Chapter 1 - CBT Past and Present

Lesson 1: What is CBT?

 This lesson begins with a thought experiment. You are asked to create an image of

putting a lemon sweet/candy in your mouth. You may have been able to imagine the

taste of the sweet, the sharpness of the lemon and the experiment may evoked pleasant

feelings.

 This exercise demonstrates how a cognition (the image of the lemon sweet) can generate

physical sensations (perhaps you salivated), emotions (if the taste was pleasant), and

even behaviour (you may have decided you will go out and buy some sweets!).

 Cognitive behaviour therapy is based on the assumption that environmental stimuli have

their impact on the organism through the way that information is processed. The

meanings we give to a situation determine our affect, physiological experience and

behavioural response. In this ‘5 areas model’ all the components of the system interact,

so it is possible for mood to influence cognition and vice versa. Our physical state, e.g.

the physical effects of a mood altering substance, will also affect our mood and thought

processes.

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 Psychotropic drugs have an impact on the physical system and traditional psychotherapies

focus on emotion. CBT focuses on the cognitive and behavioural parts of the system.

 When we speak of cognitive behaviour therapy we really mean the cognitive behavioural

therapies. These range across a spectrum from approaches that are primarily

behavioural, such as systematic desensitisation and exposure, to therapies that are highly

cognitive, such as Rational Emotive Behaviour Therapy.

 All cognitive behavioural therapies:

1. share a common interest in how thoughts, beliefs and behaviours can be the vehicle

for change.

2. are founded on social learning theory principles i.e. the idea that we learn unhelpful

habits of thinking and acting which can in turn be unlearned,

3. and are all committed to the empirical method.

 These shared values have allowed different therapies to remain under the umbrella of

CBT without the schisms seen in some other branches of psychotherapy. The European

Assocation of Behavioural and Cognitive Therapies (EABCT) is a good example of this

‘broad church’ (eabct.eu).

 In this course we will focus on cognitive behavioural models that have grown out of

Beck’s original work on cognitive therapy for depression (Beck et al 1979).

 CBT differs from psychodynamic therapy in its interest in consciously accessible meanings

rather than repressed unconscious ones.

 It differs from psychodynamic and other interpersonal therapies in emphasising a problem

focused relationship: the relationship facilitates change but is not the vehicle for change.

It is seen as a necessary but sufficient condition for change.

 CBT is much more structured and directive than traditional therapies, but is also very

collaborative, helping patients become their own therapists in the process of solving their

problems.

 Therapy is grounded in a cognitive behavioural formulation, and the techniques employed

grow out of this formulation.

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  CBT differs from traditional therapies in being much more active. The patient learns to

use cognitive and behavioural techniques to manage their problems which they practice

at home between sessions.

REFERENCES

 Beck AT, Rush AJ, Shaw BF & Emery G (1979). Cognitive Therapy of Depression. New York,
Guilford Press.

Further Reading
 Chapter * Beck JS (1995). Cognitive Therapy: Basics and Beyond. Guilford Press.

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