Cognitive Behavioral Theory

Date: Nov 17, 2019
Category: Social Work

Abstract

Cognitive-behavioral theory (CBT) is associated with the therapeutic method based on the postulate that the individual’s mood, behavior, and physical condition are determined by the basic set of his or her beliefs. The attitude to oneself, the world, and people around is the prism through which an individual processes every single life situation. Thinking habits significantly affect the individual’s instant assessment of the situation, which is realized through automatic thoughts. Cognitive behavioral therapy involves short-term treatment and is based on the concept of studying the present psychological state of a person.

It is aimed at solving the problems that disturb a patient at the moment. Consequently, it models the individual’s behavior by means of presenting topical solutions, which allow obtaining a controllable practical result. Historically, CBT is based on the classical behavioral approach combined with Ellis’ rational emotive therapy (RET) along with Beck’s cognitive therapy (CT). It is widely used to work with patients with diverse psychic disorders such as all types of phobias, anxiety, depression, eating disorders, sexual disorders, and other borderline conditions. CBT’s major goals are to conduct a functional behavioral analysis, increase the quality of self-evaluation, correct the maladaptive forms of behavior and irrational attitudes, and develop the individual’s competence in social functioning. CBT has proved to be efficient for social reintegration of the patients with the forenamed disorders. Its primary weaknesses are limited to the questionable matter of self-report evaluation and the fact that CBT is not suitable for certain individuals who lack organization and motivation.

 

Cognitive Behavioral Theory 

Cognitive behavioral theory (CBT) is known to be an approach designed to change the individual’s mental images, thoughts, and overall thought patterns. Its major goal is to help people overcome either emotional or behavioral problems. The forenamed theory emphasizes the fact that any type of human behavior or emotions result from the cognition in general and cognitive processes in particular. Thus, the change in the individual’s cognition is the major precondition for changing his or her behavior. The latest research in psychotherapy allows concluding that CBT is one of the most efficient contemporary tools used for treating various psychological disorders. The application of CBT in counseling and psychotherapy is based on the principle of correcting psychological problems that appeared as a result of strong emotional experiences. CBT can be successfully applied as a theory to treat suspicious psychological border states and a variety of disorders. In addition, owing to CBT, the probability of reoccurrence of such deviations in the future has an impressively low record. 

History of Theory

The basic concept of cognitive behavioral theory (CBT) is reflected in the fact that what individuals think and feel plays a fundamental role in the construction of their behavior. The first vital step required to obtain a profound understanding of the primary foundations of CBT is to get acquainted with its history. The first known experience with behavioral therapy was based on the theoretical positions of Pavlov’s classical conditioning and Skinner’s operant conditioning. As new generations of physicians used behavioral techniques, it became evident that psychological problems faced by the treated individuals were much more complicated than they were reported in earlier publications. The psychological theory faced practical difficulties as behavioral conditioning could not adequately explain the complex processes of socialization and learning. Further interest in self-control and self-regulation in the framework of behavioral psychotherapy dictated the shift from environmental determinism to reciprocal determinism. The first one claimed that the life of an individual was determined primarily by the impact of the external environment; the second one positioned an individual not as a passive product of the environment but as an active participant of his or her own development. The 1950s produced rational emotive therapy (ERT), which was introduced by Albert Ellis. The latter consequently preconditioned the birth of cognitive therapy (CT) by Aaron Beck in the 1960s. In 1961, Bandura also presented an article which managed to present a more integrative approach to the process of behavioral regulation. Bandura’s work elucidated the mechanisms of operant and classical learning and emphasized the significance of the cognitive process for overall regulation of behavior. Therefore, the obsolete conditioning model of human behavior gave way to the theory based on cognitive processes. Basically, the 1960s became the decade of cognitive revolution in psychology. Many therapists were affected by this revolution and, by 1970, began to refer to these changes as to a new personality theory. This fusion of behavioral and cognitive theories is considered to be the second-wave behavior therapy, also known as cognitive behavioral theory (CBT). CBT is still developing and presenting more of new treatment approaches that are believed to belong to the third-wave behavioral therapy. The study of irrational thoughts conducted by Ellis in 1977 and the analysis of cognitive schemes of various psychic disorders presented by Beck in 1993 helped estimate the affect of cognitive errors on behavior patterns. The aforementioned studies allowed developing new efficient tools and methods required to change the individual’s negative thinking by fixing his or her cognitive errors. Consequently, the integration of two waves of behavioral therapy led to the formation of the cognitive-behavioral concept. Nowadays, this concept is characterized as a form of psychotherapy aimed at changing not only the behavior but also the beliefs, attitudes, styles of learning, and expectations of different individuals. 

