What are the Cognitive and Behavioural Psychotherapies

Cognitive Therapy, Behavioural Therapy and Cognitive behavioural Therapy (Cognitive Behaviour Therapy) are three closely related forms of therapy. They are all based on research findings and clearly formulated theories of behavioural learning. The focus of all three therapies is mainly, although not exclusively on the here-and-now, rather than the past. Therapy is time limited, with measurement and evaluation of progress and can be used in order to help people irrespective of their intelligence, insight or disabilities. Aaron Beck developed the idea of Cognitive Behaviour Therapy for treating depression after noticing that depressed clients experienced specific thoughts that they were only dimly aware, unless their attention was directly focused on them. These thoughts or cognitions tended to rise quickly and automatically and were noticed not to be under conscious control. Low self-esteem, self-blame, self criticism, negative interpretations of experience, negative predictions and unpleasant recollections were persistent themes. In ambiguous situations, depressed clients Beck hypothesised were prone to make negative interpretations when a positive or more balanced view would have been more appropriate and more accurately fit the facts of the situation. To describe negative thinking in depression, Beck also postulated the presence of distortions in the way that information was processed by the individual, in particular positive information relevant to the individual was being filtered out with negative self-relevant information being more readily accepted.

The main goal of Cognitive behaviour therapy is to help individuals, families or couples bring about coping and changes in behaviour or thinking.

Goals for change may involve:

Changing behaviour e.g. being more assertive
Changing feelings e.g. being less fearful or depressed
Changing thinking patterns e.g. learning how to solve problems or deal with self defeating negative thoughts or beliefs
Improving coping e.g. dealing with panic

The therapies aim to reduce unhelpful emotions and behaviour by altering behaviour and thinking patterns. The therapy is thus based on the assumption that prior experiences and learning are currently having adverse consequences and causing distress. The purpose of therapy is to reduce this distress and any unwanted or unhelpful behaviour. This is achieved through undoing this learning and by providing new, more helpful learning experiences and behaviour. Cognitive behavioural therapists believe that a change in symptoms follows a change in thinking (or cognitive change) which is brought about by a variety of possible interventions, including the practice of new behaviours, analysis of faulty thinking patterns, and learning more adaptive and rational self-talk skills. Research on Cognitive Behaviour Therapy has shown it to have significant and positive effects for a wide variety of emotional problems particularly anxiety and depression. These positive effects may even be possible in the case for people who previously did not respond to other forms of counselling or psychotherapy. As a therapy with no adverse side-effects Cognitive Behaviour Therapy can also be very useful alongside drug treatment as well as in its own right. Therefore Cognitive Behaviour Therapy may be particularly suitable to people who don't wish to have drug treatment or for whom drug treatments have proven to be ineffective.

There are several different variations of Cognitive Behaviour Therapy, Such as Cognitive Therapy, Behaviour Therapy, Rational Emotive Behaviour Therapy and Self Instructional Training. They share similar characteristics in that clients are encouraged to treat their beliefs as hypotheses to be tested and are guided to do so in ways that protect against the biases and the distortions that preserve the problem. In Cognitive Behaviour Therapy the aim is to increase the individual's understanding of their own problem or disorder and develop coping strategies for persistent symptoms, foster self-belief and motivate themselves to regulate their own behaviour. Therapists typically work on four main areas:

Coping strategies -These procedures are aimed to reduce the distress of persistent symptoms by equipping the client with some coping strategies to manage their experiences. Therapists work with clients to find patterns of when their symptoms occur (for example, clients may panic when out shopping). Clients are encouraged to question their thinking -perhaps by looking at rational alternatives to thoughts, images and beliefs and alter their behaviour - perhaps by trying ways to distract attention or increase their pleasurable or self reinforcing activities.
Goal Setting and overcoming hopelessness or fear - Many clients describe being overwhelmed by their situation and have little understanding of how to help themselves. Therapists aim is to generate hope by highlighting worthwhile or short-term goals that may be achieved despite continuing disabilities.
Modification of negative thinking and unhelpful beliefs - There is growing consensus that psychological approaches can be used to modify negative thoughts and images and strongly-held beliefs. The therapist tries to encourage the client to consider alternative interpretations for his or her thoughts and beliefs.
Modifying dysfunctional assumptions, rules and beliefs in order to prevent relapse - Clients with continuing emotional problems may hold assumptions about his or her self, which lower their self esteem. Common themes concern being worthless, diseased, defective or of being at risk in some way. These dysfunctional assumptions may be associated with self-defeating patterns of thought and behaviour, which may be an important cause of the failure of coping strategies. To address these assumptions the therapist starts by trying to clarify their nature, perhaps by questioning about the origins of the assumptions and how they affect the client's life. It is postulated that changes in these core assumptions may prevent later relapse or setbacks.

Cognitive Behavioural Psychotherapy

What are the Cognitive and Behavioural Psychotherapies