People consider cognitive behavioral therapy (CBT) as one of the most dependable and effective models for comprehending and treating psychopathological disorders.
This approach postulates a complex relationship between emotions, thoughts, and behaviors. Highlighting how dysfunctional beliefs that are maintained over time largely produce emotional problems. Despite the suffering that the patient experiences and the possibilities and opportunities to change them, due to maintenance mechanisms.
When interpreting human conduct. Cognitive therapy resorts, where possible, to the simplest explanation which often coincides with the recovery of common sense.
The theory underlines the importance of cognitive distortions and subjective representation in the origin and maintenance of emotional and behavioral disorders. This assumption suggests that an individual’s cognitive structures and constructions, rather than events, would significantly impact and maintain psychological, emotional, and behavioral issues. The Stoic philosopher Epictetus shared this belief.
What characterizes and distinguishes cognitive psychotherapy is the explanation of emotional disorders. Through the analysis of the relationship between thoughts, emotions, and behaviors.
Cognitive-behavioral therapy (CBT). Therefore aims to help patients identify recurring thoughts and dysfunctional patterns of reasoning and interpretation of reality. To replace and/or integrate them with more functional beliefs.
CBT has assumed the role of treatment of choice for anxiety disorders. As evidenced by recent documents released by the World Health Organization (WHO) and the Institute Superior di Sanity (ISS).
Why does cognitive behavioral therapy (CBT) work?
1. Cognitive behavioral therapy is scientifically based
The clinical intervention is strictly consistent with the knowledge of mental structures and processes deduced from basic psychological research. In addition, cognitive behavioral methods have been shown in controlled studies to be effective therapy.
CBT has shown superior or at least equal results to psychotropic drugs in the treatment of depression and anxiety disorders. But much more useful in preventing relapses.
2. Cognitive behavioral therapy is goal-oriented
The cognitive-behavioral therapist works with the patient to establish the goals of the therapy, formulate a diagnosis, and agree with the patient himself on a treatment plan that fits his needs, during the very first meetings. Then, progress is periodically checked by him to ensure that the goals have been achieved.
3. Cognitive behavioral therapy is practical and hands-on
The purpose of therapy is based on the resolution of concrete psychological problems. Some typical purposes include the reduction of depressive symptoms, the elimination of panic attacks and any concomitant agoraphobia, the reduction or elimination of compulsive rituals or pathological eating behaviors, the promotion of relationships with others, the decrease of social isolation, and so on.
4. Cognitive behavioral therapy is collaborative
Patients and therapists work together to understand and develop strategies that can direct the subject to solve their problems. CBT is, in fact, a psychotherapy essentially based on the collaboration between patient and therapist. The therapist and the patient actively participate in identifying and questioning the specific ways of thinking that may be causing the emotional and behavioral problems affecting the patient in cognitive behavioral therapy.
5. Cognitive behavioral therapy is short-term
CBT is short-term whenever possible. The duration of therapy usually varies from four to twelve months, depending on the case, with weekly frequency most often. More serious psychological problems, requiring a longer period of treatment, still benefit from the integrated use of cognitive therapy, psychiatric drugs, and other forms of treatment.
The combination of two forms of therapy: behavioral and cognitive
1. Behavioral psychotherapy
Gradually exposing oneself to feared situations, learning new ways of responding, and actively coping with them, helps change the relationship between situations that create difficulties and habitual emotional and behavioral reactions in such circumstances.
2. Cognitive psychotherapy
It helps to identify recurring thoughts, fixed patterns of reasoning, and interpretation of reality that are concomitant to the strong, persistent problematic emotions experienced by the patient. It assists in correction, enrichment, integrating them with other more realistic thoughts, or, in any case, more functional to one’s well-being.
Various intervention methods achieve the modification of problematic cognitive content and processes (such as beliefs, expectations, evaluations, cognitive distortions, emotions, etc.) in cognitive behavioral therapy. These methods do not only focus on the cognitive aspects of the individual’s functioning but also address the specific emotional and behavioral components. As a result, therapists aim to reformulate dysfunctional beliefs and utilize multiple techniques to achieve successful cognitive and behavioral change in patients.
History of Cognitive Behavioral Therapy (CBT)
The fundamental assumption, postulated for the first time in the 60s by Aaron Beck and Albert Ellis (Beck 1967, Ellis 1962), is that the patient’s mental representations (beliefs, automatic thoughts, schemes) allow, with a minimum of ‘inference, to explain the psychological discomfort and its perpetration over time. Dysfunctional emotional reactions and discomfort are the results of content and formal distortions of a cognitive type: the pathology is the result of dysfunctional thoughts, patterns, and processes. Procedural and content errors “prevent” the invalidation of these schemes and contribute to the maintenance of the disorder, despite evidence to the contrary.
In explaining emotional disturbances, therefore, the role played by external events is not causal, but personal, idiosyncratic, i.e. based on the belief system and experiences of the individual subject. What makes it possible to explain emotional reactions and dysfunctional behaviors (and therefore disturbances) is the way of interpreting events based on the individual’s cognitive contents and processes.
This perspective characterizes the mind as a system of goals and knowledge used by individuals to evaluate their own experiences and regulate emotional responses, mental processes, and behaviors (Castelfranchi, Mancini & Micelle, 2002). In this framework, the patient’s mind is considered to manifest goal-directed activities that underlie psychopathological symptoms.
When was CBT developed?
Cognitive-behavioral psychotherapy developed in the 60s, as mentioned, with two psychoanalytically trained therapists: Aaron Beck and Albert Ellis.
Despite common belief, cognitive therapy was not an evolution of behavior therapy. Two clinicians with psychoanalytic training developed it independently during the same period, instead. The clinical method they developed would later become known as cognitive therapy, a term coined by Beck.
It is, therefore, a therapy that arises directly from the clinic as a method of treatment. In particular as a treatment for depression and anxiety disorders.
The encounter with behaviorism comes only later and follows two paths. On the one hand, cognitive authors, starting from the founder’s Beck and Ellis, recover from behaviorism. Both the attention to the scientific method applied to the clinic and clinical outcomes. And the repertoire of techniques typical of behavior therapy. On the other hand, authors of behavioral training. Rachman and Meichenbaum integrate the role of cognitive variables in the behavioral theoretical framework.
The International Association of Cognitive Psychotherapy acknowledges that Beck’s cognitive therapy plays a prominent role. Despite the existence of dozens of different approaches within the non-homogeneous therapeutic method known as cognitive therapy.
Approach of CBT
The situation is even more complex if one looks at the international literature. All the approaches that are defined as cognitive therapy or cognitive-behavioral therapy are considered. Even the presence and prominence of the adjective behavioral partly reflects the weight given to principles of direct behavioral derivation.
What unites all the approaches that recognize themselves in the definition of cognitive therapy? The common emphasis is on the structures of meaning and information processes. Therefore, the recognition of the cognitive variable is predominant in the explanation of clinical phenomena.
Furthermore, the treatment method always foresees, regardless of the differences in the procedures. The manipulation of the cognitive variable is the main tool for change.
