Psychology Primer: Behaviorism and Cognitive Behavioral Therapy: Difference between revisions

<blockquote>CBT can be seen as an umbrella term for many different therapies that share some common elements and theoretical underpinnings.[1] While similar views of emotion have existed for millennia[citation needed], one of the earliest form of Cognitive Behavior Therapy was Rational Therapy pioneered by Albert Ellis (1913-2007) in the early 1950s. Ellis eventually called his system Rational Emotive Behavioral Therapy in the mid 1990s, or REBT. It was partly founded as a reaction against popular psychotherapeutic theories at the time, mainly psychoanalysis.[2] Aaron T. Beck, inspired by Ellis developed another CBT approach, called Cognitive Therapy, in the 1960s.[3] Cognitive therapy rapidly became a favorite intervention to study in psychotherapy research in academic settings. In initial studies, it was often contrasted with behavioral treatments to see which was most effective. However, in recent years, cognitive and behavioral techniques have often been combined into cognitive behavioral treatment. This is arguably the primary type of psychological treatment being studied in research today.

Concurrently with the pioneering contributions of Ellis and Beck, starting in the late 1950s and continuing through the 1970s, Arnold A. Lazarus developed what was arguably the first form of "Broad-Spectrum" Cognitive-Behavior Therapy. Indeed, in 1958, Arnold Lazarus was the first person to introduce the terms "behavior therapy" and "behavior therapist" into the professional literature (i.e., Lazarus, A. A. "New methods in psychotherapy: a case study". South African Medical Journal, 1958, 32, 660-664).[citation needed] He later broadened the focus of behavioral treatment to incorporate cognitive aspects (e.g., see Arnold Lazarus' 1971 landmark book Behavior Therapy and Beyond, perhaps the first clinical text on CBT). When it became clear that optimizing therapy's effectiveness and effecting durable treatment outcomes often required transcending more narrowly focused cognitive and behavioral methods, Arnold Lazarus expanded the scope of CBT to include physical sensations (as distinct from emotional states), visual images (as distinct from language-based thinking), interpersonal relationships, and biological factors. The final product of Arnold Lazarus' approach to psychotherapy is called Multimodal Therapy and is, perhaps, the most comprehensive form of CBT in addition to REBT that also shares many of the same assumptions and theorizing.

A sub-field of cognitive behavioral therapy used to treat Obsessive Compulsive Disorder makes use of classical conditioning through extinction (a type of conditioning) and habituation. (The specific technique, Exposure with Response Prevention (ERP) has been demonstrated to be more effective than the use of medication—typically SSRIs—alone). CBT has also been successfully applied to the treatment of Generalized Anxiety Disorder, health anxiety, Social phobia and Panic Disorder. In recent years, CBT has been used to treat symptoms of schizophrenia, such as delusions and hallucinations. This use has been developed in the UK by Douglas Turkington and David Kingdon.

Other types of Cognitive Behavioral Therapy include Dialectical Behavior Therapy, Self-Instructional Training, Schema-Focused Therapy and many others.[5]

CBT has good evidence for its effectiveness in reducing symptoms and preventing relapse. It has been clinically demonstrated in over 400 studies to be effective for many psychiatric disorders and medical problems for both children and adolescents. It has been recommended in the UK by the National Institute for Health and Clinical Excellence as a treatment of choice for a number of mental health difficulties, including post-traumatic stress disorder, OCD, bulimia nervosa and clinical depression.

Cognitive Behavioral Therapy most closely allies with the Scientist-Practitioner Model of Clinical Psychology, in which clinical practice and research is informed by: a scientific perspective; clear operationalization of the "problem" or "issue"; an emphasis on measurement (and measurable changes in cognition and behavior); and measurable goal-attainment.

Cognitive Behavioral Therapy (CBT) is an umbrella-term for psychotherapies that deal with cognitions, assumptions, beliefs, evaluations and behaviors, with the aim of influencing emotions and behaviors that relate to maladaptive and dysfunctional appraisal of events. The general approach, developed out of behavior modification, Cognitive Therapy and Rational Emotive Behavior Therapy, has become widely used to treat various kinds of psychopathology, including mood disorders and anxiety disorders. The particular therapeutic techniques vary within the different approaches of CBT according to the particular kind of problem issues, but commonly may include keeping a diary of significant events and associated feelings, thoughts and behaviors; questioning and testing cognitions, assumptions, evaluations and beliefs that might be unhelpful and unrealistic; gradually facing activities which may have been avoided; and trying out new ways of behaving and reacting. Relaxation, mindfulness and distraction techniques are also commonly included. CBT is widely accepted as an evidence- and empiricism-based, cost-effective psychotherapy for many disorders and psychological problems. It is sometimes used with groups of people as well as individuals, and the techniques are also commonly adapted for self-help manuals and, increasingly, for self-help software packages.

One of the objectives of CBT typically is to identify and monitor thoughts, assumptions, beliefs and behaviors that are related and accompanied to debilitating negative emotions and to identify those which are dysfunctional, inaccurate, or simply unhelpful. This is done in an effort to in a wide array of different methodologies replace or transcend them with more realistic and self-helping ways.

An example from cognitive therapy may illustrate this process: Having made a mistake at work, a person may believe, "I'm useless and can't do anything right at work." Strongly believing this, in turn, tends to worsen his mood. The problem may be worsened further if the individual reacts by avoiding activities and then behaviorally confirming his negative belief to himself. As a result, an adaptive response and further constructive consequence becomes 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 destructive behaviors, the feelings of depression may, over time, be relieved. The client may then become more active, succeed and respond more adaptive more often, and further reduce or cope with his negative feelings.

Cognitive behavioral therapy generally is not an overnight process. Even after patients have learned to recognize when and where their mental processes go awry, it can take months of effort to replace a dysfunctional cognitive-affective-behavioral process or habit with a more reasonable and adaptive one.

The cognitive model especially emphasized in psychiatrist Aaron Beck's cognitive therapy says that a person's core beliefs (often formed in childhood) contribute to "automatic thoughts" that pop up in everyday life in response to situations. Cognitive Therapy practitioners commonly hold that clinical depression is typically associated with negatively biased thinking and dysfunctional thoughts.