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What is cognitive therapy?Cognitive Therapy is a psychological approach to treatment that has evolved out of the work of Aaron Beck and his colleagues at the University of Pennsylvania. While Beck calls his method Cognitive Therapy, a number of authors have developed methods independently. Some of these writers call their approach, “Cognitive-Behavioral Therapy,” (CBT) emphasizing their differing point of origination from Beck’s.
Cognitive therapy approaches recognize the role of individual development, family background, and biological factors in mental disorders, but they are distinguished from other therapies (like psychoanalysis or behavior modification) in that that the thinking, reasoning person is given a central role in the change process. Therapist and client work in a collaborative dialogue focused in the reality of the present. Session work involves an ongoing examination of automatic thought processes, self-perpetuating beliefs and sometimes-erroneous conclusions and encouraging social and personal experimentation, leading to adaptive behavioral change. One of the contributions of the cognitive approach is the realization that thoughts, particularly automatic thoughts, often “trigger” and give fuel to the beliefs, feelings and behavioral reactions that follow.
Cognitive therapists have developed models for understanding the structures of many psychological ailments. The concept of a “schema,” referring to the inner sense of how to act in a given situation has been used to map out the most common problems in living and coping. Consider, for example, that a child does not at first know how to behave in a restaurant, knocking things over, bothering nearby patrons, and leaving a large scale mess in his wake (he doesn’t have the schema, yet.). Over time and trials he gradually learns how to wait to be seated, order from a menu, and hopefully, pick up the check.
Life presents an enormous variety of situations, each demanding our understanding and adaptive responding. When these situations get out of hand or an individual cannot keep up with or meet the demands of basic life situations, problems of adjustment or even psychological disorders may arise. Cognitive therapists have done a lot of work to figure out the schemas that are prone to difficulty and have developed techniques for corrective and therapeutic action.
After years of refinement, CBT approaches have enabled patients who may be disabled by schizophrenic disorders, depression, anxieties, or addictions, to identify and then change some of the processes by which their thoughts, beliefs, feelings and actions interact, promoting healthier states of mind and body.
How does it work?
Based on our understanding of the core schemas for psychological disorders and our growing awareness of healthier mental states, clinicians examine how these processes work for each individual and then design programs that assists them to learn to self-manage on their own.
Though there may be a biological aspect to, for example, depression, many individuals do not suffer from bad body chemistry per se. Rather, they have fallen prey to a complex of negative thinking (so called, bad self-fulfilling prophecies), depressive beliefs, and inabilities to act effectively towards more favorable mental states.
CBT provides an opportunity for rational dialogue, personal problem solving and learning new skills for coping with and changing bodily states (relaxation and energizing strategies), mental states (symptom reduction and coping skills strategies), and social states (assertive training, communication skills training).
Participants learn that they can change their negative emotions into healthier states by first monitoring and attending to and then changing the ways that they think about themselves, including their automatic thoughts, their world and the environment around them, and their future.
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