Cognitive behavioral therapy (CBT) is a combination of behavioral and cognitive interventions guided by principles of applied science. The behavioral interventions seek to decrease negative behaviors and increase positive ones by modifying the rewards and consequences. Cognitive interventions aim to alter negative thoughts, self-statements or beliefs.
Behavioral theory stems from the operant conditioning theory of B.F. Skinner in which behaviors are modified through the use of positive and negative reinforcement. Simply put, actions and behavior can be rewarded or punished and thereby create incentive for a person to choose the action that brings about a positive result. Cognitive theory encompasses the notion that one’s view of the world shapes the reality of similar thoughts. Plato’s theory of forms illustrates this concept, representing what is real in the world. Cognitive theory is also illustrated by Rene Descartes’ concept of “I think therefore I am,” found in “The Discourse on The Method,” which demonstrates traditional behaviorism with more of a focus on internal thought processes.
How to determine if CBT is needed
There isn’t one type of person or personality that is immune to reacting towards a situation in a negative way, based on perceptions or misperceptions of past experiences. However, studies have shown that certain clinicians don’t find CBT as effective when treating people with PTSD, or other related disorders. CBT is thought to be more beneficial to those who are self aware of any type of mental health disorder, as well as for those who can admit to having a problem with their thinking patterns. In this way, patients can gain a different perspective and thought process in regards to situations that may have been difficult or troublesome for them in the past.
Cognitive therapy theorists
CBT was originally pioneered by Dr. Aaron Beck of the University of Pennsylvania in the 1960s. Dr. Beck and other cognitive therapy theorists and practitioners focused on certain key cognitive structures and processes. Among these were automatic thoughts, underlying assumptions of the world and core beliefs. According to Dr. Beck, CBT is best utilized through the use of monitoring the reoccurrences of automatic thoughts that patients have throughout their day, or after a certain course of events. An automatic thought is the reaction or thought a person has immediately following an external event or situation.
According to a more recent study done by Dr. Martin E.P. Seligman, Dr. David L. Rosenhan and Dr. Elaine F. Walker in “Abnormal Psychology,” expectations, appraisals and attributions are types of automatic thoughts. An expectation is the idea that certain behaviors or actions will bring about certain outcomes. A person’s expectation of how they may be able to execute a particular behavior is considered self-efficacy. The continuing process of evaluating experiences, and their meanings, as well as an individual’s response to those experiences is called an appraisal. An attribution is the person’s explanation of why the event happened.
Analyzing patterns of thinking such as expectations, appraisals and attributions is prevalent in the practice of CBT, to allow patients to come to a more grounded reality of what happened, how it happened, why it happened, their action or reaction in response to the event and then be able to access what they might do differently in the future in regards to similar experiences.
Through continuous practice of CBT, patients are able to gain a stronger understanding of their thoughts, feelings and world views, as well as strengthen their understanding of how their reactions to situations bring about positive or negative results.
Everybody is mentally conditioned throughout life and there are different factors to how one builds his or her worldview and core-beliefs. Such conditioning could come from family, friends, church, school or one’s particular ethnic cultural background. Often there are errors in a person’s expectations, appraisals and attributions of their experiences which can be a result of a set core-belief or world view that hasn’t yet been analyzed or challenged in the person’s life. CBT allows the patient to learn a systematic way of identifying such distorted errors in judgment.