Cognitive – Behavioral Therapy –

The cognitive-behavioral therapies share the following assumptions (Ingram and Scott, 1990):

  1. Individuals respond to cognitive representations of environmental events rather than the events themselves;
  2. Learning is cognitively mediated;
  3. Cognition mediates emotional and behavioral dysfunction (cognition affects emotions and behavior and vice versa);
  4. Some forms of cognition can be recorded and evaluated;
  5. Modifying cognitions can change emotions and behavior; and
  6. Both cognitive and behavioral procedures for change are desirable and can be integrated into interventions.

The cognitive behavioral therapy is a generic term that refers to therapies that incorporate both behavioral interventions (direct attempts to reduce dysfunctional behaviors and emotions by modifying behavior) and cognitive interventions (attempts to reduce dysfunctional behaviors and emotions by modifying the individual’s evaluations and thought patterns. ). Both types of interventions are based on the assumption that prior learning is currently producing maladaptive consequences and that the purpose of therapy is to reduce unwanted distress or behavior by unlearning what was learned or by providing new, more adaptive learning experiences. (Brewin, 1996).

Some of the main characteristics of cognitive-behavioral therapy would be the following (Ingram and Scott, 1990):

  1. Cognitive variables constitute important causal mechanisms,
  2. The specific objectives of some procedures and techniques are cognitive,
  3. A functional analysis is carried out of the variables that maintain the disorder, especially the cognitive variables,
  4. Behavioral and cognitive strategies are used in the attempt to modify cognitions,
  5. Notable emphasis is placed on empirical verification,
  6. The therapy is of short duration,
  7. Therapy is a collaboration between therapist and patient, and
  8. Cognitive-behavioral therapists are directive.
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Cognitive-behavioral therapies incorporate behavioral and cognitive procedures in their application to different problems. They have been proposed three main classes of cognitive-behavioral therapies (Mahoney and Arnkoff, 1978):

  1. The methods of cognitive restructuringwhich assume that emotional problems are a consequence of maladaptive thoughts and, therefore, their interventions try to establish more adaptive thinking patterns.
  2. The therapies of coping skillswhich try to develop a repertoire of skills to help the patient cope with a series of stressful situations.
  3. The therapies of troubleshootingwhich constitute a combination of the two previous types and which focus on the development of general strategies to deal with (solve) a wide range of personal problems, insisting on the importance of active collaboration between the patient and the therapist.

Therefore, Cognitive-Behavioral Therapy is characterized by being an active and directive method, and in it patient and therapist work together and in a structured manner, with tasks outside of session.

It uses both behavioral and cognitive techniques in different combinations depending on the symptoms to be addressed: breathing and relaxation, autogenic training, cognitive restructuring, live and delayed exposure, positive self-instructions, problem solving, etc.

Evidence of clinical efficacy

The results of controlled clinical investigations provide strong support for the effectiveness of cognitive-behavioral therapies in general. The results should not be confused with each other, since the degree of effectiveness is variable and depends on the type of behavioral problem, in such a way that some techniques are better than others and the integration of cognitive and behavioral technology seems to yield better results.