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What is Cognitive Behaviour Therapy (CBT)? Formal definition: CBT is a form of psychotherapy based on cognitive therapy and behaviour modification, in which the client or patient learns to replace dysfunctional self-speech (such as “I knew I’d never be able to cope with this job”) with adaptive alternatives(“The job’s not going well, but I am capable of working out a plan to overcome the problems”). Cognitive Therapy (CT) and Behaviour Modification (BM) CT is ‘a form of psychotherapy aimed at modifying people’s beliefs, expectancies, assumptions, and styles of thinking, based on the assumption that psychological problems often stem from erroneous patterns of thinking and distorted perceptions of reality…’ BM is a collection of psychotherapeutic techniques aimed at altering maladaptive behaviour patterns, the basic assumptions being that most forms of mental disorder can be interpreted as maladaptive patterns of behaviour, and that treatment involves the unlearning of these behaviour patterns and the learning of new ones. The Origins of CBT The emergence of CBT is ascribed to the American psychiatrist Aaron T Beck (b.1921). He developed it while treating people for depression. Beck used to adopt a psychoanalytic approach towards the treatment of depression. He assumed the validity of its theoretical proposition that depression was due to a retroflected hostility, expressed as “a need to suffer”. However, during the second half of the 1950s he came to realise through empirical observation and study of his depressed patients that the theory was wrong. The treatment based on its assumptions did not work and the patients themselves expressed their problems differently. Aaron Beck’s agonizing reappraisal This ‘marked discrepancy between laboratory findings and clinical theory’ led Beck to an “agonizing reappraisal” of his ‘own belief system’. He came to the conclusion that depressed people had ‘a global negative view’ of themselves. Consequently, Beck and his colleagues devised an interactive treatment with their patients in which the patients were set ‘homework’ which consisted of observing their automatic negative mental reactions and replacing them with positive responses structured as incremental steps that could be taken to deal with the observed challenges. This approach worked well and directly ameliorated the depression symptoms. Increasing use of CBT Since its development in the 1960s CBT has grown almost exponentially in its clinical applications. It has proved its effectiveness with a range of personality disorders: Anxiety including panic disorder Obsessive compulsive disorder Eating disorder Bipolar disorder, and Couples and family problems.
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