An Introduction to Cognitive Therapy

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4/22/12

Cognitive Therapy & CBT

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An Introduction to Cognitive Therapy & Cognitive Behavioural Approaches By Dr Greg Mulhauser, Managing Editor

Cognitive therapy (or cognitive behavioural therapy) helps the client to uncover and alter distortions of thought or perceptions which may be causing or prolonging psychological distress.

Underlying Theory of Cognitive Therapy
The central insight of cognitive therapy as originally formulated over three decades ago is that thoughts mediate between stimuli, such as external events, and emotions. As in the figure below, a stimulus elicits a thought — which might be an evaluative judgement of some kind — which in turn gives rise to an emotion. In other words, it is not the stimulus itself which somehow elicits an emotional response directly, but our evaluation of or thought about that stimulus. (Some practitioners use Ellis’s ABC model, described on our page about rational emotive behaviour therapy, to describe the role of thoughts or attitudes mediating between events and our emotional responses.) Two ancillary assumptions underpin the approach of the cognitive therapist: 1) the client is capable of becoming aware of his or her own thoughts and of changing them, and 2) sometimes the thoughts elicited by stimuli distort or otherwise fail to reflect reality accurately.

A common ‘everyday example’ of alternative thoughts or beliefs about the same experience and their resulting emotions might be the case of an individual being turned down for a job. She might believe that she was passed over for the job because she was fundamentally incompetent. In that case, she might well become depressed, and she might be less likely to apply for similar jobs in the future. If, on the other hand, she believed that she was passed over because the field of candidates was exceptionally strong, she might feel disappointed but not depressed, and the experience probably wouldn’t dissuade her from applying for other similar jobs. Cognitive therapy suggests that psychological distress is caused by distorted thoughts about stimuli giving rise to distressed emotions. The theory is particularly well developed (and empirically supported) in the case of depression, where clients frequently experience unduly negative thoughts which arise automatically even in response to stimuli which might otherwise be experienced as positive. For instance, a depressed client hearing “please stop talking in class” might think “everything I do is wrong; there is no point in even trying”. The same client might hear “you’ve received top marks on your essay” and think “that was a fluke; I won’t ever get a mark like that again”, or he might hear “you’ve really improved over the last term” and think “I was really abysmal at the start of term”. Any of these thoughts could lead to feelings of hopelessness or reduced self esteem, maintaining or worsening the individual’s depression. Usually cognitive therapeutic work is informed by an awareness of the role of the client’s behaviour as well (thus the term cognitive behavioural therapy, or CBT). The task of cognitive therapy or CBT is partly to understand how the three components of emotions, behaviours and thoughts interrelate, and how they may be influenced by external stimuli — including events which may have occurred early in the client’s life. counsellingresource.com/lib/therapy/types/cognitive-therapy/ 1/3

4/22/12

Cognitive Therapy & CBT

Therapeutic Approach of Cognitive or Cognitive Behavioural Therapy Cognitive therapy aims to help the client to become aware of thought distortions which are causing psychological distress, and of behavioural patterns which are reinforcing it, and to correct them. The objective is not to correct every distortion in a client’s entire outlook — and after all, virtually everyone distorts reality in many ways — just those which may be at the root of distress. The therapist...
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