Cognitive Behavior Therapy
Cognitive Behavior Therapy
By Beck Institute
History of Cognitive Behavior Therapy
(CBT)
• Cognitive Therapy (CT), or Cognitive Behavior Therapy (CBT) ,was pioneered
by Dr. Aaron T. Beck in the 1960s, while he was a psychiatrist at the University
of Pennsylvania. Having studied and practiced psychoanalysis, Dr. Beck
designed and carried out several experiments to test psychoanalytic concepts
of depression. Fully expecting the research would validate these fundamental
concepts, he was surprised to find the opposite.
• As a result of his findings, Dr. Beck began to look for other ways of
conceptualizing depression. He found that depressed patients experienced
streams of negative thoughts that seemed to arise spontaneously. He called
these cognitions “automatic thoughts.” He found that the patients’ automatic
thoughts fell into three categories. The patients had negative ideas about
themselves, the world and/or the future.
• Dr. Beck began helping patients identify and evaluate these automatic
thoughts. He found that by doing so, patients were able to think more
realistically. As a result, they felt better emotionally and were able to
behave more functionally.
• When patients changed their underlying beliefs about themselves,
their world and other people, therapy resulted in long-lasting change.
Dr. Beck called this approach “cognitive therapy.” It has also become
known as “cognitive behavior therapy.”
What is Cognitive Behavior Therapy?
• What is Cognitive Behavior Therapy (CBT)?
• Cognitive Behavior Therapy (CBT) is a psychotherapy that has been shown to be
effective in over 1,000 research studies. It is a time-sensitive, structured, present-
oriented psychotherapy that helps individuals identify goals that are most
important to them and overcome obstacles that get in the way. CBT helps people
get better and stay better.
• CBT is based on the cognitive model: the way that individuals perceive a situation
is more closely connected to their reaction than the situation itself.
• One important part of CBT is helping clients figure out what they most want from
life and move toward achieving their vision. They learn skills to change thinking
and behavior to achieve lasting improvement in mood and functioning and sense
of well-being.
• CBT uses a variety of cognitive and behavioral techniques, but it isn’t
defined by its use of these strategies.
• We do lots of problem solving and we borrow from many
psychotherapeutic modalities, including dialectical behavior therapy,
acceptance and commitment therapy, Gestalt therapy, compassion
focused therapy, mindfulness, solution focused therapy, motivational
interviewing, positive psychology, interpersonal psychotherapy, and
when it comes to personality disorders, psychodynamic
psychotherapy.
What is the theory behind cognitive behavior
therapy?
• Cognitive behavior therapy is based on the cognitive model: the way we perceive
situations influences how we feel emotionally.
• For example, one person reading this website might think, “Wow! This sounds good,
it’s just what I’ve always been looking for!” and feels happy. Another person reading
this information might think, “Well, this sounds good but I don’t think I can do it.” This
person feels sad and discouraged.
• So it is not a situation that directly affects how people feel emotionally, but rather,
their thoughts in that situation. When people are in distress, their perspective is often
inaccurate and their thoughts may be unrealistic.
• Cognitive behavior therapy helps people identify their distressing thoughts and
evaluate how realistic the thoughts are. Then they learn to change their distorted
thinking. When they think more realistically, they feel better. The emphasis is also
consistently on solving problems and initiating behavioral changes.
What are the most essential components of
CBT treatment?
• It’s important to remember that cognitive behavior therapists use a different formulation for each
psychiatric disorder.
• We use this formulation in conceptualizing the individual patient, which is an essential component to
developing a sound therapeutic relationship, setting goals, planning treatment, and selecting
interventions.
• Building trust and rapport with patients from the very first contact, demonstrating accurate
empathy, sharing the conceptualization with the patient (and making sure it “rings true” for the
patient), and collaborating are also essential.
• Another important part of every therapy session is helping patients respond to inaccurate or
unhelpful ideas.
• The basic question to ask when a patient is reporting a distressing situation, emotion, or
dysfunctional behavior is: “What is going through your mind right now?” Once we help patients
identify their dysfunctional thinking, we help them gain more adaptive and accurate perspectives,
especially by helping them examine the validity and usefulness of their thoughts. We also help them
design behavioral experiments to test the accuracy of their predictions.