences become unlikely, which reinforces the original belief of being "useless." In therapy, the latter example could be identified as a self-fulfilling prophecy or "problem cycle," and the efforts of the therapist and client would be directed at working together to change it. This is done by addressing the way the client thinks and behaves in response to similar situations and by developing more flexible ways to think and respond, including reducing the avoidance of activities. If, as a result, the client escapes the negative thought patterns and dysfunctional behaviors, the feelings of depression may be relieved over time. The client may then become more active, succeeding and responding adaptively more often; further coping with or reducing his negative feelings.

Historical development

Becoming disillusioned with long-term psychodynamic approaches based on gaining insight into unconscious emotions and drives, Beck came to the conclusion that the way in which his clients perceived, interpreted and attributed meaning in their daily lives—a process scientifically known as cognition— was a key to therapy.^[2] Albert Ellis was working on similar ideas from a different perspective, in developing his Rational Emotive Behavior Therapy (REBT).

Beck outlined his approach in Depression: Causes and Treatment in 1967. He later expanded his focus to include anxiety disorders, in Cognitive Therapy and the Emotional Disorders in 1976, and other disorders and problems.^[3] He also introduced a focus on the underlying "schema"—the fundamental underlying ways in which people process information— about the self, the world or the future.

The new cognitive approach came into conflict with the behaviourism ascendant at the time, which denied that talk of mental causes was scientific or meaningful, rather than simply assessing stimuli and behavioural responses. However, the 1970s saw a general "cognitive revolution" in psychology. Behavioral modification techniques and cognitive therapy techniques became joined together, giving rise to Cognitive Behavioral Therapy. Although Cognitive therapy has always included some behavioral components, advocates of Beck's particular approach seek to maintain and establish its integrity as a distinct, clearly-standardized kind of cognitive behavioral therapy.^[4]

Cognitive therapy and depression

According to Beck’s theory of the etiology of depression, depressed people acquire a negative schema of the world in childhood and adolescence; children and adolescents who suffer from depression acquire this negative schema earlier. Depressed people acquire such schemas through a loss of a parent, rejection by peers, criticism from teachers or parents, the depressive attitude of a parent and other negative events. When the person with such schemas encounters a situation that resembles the original conditions of the learned schema in some way, even remotely, the negative schemas of the person are activated.^[5]

Beck also included a negative triad in his theory. A negative triad is made up of the negative schemas and cognitive biases of the person. A cognitive bias is a view of the world. Depressed people, according to this theory, have views such as “I never do a good job.” A negative schema helps give rise to the cognitive bias, and the cognitive bias helps fuel the negative schema. This is the negative triad. Also, Beck proposed that depressed people often have the following cognitive biases: arbitrary inference, selective abstraction, overgeneralization, magnification and minimization. These cognitive biases are quick to make negative, generalized, and personal inferences of the self, thus fueling the negative schema.^[5]

Methods of Cognitive Therapy

• collaborative empiricism
• guided discovery
• socratic questioning

See also

• Psychotherapy
• Aaron T. Beck
• Cognitive Behavioural Therapy
• Cognitive-shifting
• Albert Ellis
• William Glasser

References

1. ^ Judith S. Beck. "Questions and Answers about Cognitive Therapy". About Cognitive Therapy. Beck Institute for Cognitive Therapy and Research. http://beckinstitute.org/InfoID/220/RedirectPath/Add1/FolderID/237/SessionID/%7B5FF27F90-1CA2-4959-81BF-D208B73FA53F%7D/InfoGroup/Main/InfoType/Article/PageVars/Library/InfoManage/Zoom.htm. Retrieved on 2008-11-21. 
2. ^ Goode, Erica (11 January 2000). "A Pragmatic Man and His No-Nonsense Therapy". The New York Times. http://partners.nytimes.com/library/national/science/health/011100hth-behavior-beck.html. Retrieved on 2008-11-21. 
3. ^ Deffenbacher, J. L; Dahlen E. R, Lynch R. S, Morris C. D, Gowensmith W. N (December 2000). "An Application of Becks Cognitive Therapy to General Anger Reduction". Cognitive Therapy and Research 24 (6): 689–697. doi:10.1023/A:1005539428336. http://www.ingentaconnect.com/content/klu/cotr/2000/00000024/00000006/00227192. Retrieved on 2008-11-21. 
4. ^ Judith S. Beck. "Why Distinguish Between Cognitive Therapy and Cognitive Behaviour Therapy". Beck Institute for Cognitive Therapy and Research. http://www.beckinstitute.org/InfoID/150/RedirectPath/Add1/FolderID/177/SessionID/{0D09F15E-3892-4E06-BB1E-1B50944EA9E9}/InfoGroup/Main/InfoType/Article/PageVars/Library/InfoManage/Zoom.htm. Retrieved on 21 November 2008. [ ] - The Beck Institute Newsletter, February 2001
5. ^ ^{a b} Neale, John M.; Davison, Gerald C. (2001). Abnormal psychology (8th ed.). New York: John Wiley & Sons. pp. pp. 247–250. ISBN 0-471-31811-6. 

External links

• An Introduction to Cognitive Therapy & Cognitive Behavioural Approaches
• An Introduction to Rational Emotive Behaviour Therapy
• Beck Institute for Cognitive Therapy and Research
• Academy of Cognitive Therapy
• Cognitive Therapy Today
• Instituto de Terapia Racional Emotiva- Lima, Perú
• Cognitive Therapy Podcasts (The Jove Institute)
• Self Mastery Through Conscious Autosuggestion A book on conscious autosuggestion by Émile Coué