The Roots of Cognitive Behavioral Therapy
Historically, BT can be divided into three generations. The first generation is in part a rebellion against prevailing therapeutic concepts of the day (the Psychoanalytic and Humanistic approaches). Early interventions focused directly on reducing problematic manifestations of behavior, using techniques based on well-defined and strictly validated scientific principles. An example can be made of an individual suffering from social anxiety who avoids situations in which he may be subject to judgment or criticism. The main goal of treatment would involve increasing exposure to such social situations or reducing anxiety from the stressful situations.
However BT was not insulated from events happening outside it. The “cognitive revolution” in psychology took place in the 1960s, and by the 1970s many behavior therapists influenced by it began to call their therapy “Cognitive Behavior Therapy” (CBT). Wilson (1982) states:
During the 1950s and 1960s, the behavior therapies developed within the framework of classical and operant conditioning principles that had originally served importantly to distinguish behavior therapy from other clinical approaches. Over the course of the 1970s, this conceptual commitment to conditioning theory peaked out — some would say even waned. In part this change reflected the shift to more technological considerations governing the increasingly broad application of behavioral techniques that had been developed and refined during the previous period of growth. Moreover, as psychology “went cognitive” during the 1970s, cognitive concepts inevitably were drawn upon to guide and explain treatment strategies, (p. 51).
Mahoney, an early leader in CBT, stated a similar theme (1984):
By the late 1970s it was clear that cognitive behavior therapy was not a fad; indeed it had its own special interest group in the AABT (Association for the Advancement of Behavior Therapy). It had become a more frequent topic at conventions, in journals, and in research, and it had become more pervasively integrated into behavioral psychotherapies. Behavior therapy, like psychology in general, had “gone cognitive.” (p. 9)
Part of this movement argued that learning research was still relevant but the research that should influence second-generation behavior therapy was human learning research that examined cognitive mediators of learning. The argument was that conditioning in humans is not automatic and direct, but rather is mediated by the person’s verbal and cognitive abilities. Awareness, attention, expectancy, attribution, and linguistic representation were constructs thought to be necessary to account for learning. The argument was that animal conditioning models were inadequate for the study of human learning because these neglected to include the unique abilities of humans such as verbal abilities. Thus, these animal conditioning models needed to be supplemented or replaced by cognitive accounts.
Therefore, the advent of cognitivism in the 1960’s brought about a paradigm shift within the field of experimental psychology. While the behavioural model had regarded cognitive processes as an epiphenomenon, a new approach appeared that considered cognitive knowledge of central importance in psychological investigation, while still maintaining an empirical view.
Cognitive therapy is thus born (Beck, Shaw, Rush & Emery, 1979; Meichenbaum, 1977; Mahoney, 1974) and with it, the second generation of BT. The concept of associative learning was abandoned leaving room for more flexible principles which took into account the role of internal experiences (thoughts and feelings) in determining human behavior; humans are, first and foremost, thinking beings, capable of organizing their behavior and modifying it according to circumstances (Bandura, 1969).
The study of irrational thoughts (Ellis, 1977) and cognitive schemata of mental illness (Beck, 1993) has identified how certain errors of cognition can be pervasive in certain types of patients and, for each of these, a variety of techniques are aimed at changing negative automatic thoughts. Returning to the example of the individual with social anxiety, the objectives of graded exposure in social situations, or the reduction of anxiety in relation to those same situations, are extended to include questioning the validity of the automatic thoughts related to the social situation, as well as the judgment of others.
Therefore it is the integration between the first two generations of BT that gives rise to the concept of CBT, which is characterized by a form of psychotherapy aimed at modifying not only overt behaviors but also beliefs, attitudes, cognitive styles and expectations of the client (Galeazzi & Meazzini, 2004).
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 These include: Mindfulness-based Cognitive Therapy (mBct) and Mindfulness-Based Stress Reduction (mBsr), Acceptance and Commitment Therapy (act), Dialectical Behavior Therapy (dBt), Functional Analytic Psychotherapy (Fap) and Integrative Behavioral Couples Therapy (iBct).