Professional Documents
Culture Documents
COGNITIVE THERAPY
Argosy University
Section B
Cognitive Therapy (CT) is a “system of psychotherapy based on a theory which
maintains that how an individual structures his or her experiences largely determines how
he or she feels and behaves” (Beck & Weishaar, 1986 cited by Freeman & Dattilio,
1992). Simply, Cognitive Therapy operates under the assumption that thoughts, beliefs,
attitudes and perceptual biases influence what emotions will be experienced and also the
intensity of those emotions. Cognitive Therapy was pioneered by Aaron Beck for the
evolved to enhance adaptation to the environment, and hence survival. The basic needs of
humans are thought to be preservation, reproduction, dominance, and sociability (Clark &
The cognitive model proposes that our emotions and behavior are the product of
our perceptions of situations (J.S. Beck, 1995 cited by Murdock, 2004). Cognition means
both the process and content of thinking, or how you think and what you think (Kovacs &
information with which we are constantly confronted (Murdock, 2004). Memories of our
experiences are stored and configured efficiently into the schemas. Certain schemas cause
behavioral and emotional problems. These schemas are formed early on in life as a
function of negative experiences. They are built upon by experiences that occur
criticism, and conditional statements of love, might form a core belief in which the
person feels "flawed." Such a core belief would make this person vulnerable to
The core beliefs are the most basic beliefs we hold; they are absolute and hard to
modify. The intermediate beliefs are attitudes or rules that are between the core beliefs
and automatic thoughts. These beliefs include “should” and “must” beliefs.
The automatic thoughts are evaluative statements or images that exist alongside
our more conscious thoughts. They can be functional or distressing and tend to be
reasonable to the thinker. They are the result of our core and intermediate beliefs.
motivational and behavioral schemata), which can act in synchrony to produce goal-
directed strategies (Beck, 1996 cited by Scott, 2001). Beck & Clark (1997) cited by
Murdock (2004) say that there are three major mode categories: primal (most basic kinds
of operation and function to meet goals: threat, loss, victim and self-enhancement),
constructive (developed through life experiences and serve to increase the life resources
available to the individual), and minor (tend to be under more conscious control than the
CT views personality as being shaped by central values (or core beliefs) that
develop early in life as a result of factors in one’s environment. These schemas constitute
the basis for coding, categorizing, and evaluating experiences and stimuli that an
individual encounters in his or her world (Freeman & Dattilio, 1992). The individual
current functioning is also influenced by his early life experience because we develop
schemas and associated core beliefs in childhood (Clark & Beck, 1999; Persons &
allows them to meet goals of survival, reproduction and sociability. They do not rely on a
lot of primary mode processing and do not show a lot of distorted thinking and probably
distinguishing adequately between imagination and reality (Kovacs & Beck, 1979 cited
by Freeman & Dattilio, 1992). Their rules or standards are often too rigid or absolutist
like the result of faulty schemas: erroneous assumptions. An example of such schema will
be the rotten person schema or what Albert Ellis called a worm schema. This person will
be sure that he cannot do anything right and that others hate him (Murdock, 2004).
The cognitive distortions are very similar to Ellis’ irrational beliefs. All the work
of Albert Ellis in RET has provided support to the principles of CT and impetus to the
development of what is now Cognitive Behavior Therapy (Freeman & Dattilio, 1992).
