Cognitive behavioral therapy (CBT) is a short-term, problem-centered therapy that is used to address psychopathology within the individual (Beck, 1995). This model of therapy is used to address issues of depression, anxiety, eating disorders, relational problems, and drug abuse, and can be utilized when working with individuals, as well as within group and family modalities. The core aspects of this therapy include collaboration and participation by the client, a strong alliance between therapist and client, and an initial focus on current problems and functioning (Beck, 1995).
The theory of CBT emphasizes the relationship between the individual’s thoughts feelings and behaviors, which is seen as being the underlying cause of psychopathology in individuals. Therefore, this theory asserts that the identification, evaluation, and modification of one’s negative thoughts will lead to an improvement in one’s mood and behaviors (Beck, 1995). It is important to understand the concepts and theory from which CBT is based in order for it to be efficiently implemented in therapeutic work with individuals, groups, or families.
While CBT is used to treat psychological disorders, this theory can be examined by looking at the thoughts, feelings, and behaviors of individual’s with an absence of psychopathology. Beck (1979) and Beck (1995) present the cognitive model in order to explain the theory of CBT. The cognitive model demonstrates that the emotions that an individual experiences and the behaviors that they exhibit are a result of their perception of a situation or event (Beck, 1995).
When in any given situation, an individual’s immediate thought response is their automatic thought (Beck, 1995). These thoughts are an immediate evaluation of the situation, which in turn directly influence the feeling that a person has about the situation. Automatic thoughts are experienced by everyone and occur in the individual’s mind prior to reasoning. These thoughts occur swiftly and often times the individual may be unaware that they have occurred, being more observant of the emotion that they are feeling in the moment (Beck, 1995).
Once an automatic thought occurs within the individual, it triggers a feeling, which in turn triggers the individual’s response, such as a behavior and/or physiological response. For example, after a young child begins to pick up his blocks to be put away, his mother rubs him on the back and gives him praise for his actions. His automatic thought may be, “I am good when I put away blocks,” triggering a feeling of confidence, an increased level of physical energy, and the behavior of putting away the remaining blocks. Automatic thoughts can be neutral, positive, or negative.
We all have our own automatic thoughts as we move through our day-to-day lives and interact with others. In regards to individuals with psychological disorders, the cognitive model looks at how negative thoughts influence the individual’s feelings and behaviors (Beck, 1995). From a CBT lens, it is the negative automatic thoughts that an individual has that perpetuate symptoms of psychological disorders, the occurrence of negative mood, uncomfortable physiological responses, and maladaptive or inappropriate behaviors (Beck, 1995).
While we all have moments of experiencing negative automatic thoughts, for those with psychological disorders, and more pervasive difficulties in living, negative thoughts are often experienced in situations that are neutral, producing negative feelings that lead to maladaptive behaviors or responses that would not typically be expected from the neutral situation (Beck, 1995). Aaron Beck presents theory of the cognitive model of how depression is rooted and perpetuated in individuals as a result of the interaction between negative automatic thoughts, feelings, and behavioral response.
In this discussion, depression is conceptualized in terms of the cognitive triad, which describes three components of negative thinking of the depressed individual: the individual’s negative view of self, their negative view of the others and the world, and their negative view of the future (Beck, Rush, Shaw, & Emery, 1979). The cognitive triad is maintained via the remaining components of Beck’s cognitive model of depression, the individual’s schemas, or core beliefs, and the utilization of faulty thinking, or cognitive errors (Beck, Rush, Shaw, & Emery, 1979).
Cognitive theory asserts that our automatic thoughts are rooted in our core belief system or cognitive schemas. Core beliefs begin to be developed early in life and are based on experiences that the individual has throughout their life. Because these beliefs are so grounded in how the individual views their life, others, and the world, and begin to be cultivated so early in development, they become a fundamental aspect of the individual, who considers them to be absolute truths (Beck, 1995).
Core beliefs are deeply rooted in an individual, so much so that the individual may be unaware of the belief and how it influences their thoughts about themselves and the world. Each belief can have varying levels of presence within an individual’s day to day life, with some core beliefs remaining predominately dormant and only being activated in certain situations, while others may be frequently present in an individual’s thoughts (Beck, 1995).
It is the individual’s cognitive schemas that allows for the categorization and evaluation of different experiences or situations (Beck, Rush, Shaw, and Emery, 1979). The core belief system maintains the way an individual experiences and thinks about a given situation (Beck, Rush, Shaw, & Emery, 1979). While everyone conceptualizes a given situation in their own way, each individual typically conceptualizes similar situations in a similar way based on their own core beliefs (Beck, Rush, Shaw, and Emery, 1979).
Within a set of similar situations, the individual’s core beliefs trigger automatic thoughts, which in turn trigger the individual’s emotional and behavioral response. Over time, the individual’s responses to similar situations become more consistent, thereby causing the development of a routine response to these types of situations. As this consistently occurs, the schema connected to particular type of event is further developed and the individual’s assertion that the belief holds absolute truth is strengthened (Beck, Rush, Shaw, & Emery, 1979).
Beck’s theory underlying CBT focuses on the idea that symptoms of depression, as well as those of other psychological disorders, are developed and maintained through to the individual’s negative core beliefs and triggered negative thoughts. In addition to the individual’s negative schemas, Beck’s theory states that the cognitive triad of negative cognitions of self, others, and future is further perpetuated through patterns of faulty thinking (Beck, Rush, Shaw, & Emery, 1979).
There are a variety of faulty thinking mechanisms that are used by individual’s to support their automatic thoughts and core beliefs, even in light of contradictory evidence (Beck, Rush, Shaw, & Emery, 1979). This type of thinking can be characterized as labeling, over generalizing, personalization, emotional reasoning, magnification or minimization, and all-or-nothing or impetrative thinking (Beck, 1995). These cognitive errors are often extreme and unrealistic ways in which the individual assesses and draws conclusions regarding their problems, which is then used to further support their negative belief system and automatic thoughts.
CBT theory declares that the individual can learn to identify their automatic thoughts, thereby creating an avenue for changing the emotions, behaviors, and psychological responses to various situations. When utilizing CBT with a client, it is necessary for the therapist to conceptualize the individual’s presenting problems from the perspective of the cognitive model (Beck, 1995). This can be done through the work of gathering information regarding the individual’s current problems, diagnosis, and how the problems have been developed and maintained.
As this information is collected, the CBT therapist begins to assess and identify the inaccurate and unhelpful thoughts connected to the problems, and the behaviors that are exhibited as a result of this thinking (Beck, 1995). As this is done, the therapist can then begin to guide the individual to identify, examine, and correct or modify the negative automatic thoughts, underlying core beliefs, and faulty thinking mechanisms that have sustained the presenting problems (Beck, 1995).