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Cognitive behaviour therapy (CBT)

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The basis of cognitive behavioural therapy is that psychological disease stems from faulty patterns of thinking and behaviour.

The idea for developing this form of psychotherapy took root in the 1960s when Aaron Beck began to notice that his patients with depression often verbalized thoughts that were lacking in validity. He also noted characteristic “cognitive distortions” in their thinking. These empirical observations then led him to start viewing depression not so much as a mood disorder but as a cognitive disorder.

Based on his clinical observations and empirical findings, Beck outlined a new cognitive theory of depression. He published Cognitive Therapy for Depression after having published a study that evaluated and demonstrated the efficacy of cognitive therapy. (1)

Faulty thinking originates in maladaptive attitudes and assumptions acquired early in life. Problems arise when these assumptions are challenged by a critical life event. If the attitudes are too extreme or rigidly held then the patient may develop irrationally negative thought patterns.

For example:

  • maladaptive attitude: happiness consists of career success
  • critical life event: failure to be promoted
  • negative thought process: I am a complete failure

Faulty behaviour exacerbates the problems caused by the cognitive disorder. Patients may become socially withdrawn, take less exercise and adopt avoidance behaviour.

Cognitive behaviour therapy uses a range of techniques to challenge the faulty thought processes and behaviour and is based on a straightforward, common-sense model of the relationships among cognition, emotion, and behaviour. (2)

Reference

  1. Cognitive Therapy for Depression (Beck, Rush, Shaw, and Emery, 1979)
  2. de Jonge M et al. Preventive cognitive therapy versus care as usual in cognitive behavioural therapy responders: A randomized controlled trial. J Consult Clin Psychol. 2019 Jun;87(6):521-529

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