Cognitive Therapy

One form of cognitive therapy is cognitive-behavioral therapy (CBT). It is a collaborative endeavor between patient and doctor that involves active participation from the patient. It is goal-oriented, focuses on current problems that the patient is facing, and empowers the patient to take charge of his or her thinking and behavior. It is also typically limited to 6 to 16 sessions.

It works by helping the patient identify dysfunctional thoughts and beliefs. Typically, patients with psychiatric and psychological disorders have a negative bias because they tend to discount positive information about themselves and others. Their beliefs are absolute, global, and they tend to overgeneralize their beliefs to similar instances.

Patients with a negative bias have a core belief structure that revolves around two major convictions: (1) the belief that they are unloveable or (2) the belief that they are unworthy or helpless. These core beliefs are funneled through intermediate beliefs involving rules and attitudes to follow. For example, “I am unloveable so therefore I should avoid asking for things for myself.” As a result, these intermediate beliefs give rise to automatic thoughts that consist of emotions and physiological and behavioral responses. For instance, “I feel bad when someone gives me something and I get sick to my stomach. I behave likes it’s no big deal.”

In cognitive therapy, the patient and doctor examine and test the validity of these thoughts and and their function in the patient’s life. Together they construct more adaptive responses for the patient to rehearse through “homework” assignments and through reading or “bibliotherapy.” The goal is to replace less adaptive responses and behavior with more adaptive responses and behavior so that the patient may live a more fulfilling life.

There are two major schools of cognitive-behavioral therapy: CBT, which originated with Aaron Beck, MD at the University of Pennsylvania and Rational-Emotive Behavior Therapy (REBT), which originated with Albert Ellis, PhD in New York at the Albert Ellis Institute.

Suggested reading:

Beck, J. S. (1995). Cognitive therapy: Basics and beyond. NY: Guilford.

Neenan, M., & Dryden, W. (2005). Rational-Emotive Behavior Therapy in a Nutshell. NY: Sage.