Cognitive-behavioral therapy: what is it and on what principles is it based?

the cognitive behavioral therapy is one of the most important concepts of applied psychology, because it allows to approach very diverse problems by applying techniques which have scientific approval.

It is a form of intervention inherited from the theoretical and practical principles of behavioral psychology, to which are added the methods and objectives of cognitive therapy. In this article, we will see what it is and why it is so used by psychologists.

    What is cognitive behavioral therapy?

    In the fields of psychological intervention and clinical psychology, a large number of proposals are offered to many categories of patients and problems. The offer is very varied, and it’s easy to get lost in the jungle of labels, names and descriptions of the therapeutic approach.

    However, one of these types of therapy is receiving special attention nowadays, both in consultations and clinics and in psychology faculties.

    It is a cognitive-behavioral therapy, a therapeutic orientation which has a scientifically proven effectiveness in different types of intervention. Moreover, one of the most characteristic aspects of this is that it adapts to a wide variety of needs and problems to be addressed in the treatment of patients.

    Change behaviors and thoughts

    If you’ve ever stopped to think about the conventional idea of ​​what a “psychological problem” is, you have probably realized that this type of problem has two sides.

    On the one hand, there is a material and objective aspect, which is recognizable by many people and which can be measured on the basis of specific scales. On the other hand, a group that responds to subjective states of consciousness, that is, aspects of the mental and private life of the person having the problem and which usually have an emotional translation.

    Cognitive behavioral therapy responds to the need to intervene in these two areas. And he does it by pushing thanks to the synergies that are established between the part of the intervention focused on mental processes and that which is oriented towards actions and changes in the material environment of the patient. That is to say, this therapeutic orientation which acts on both actions and thoughts.

    The foundations of this form of psychological intervention

    Cognitive behavioral therapy is being considered born from the fusion of behavioral therapies and those derived from cognitive psychology.

    On the one hand, behaviorism (and especially BF Skinner’s radical behaviorism) serves as an example of a thorough methodology and very close to the precepts of the scientific method, which it allows you to objectively assess the progress made during therapy.

    On the other hand, cognitive therapy emphasizes the need not to give up taking into account directly unobservable mental processes, since a large part of the usefulness of therapy lies in the subjective well-being of patients and this factor should not be able to be saved. through pure behavior analysis.

    However, and although in the context of cognitive behavioral therapy in one of its forms, we work with constructs that refer to the “mental world” which is not directly observable, efforts are made to ensure that the mental elements involved in diagnosis and intervention fall into well-defined and translatable categories. to quantitative variables in order to be able to make an exhaustive follow-up of the changes that are made at the subjective level.

    Therefore, all kinds of esoteric and ambiguous formulations of the person’s way of thinking are avoided and category systems are created in which recurring ideas are classified into each other into classifications that meet a single criterion.

    Deepening of the differences with behaviorism

    Cognitive behavioral therapy it inherits some foundations of behavioral psychologyLike the emphasis on hands-on learning processes and the idea that association is a central concept in therapy. However, it incorporates the need to act, in addition to the behavior, on the thoughts of the person. Above all, the intervention on the “mental” part focuses on the cognitive schemas and the conceptual categories from which the person interprets reality.

    Inappropriate beliefs, once located, are also explored to train the client in their ability to locate everyday facts that contradict these budgets. So, if the person has self-esteem issues, they can be taught to pay attention to displays of admiration from friends and family, which are a type of stimulus that is easily ignored when self-image is severely affected. damaged.

    In short, any type of cognitive behavioral therapy is based on the idea that emotions and behavioral styles depend not only on the physical stimuli that come to us from the environment, but also on the thoughts that shape the way we perceive. our own mental processes.

    How did this type of therapy come about?

    Cognitive behavioral therapy is taught by recognizing styles of thinking that predispose to drawing conclusions of little use to the patient, or dysfunctional thoughts. That is why it is necessary to train the person so that he is able to think about his own way of thinking and to consider which points are contradictory and which are not. This way, it is continued that the client has more ability to question the categories with which he works (Like “success and failure”) and spot typical thought patterns that give you trouble.