The initial goal is to establish rapport with the client. This is very important
because it is a collaborative process. The principal goal of CT is to change beliefs that are
leading to psychological dysfunction to ones that are more adaptive (Kovacs & Beck,
1978 cited by Murdock, 2004). To help the client to change any distorted perceptions that
individuals have of the world and of themselves, this means learning to think differently
Assessment is used in a formal and informal way in CT. The initial evaluation
In CT the counselor takes an active part in solving the client’s problems. The
counselor is an expert who teaches the client first the principles of CT. The counselor
needs to be caring, collaborative and competent. The counselor will ask a lot of questions
and assign tasks that have to do with the client’s problems. The client needs to work hard
to learn about CT first and will have to do homework that is developed with his/her
treatment and has been very thoroughly researched. In study after study, it has been
shown to be very effective. Its focus is on current issues and symptoms versus more
traditional forms of therapy, which tend to focus on a person's past history. The usual
format is weekly therapy sessions coupled with daily practice exercises designed to help
the cognitive structures and behavioral techniques in the interest of behavioral activation
or to teach new skills. Homework is essential. Questioning is one of the most basic
interventions. Socratic questioning refers to asking leading questions so that the client
comes to the cognitive therapy conclusion (Murdock, 2004). For example, if a person is
upset because a friend isn’t returning a phone call, they may be assuming that the friend
is mad or has suddenly decided they hate the worrier and never want to speak to him
again. If the person then asks themselves, “Why would they be mad?” and comes up with
no reasonable answer, they can then ask, “Is it possible they are just very busy?” Through
this method of questioning the assumption, the person realizes that they probably have no
reason to be upset about the problem of the unreturned phone call (Unknown author,
2004).
Other Cognitive Techniques are: Downward Arrow: to identify core beliefs, the
counselor follows a client’s statement by asking, “If so, then what?” Decatastrophizing:
to balance their focus on the worst anticipated state by reestimating the situation and
asking, “So what’s the worst thing that might occur? And if so, would this be so
horrible?” Problem Solving: a list of problems can be made in the first session and every
week the client can come with new problems that he/she had during the week, the
counselor can give possible solutions and encourage the client to do active problem-
solving him or herself. It is helpful to do this on paper with these specific points:
problem, special meaning, automatic thoughts and beliefs, response to special meaning
for the client desired behaviors in social situations, Bibliotherapy: this is a very strong
technique, the client can read a book such as Love is Never Enough, Feeling Good or the
Feeling Good Handbook, Own Your Own Life, Talk Sense to Yourself, Woulda, Coulda,
Shoulda. Other techniques are: Behavioral Rehearsal, Graded Task Assignments, Activity
who readily adopt the scientist method for exploring their own psychology, and who
place credence in the basic theoretical approach of cognitive therapy may be a good fit
for CT. Freeman & Dattilio believe that CT is an excellent fit for clients with depression,
anxiety or anger management, personal disorders and marital discord. Bush, (2003),
thinks that it is also a good fit for mood swings, shyness and social anxiety, panic attacks
and phobias, obsessions and compulsions (OCD and related conditions), worry, post-
traumatic stress symptoms (PTSD and related conditions), eating disorders (anorexia and
bulimia) and obesity, insomnia and other sleep problems, difficulty establishing or
staying in relationships, problems with marriage or other relationships you're already in,
dependency and “enabling”, trouble keeping feelings such as anger, sadness, fear, guilt,
expression.
Cognitive Therapy interests me because I know that most agencies in the field use
it. I think that it is a good therapy if your interest is immediate results. It is good also
because insurance companies ask for a formal DSM-IV diagnosis. This approach has the
best record in outcome research, and is well proven to be effective. What I am not
completely in agreement with is that this theory does not take an interest in client’s past. I
believe that your past shapes what you are now and that problems in the present may
result from situations from the past, from unfinished situations. I believe that a person can
take action in life when they gain insight and realize where the problem came from.
Multiculturally speaking, Asian American groups can be a good fit for this theory
because with this population the counselor needs to focus on the specific problem and
deal with the present or immediate future, not with the past or dealing with deep
emotions, and they value authority. It might work also with Latin American populations
but the counselor needs to keep in mind that this group is considerate of the opinions of
their families. Something common in these groups is that they usually believe in an
external power. This theory is an individualistic approach that has emphasis on individual
choice. The counselor needs to know about their cultures before trying to act against their
beliefs.
theory.
REFERENCES
http://www.habitsmart.com/cogintro.html
http://bjp.rcpsych.org/cgi/content/full/178/41/s164
http://www.cognitivetherapy.com/basics.html
Behavioral Approaches.
http://counsellingresource.com/types/cognitive-therapy/
http://www.anxiety-and-depression-solutions.com/articles/howcbtworks.htm