Types of Problems the Theory Is Most Useful for

There are many approaches and techniques derived from the theoretical development of cognitive behavioral therapy (CBT). A CBT therapist can successfully determine the parasitic thoughts and consequently change their direction with the help of the so-called Socratic questions: Who said that everything is bad? What makes you think it will last forever? etc. 

CBT offers a variety of other cognitive techniques that allow transforming negative thinking patterns into positive ones. In addition, it assists in alleviating the mental distress suffered by the client by means of autotraining, meditative techniques, communicational training, etc. Therefore, negative thoughts are replaced by more optimistic ones, which, in turn, stimulate the individual to manifest adaptive and healthy behavior patterns. 

For instance, if an individual is often thinking about different accidents and crashes while travelling by air and tries to avoid air transportation by all means, CBT may be the most efficient therapy to help him or her overcome such fear. In other words, CBT is able to assist individuals in coping with all sorts of fears that were created by themselves and their cognitive schemes. Thus, CBT is particularly useful in dealing with obsession neurosis or such obsessive-compulsive disorders as mysophobia, dromophobia, arachnophobia, eating disorders, depressions, panic attacks, sexual disorders, addictive behaviors, etc. Years ago, the forenamed disorders were considered symptoms of schizophrenia and were treated with the help of medical substances known as neuroleptics. Nowadays, they are successfully treated with CBT’s exposure therapy.

The major goal of CBT’s exposure therapy is to teach the patients to self-regulate their cognition. It is widely known that an individual cannot control every aspect in the surrounding world. CBT allows people controlling the way they comprehend and perceive each of these aspects. Evidently, the theory is especially applicable in terms of helping people with anxiety disorders in general and social anxiety in particular. In terms of social anxiety, it is necessary to say that CBT’s major goal is the integration of an individual into diverse social situations and consequently decreasing anxiety in relation to these situations. CBT questions the validity of the patient’s initial thoughts related to a given social situation, as well as his or her judgments about other situations. Neurosis, anxiety, depression, as well as addictive behavior are the primary targets of CBT as it transforms the individual’s maladaptive automatic thoughts and basic negative beliefs. The analyzed therapy helps people with depression feel that they a not losers, but winners. It motivates individuals to overcome passivity, social isolation, tendency to escape, the scope of cognition proclaiming hopelessness and defeat. CBT offers an everyday plan of actions for such patients and gradually teaches them to efficiently outlive different social interactions. CBT is becoming more and more popular due to the growing record of its psychotherapeutic successes. In the majority of cases, CBT is a short-term treatment plan for patients with obsession neurosis. In addition, it is very often more accessible than other types of psychotherapy that are frequently designed for long-term interaction with the clients.