    The process by which the patient recognizes the cognitive aspects that cause him discomfort and can act on them is based on an action model inspired by the Socratic dialogue. This implies that during part of the cognitive behavioral therapy sessions, the professional will provide the necessary feedback to the patient so that he in turn detects the contradictions or unwanted conclusions that lead to his thinking styles and patterns. cognitive.

    the therapist he does not guide the patient through this process, but rather asks questions and underlines the statements that the same client has made so that the latter can deepen the study of his own thought.

    The second part of cognitive behavioral therapy consists of intervening on the cognitive and material foci detected. This involves, on the one hand, setting specific objectives to be achieved, and on the other hand, train the patient to be able to determine from his own criteria the strategies which bring him closer and closer to these objectives. In addition, since the objectives have been defined in such a way that it can be impartially checked whether they have been achieved or not, it is easy to measure the progress made and the pace at which it is taking place and take note of it. and, if necessary, make modifications to the intervention program.

    Achieving goals during a cognitive behavioral therapy session program may involve, for example, greatly minimize the effects of a phobia, ending an addiction or giving up an obsessive thinking style. In short, problems with a material side and another subjective or emotional side.

    What is it used for?

    Cognitive behavioral therapy can be applied in a practical way at all ages, Yen a variety of problems. For example, it is used to intervene in anxiety and phobic disorders, dysthymia, bipolar disorder, depression, etc. It can also be used to help in cases of neurological disorders in which support is necessary to know how to best manage the symptoms, and even in psychotic disorders related to schizophrenia.

    However, in some disorders, behavior therapy has been shown to be almost as effective as cognitive behavioral therapy, without the need to perform tasks of changing beliefs and thought patterns. For example, it is common for psychologists to use behavior therapy, and not cognitive behavioral therapy, when very young children need care because they do not yet have good control over thinking. abstract and the articulation of concepts through language.

    The effectiveness of this type of psychotherapy

    Cognitive behavioral therapy is currently considered to be the only type of psychotherapy results have been validated by the scientific method. This means that its effectiveness is supported by empirical observations in which many groups of patients who have undergone treatment with cognitive behavioral therapy have improved much more than one would expect if they had not followed. therapy or had followed a placebo effect program.

    When we say that cognitive behavioral therapy has been shown to be effective thanks to the application of the scientific method, it means that there is strong reason to believe that the improvement felt by people who have tried this type therapy is caused by the use of these psychological interventions, not by other variables. this does not imply that 100% of people who go to cognitive behavioral therapy sessions will improve, but a very important part of these.

    In addition, this improvement can be reflected in objective and observable criteria, such as success or not in quitting smoking. This is a characteristic that distinguishes cognitive behavioral therapy from other forms of intervention, many of which, by not setting measurable goals according to a well-defined criterion, can hardly be subjected to empirical examination to determine their effectiveness by the scientific method.

    On the other hand, it should be borne in mind that the degree of effectiveness of each type of therapy depends on the disorder to be treated; taking this into account, cognitive behavioral therapy is the one that has been shown to be effective in a greater number of psychological disorders.

    Bibliographical references:

    • Field, TA, Beeson, ET, Jones, LK (2015), The New ABCs: A Practitioner’s Guide to Neuroscience-Informed Cognitive-Behavior Therapy, Journal of Mental Health Counseling, 37 (3): pp. 206-220.
    • Froggett, L. and Richards, B. (2002). Explore the bio-psychosocial. European Journal of Psychotherapy and Counseling, vol. 5 (3). pages 321 to 326.
    • Seligman, LD, Ollendick, TH (2011). Cognitive-behavioral therapy for anxiety disorders in young people. Psychiatric clinics for children and adolescents in North America. 20 (2): pages 217 to 38.
    • Spurgeon, JA, Wright, JH (2010). Computer Assisted Cognitive Behavioral Therapy. Current psychiatric reports. 12 (6): pages 547-52.
    • Wampold, BE, Flückiger, C., Del Re, AC, Yulish, NE, Frost, ND, Pace, BT, et al. (2017). Searching for the Truth: A Critical Review of the Cognitive Behavioral Therapy Meta-analysis. Research in psychotherapy. 27 (1): pages 14 to 32.

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