Cognitive Behavioral Counseling Theory

Developed by Dr. Aaron T. Beck, Cognitive Therapy (CT), or Cognitive Behavior Therapy (CBT), is a form of psychotherapy in which the therapist and the client work together as a team to identify and solve problems. Therapists use the Cognitive Model to help clients overcome their difficulties by changing their thinking, behavior, and emotional responses. Cognitive therapy has been found to be effective in more than 1000 outcome studies for a myriad of psychiatric disorders, including depression, anxiety disorders, eating disorders, and substance abuse, among others, and it is currently being tested for personality disorders. It has also been demonstrated to be effective as an adjunctive treatment to medication for serious mental disorders such as bipolar disorder and schizophrenia. Cognitive therapy has been extended to and studied for adolescents and children, couples, and families. Its efficacy has also been established in the treatment of certain medical disorders, such as irritable bowel syndrome, chronic fatigue syndrome, hypertension, fibromyalgia, post-myocardial infarction depression, non cardiac chest pain, cancer, diabetes, migraine, and other chronic pain disorders.

Dr. Beck began helping patients identify and evaluate these automatic thoughts. He found that by doing so, patients were able to think more realistically. As a result, they felt better emotionally and were able to behave more functionally. When patients changed their underlying beliefs about themselves, their world and other people, therapy resulted in long-lasting change.


As a result of his findings, Dr. Beck began to look for other ways of conceptualizing depression. He found that depressed patients experienced streams of negative thoughts that seemed to arise spontaneously. He called these cognitions “automatic thoughts.” He found that the patients’ automatic thoughts fell into three categories. The patients had negative ideas about themselves, the world and/or the future.


In the years since its introduction, CT has been studied and proven effective in treating a wide variety of disorders. More than 500 studies have demonstrated its efficacy for psychiatric disorders, psychological problems and medical problems with a psychiatric component. Today, research continues into cognitive therapies for suicide prevention, and schizophrenia and other psychopathologies. In addition, ongoing research is being conducted to measure the impact of city mental health agencies’ organization structure on the adoption of cognitive therapy by public health systems.


The goals of cognitive therapy are to help individuals achieve a remission of their disorder and to prevent relapse. Much of the work in sessions involves aiding individuals in solving their real-life problems and teaching them to modify their distorted thinking, dysfunctional behavior, and distressing affect. Therapists plan treatment on the basis of a cognitive formulation of patients’ disorders and an ongoing individualized cognitive conceptualization of patients and their difficulties. A developmental framework is used to understand how life events and experiences led to the development of core beliefs, underlying assumptions, and coping strategies, particularly in patients with personality disorders.


Cognitive Behavioral Therapists use a wide variety of techniques to help patients change their cognitions, behavior, mood, and physiology. Techniques may be cognitive, behavioral, environmental, biological, supportive, interpersonal, or experiential. Therapists select techniques based on their ongoing conceptualization of the patient and his or her problems and their specific goals for the session. They continually ask themselves, “How can I help this patient feel better by the end of the session and how can I help the patient have a better week?” These questions also guide clinicians in planning strategy.

Referances:


Corey, G. (2013). Theory and practice of counseling and psychotherapy. (9th ed. ed.). Belmont, CA:           Brooks/Cole CENGAGAE Learning.