This type of therapy may be conducted in a variety of settings such as groups, families and individuals ("Cognitive Behavioral," 2004). Problems like anxiety, depression, guilt, anger, and low self esteem, in addition to adjustment difficulties are treated with this type of therapy (2004). Issues that go to sleep disturbances, and post-traumatic stress are things that may be addressed as well (2004). The goal of the treatment is to have the wherewithal to restructure perceptions, thoughts and beliefs (2004). An example might be that an individual has obsessive thoughts about a particular fear. The therapist might address the preconceived notions about the fear that may be false. For instance, someone is afraid that she will be mugged. The therapist may point out that only a small percentage of people are victims of crime. As a remedy, the individual may use affirmations or other techniques to break the thought pattern and instead think about other things. Several techniques used with this model include cognitive rehearsal, thought stopping, the channeling of irrational beliefs, self-monitoring, relaxation, and social skills training (2004).
Thought the use of the CBT method, clients are evaluated to make sure a history and background is discerned and then they are asked to complete a questionnaire ("Cognitive Behavioral," 2004). Clients are asked to complete interviews or questionnaires and treatment generally occurs on a weekly basis; sessions usually examine current issues (2004). A Treatment Plan is suggested and goals are set in order to measure the progress of the therapy (2004). The amount of sessions one may require does vary with the type of difficulties that are being treated (2004). Yet, this therapy can be used on a short term basis. Clients are supposed to be active participants in respect to their own therapy (2004). They often choose when the treatment will end. Again, CBT is divided by different types of therapy.
It seems that the first approach was developed by Albert Ellis and called Rational Emotive Therapy (RET) ("History," 2004). Rational Emotive Therapy (RET), also called Rational Emotional Behavior Therapy (REBT) since 1993, is rooted in the 1950s, and maintains that all people are born with self defeating tendencies (McGinn, 1997). It is the brainchild of Albert Ellis and is quite well known amongst psychologists. According to R.E.B.T., when something goes wrong, people have a choice of feeling healthy emotions such as sorrow, disappointment or frustration or negative emotions such as terror, depression and self-pity (1997). The former are considered healthy because they entice the individual to try again (1997). For example, if a child loses at baseball and decides not to play the game again because of the emotional consequences, he is feeling sorry for himself. On the other hand, if he becomes angry because he was not paying attention or did not practice enough, he may go home and practice pitching or batting so that he might win the next time. While he is experiencing negative emotions in both instances, there is only a positive and rational component in the latter.
Interestingly, Ellis created the approach due to the fact that he did not like Psychoanalysis ("History," 2004). The origins of RET are actually much more significant and it goes back to the Stoics, including people like Marcus Aurelius and Epictetus (2004) . Epictetus wrote that men are not bothered by their situation, but rather how they look at these situations (2004). In other words, cognition was the root of the problem. The psychotherapist who also influenced the development of RET was Alfred Adler, a man who developed Individual Psychology (2004). Adler was a neo-Freudian who claimed that he is convinced that an individual's behavior does come from his thoughts (2004). Ellis had been influenced by behaviorists like George Kelly, John Dollard, Joseph Wolpe and Neal (2004).
Ellis was in fact one of the leading therapists in this area during the 1950s, but in the 1960s it was Aaron Beck, a medical doctor, who create the approach called Cognitive Therapy ("History," 2004). Beck's approach had best been known for its ability to treat depression (2004). Beck continues to work in this area and in recent years made an impressive discovery. He draws on others' work and claims that cognitive therapy may be successfully used to treat schizophrenics (Beck & Rector, 1998). It is an idea that makes sense but is revolutionary at the same time. In the past, it was thought that a schizophrenic does not have any control over the thoughts or voices in his head. Yet, authors claim that paranoid schizophrenics often blame other people for their problems and they have a low opinion of themselves (1998). They also tend to pay attention to things that may pose a threat to them (1998). Hallucinations have been associated with a perceptual bias that is similar and people who do hear voices in their heads are also inclined to mistake "printed words for speech or misidentify garbled sounds as words" (1998, 4). Familiar techniques of cognitive therapy are supposed to be able to correct automatic thoughts as well as errors in perception (1998). One can see that Beck's work is influential not only for the larger community but also for smaller, mentally ill populations.
During the 1960s, Maxie C. Maultsby, Jr., M.D. , who was a student of Ellis' would go on to develop Rational Behavior Therapy ("History," 2004). Maultsby would contribute several ideas including an emphasis on "client rational self-counseling skills and therapeutic homework" (2004). Maultsby's did contribute the concept of "thought shorthand "and calls these "attitudes" (2004). Those types of thoughts Beck would later refer to as "automatic thoughts" (2004). Other disciplines that fall under this therapeutic umbrella include Rational Emotive Imagery, the Five Criteria for Rational Behavior, and Rational Self-Analysis (2004). Additional therapists who made contributions in this area are Michael Mahoney, Ph.D., Donald Meichenbaum, Ph.D. and David Burns, M.D (2004). David Burns would once again make CBT popular with his best seller entitled Feeling Good, a book that came out in the 1980s (2004).
Cognitive behavioral therapy (CBT) has in fact become a respected and empirically established mode of psychotherapy and a review of the experimental literature demonstrates the effectiveness of CBT for adults (Dia, 2001). In the review, CBT had been efficacious for depression and generalized anxiety disorder as well as social phobia and obsessive compulsive disorder (2001). It has also been recommended for substance abuse and dependence, agoraphobia, and panic disorder (DeRubeis & Crits-Christoph, 1998 as cited in Dia, 2001). CBT obviously involves the use of both behavioral and cognitive techniques so that the patient, when confronted with a situation, can use self talk methods as well as specific behavior modifications. Key concepts of the approach will again depend upon the disorder being treated. However, it becomes clear that CBT and its various forms are appropriate to treat a variety of patients.
References
Beck, A. T. & Rector, N.A. (1998). Cognitive Therapy for Schizophrenic Patients. Harvard Mental Health Letter, 15 (6), 4-6.
Cognitive Behavioral Therapy. (n.d.). Retrieved February 27, 2005 from http://www.psychnet-uk.com/psychotherapy/
psychotherapy_cognitive_behavioural_therapy.htm
Dia, D.A. (2001). Cognitive-Behavioral Therapy with a Six-Year-Old Boy with Separation Anxiety Disorder: A Case Study.
Health & Social Work, 26 (2), 125-128.
History of Cognitive-Behavioral Therapy (2004). Retrieved February 27, 2005 from http://www.nacbt.org/historyofcbt.htm
McGinn, L. K. (1997). Interview:Albert Ellis on rational emotive behavior therapy. American Journal of Psychotherapy, 51 (3), 309-316.