Strengths of the Theory

According to the latest research presented by the World Health Organization and the US Department of Health and Human Services, cognitive behavioral therapy (CBT) is the most effective method of treatment of most mental disorders. Anxiety disorders, addictions, obsessions, posttraumatic stress disorders, phobias, sexual and other disorders are among the problems successfully treatable by this method of psychotherapy. It also gives excellent results in treatment of neuroses, depression, and panic attacks. Modern psychologists and psychiatrists support the efficiency of CBT method. In Western psychotherapy, cognitive behavioral therapy (CBT) is the most common technique of treatment as it reveals its tendency to show good results in a relatively short period. Many of the symptoms and behavioral problems are the result of gaps in learning, education, and upbringing. CBT helps a patient fill in these gaps, which differ from client to client. Therefore, another strength of CBT is that it is highly individualized for each patient and family. Psychotherapists learn and understand the history of the family that supports the patient's dysfunctional behavior. In addition, CBT emphasizes close relationship between the behavior of an individual and the social environment. It clearly identifies that stimuli affect the individual’s behavior and tracks the client’s thoughts in response to diverse problematic situations. CBT helps people satisfy their basic needs such as safety, belonging, success, and freedom by means of modeling their behavior using methods and techniques of classical and operant learning, cognitive learning, and self-regulation of behavior. Another vital aspect in terms of CBT efficiency is that it admits that both thoughts and emotions affect each other and are two links of one single chain. It permits to reevaluate negative past experiences and offers schemes affecting the process of evaluation of the events and adaptation. Due to the complexity of such schemes, CBT changes the way the patient interprets the reality (Hofmann, Asnaani, Vonk, Sawyer & Fang, 2012). In this regard, CBT works in the constructivist manner actively involving the patient and his or her family. In addition, CBT is known to have a structured psychotherapeutic pattern as it provides for a systematic homework and active reinforcements programs, and offers the client to maintain records and diaries. The forecast and effectiveness of the treatment parameters are determined to improve the behavior of the client. Unlike other psychotherapeutic trends, CBT does not concentrate on the removal or exclusion of undesirable behavior or response, aggression, ticks, and phobias, but makes emphasis on shifts teaching patients positive behaviors such as self-confidence, positive thinking, etc. In other words, it performs a shift from a pathogenic to a sanogenic approach. Moreover, CBT stimulates its clients to change and engages them into the self-help process, which is extremely important for individuals with borderline disorders that are often based on infantilism. It offers a life-coping strategy based on the principles of social adaptation, which often significantly improves the quality of the client’s social behavior patterns.

Weaknesses of the Theory 

Despite its evident strengths, cognitive behavioral therapy (CBT) does have certain limitations and weaknesses, which are commonly used to criticize it. First, CBT is not suitable for every given psychological problem and at times is not applicable to particular psychiatric conditions. Its major issue is that not all individuals are ready and willing to present sufficient persistence and dedication in order to gradually and patiently change their thinking patterns working together with the CBT therapist. Many individuals face major difficulties dealing with CBT due to the hard work it requires. In addition, the analyzed therapeutic method implies systematic homework as an essential part of the client’s progress. For some people this homework is a challenging and complicated task due to multiple reasons: lack of self-organization and overall decreased level of motivation for changing. Practically, CBT takes the client away from his or her comfort zone. Combined with the client’s initial high anxiety levels, it makes such therapy seem like an unappealing experience causing distress. Nevertheless, the major weaknesses of CBT are associated with the limitations of self-report evaluation and measurement of subjective cognitive change. CBT critics believe that the data reported by the individuals may not reflect the true ongoing thinking situation due to its moment-to-moment nature. Another highly criticized aspect of CBT deals with the fact that an individual processes a large portion of information subconsciously. The latter is claimed to lack adequate conscious appraisals in terms of its psychotherapeutic effects. Therefore, the analyzed therapeutic model requires an additional conscious acceptance component, which has become the major focus of the third-wave cognitive behavioral therapies. In spite of the listed limitations, the potential benefits of CBT outweigh the weaknesses, which converts CBT into one of the most promising spheres of psychological and psychiatric research.

Conclusion

It is impossible to underestimate the significance of the cognitive process as the potential reason of emotional and behavioral problems. The relationship between thinking, emotions, and behavior was often attributed to abstract theories, which did not facilitate the client’s comprehension of these interrelation patterns. In response to this bias that favors invisible and mysterious processes, behavioral therapy was limited only to visible external actions. It was later that cognitive behavioral therapy focused on thoughts as a driving force of human behavior. Cognitive behavioral therapy is not a return to traditional therapy. In contrast to earlier approaches, cognitive behavioral therapy systematically explores the inner material, categorizes mental processes, and links them to external events. The latter occurs owing to a careful observation of thoughts, feelings, and behavior of the client in the course of time. Cognitive behavioral therapy focuses on teaching by means of training to acquire specific skills of direct relevance to the existing problem. CBT is concentrated on the acquisition of skills and the patient's own responsibility for the results of application of these skills. Consequently, it can help a patient improve his or her self-control patterns and ability to cope with difficulties. In other words, the confirmed efficiency of CBT as a therapeutic method implies the successful approbation of the scientific method to the field of analysis and correction of the cognitive process.