Chapter 1: Basic Principles of Cognitive-Behaviour Therapy - Wright, Basco & Thase
Cognitive Behaviour Therapy = a commonsense approach that is based on two central tenets:
1. Our cognitions have a controlling influence on our emotions and behaviour;
2. How we act or behave can strongly affect our thought patterns and emotions.
Aaron T. Beck → first to develop theories and methods for using cognitive and behavioural
interventions for emotional disorders. His early formulations were centred on the role of
maladaptive information processing in depression and anxiety. His first therapy that focused on
cognitions was targeted at reversing dysfunctional cognitions and related behaviours.
The behavioural components in CBT are based on the theories of Pavlov, Skinner and others,
focusing mainly on behavioural interventions such as desensitisation and relaxation training. As
research on behaviour therapy expanded, cognitive theories and strategies were merged in to
add context, depth, and understanding to behavioural interventions.
Cognitive Behavioural Model = cognitive processing is given a central role in the
cognitive-behavioural model, because people continually appraise the significance of events in
the environment around and within them (e.g., stressful events, memories, bodily sensations),
and cognitions are often associated with emotional reactions. In treating problems like social
anxiety, therapists can use methods that target all three areas of pathological functioning
identified in the basic CBT model: cognitions, emotions, and behaviours
→ the basic CB model is purposefully simplified to direct the attention of the clinician to the
relationships among thoughts, emotions, and behaviours to guide treatment interventions
There are three levels of Cognitive Processing:
1. Consciousness → highest level: rationality → allows us to monitor and
assess interactions with environment, link past memories with present,
and control & plan future actions.
2. Automatic Thoughts → cognitions streaming quickly into our mind when
in the middle of situations/recalling events: might be subconsciously aware
of these thoughts, but they are not further analysed.
3. Schemas → core beliefs acting as templates/rules for processing information: allow
humans to screen, filter, code and assign meaning to information from the environment.
CBT is designed to help clients detect and modify (dysfunctional) inner thoughts, and to being
autonomous cognitive into conscious awareness and control
Automatic Thoughts (AT) = often not aware of our AT, but are able to recognise and
understand them if we draw attention to them (do not occur only in emotional disorders).
,→ People with depression & anxiety often experience floods of ATs that are
maladaptive/distorted, generating painful emotional reactions and dysfunctional behaviour.
Cognitive Errors (CE) = Beck theorised (later confirmed by research) that there are
characteristic errors in logic in the automatic thoughts and other cognitions of persons with
emotional disorders. Six main categories of cognitive errors are:
1. Selective Abstraction/Ignoring Evidence → a conclusion is drawn after looking at only a
small portion of the available information: salient data is screened out/ignored to
confirm the person’s biassed view of the situation to fit them.
2. Arbitrary Inference → a conclusion is drawn in the face of contradictory/absent evidence.
3. Overgeneralisation → a conclusion is drawn about one or more isolated incidents and then
is extended illogically to cover broad areas of functioning.
4. Magnification & Minimisation → significance of attribute/event/sense is made big/small.
5. Personalisation → external events are related to oneself when there is little or no basis for
doing so: excessive responsibility or blame is taken for negative events.
6. Absolutistic/All-Or-Nothing Thinking → judgements about personal experiences or others
are placed into one of the two categories (all good/perfect or all bad/failure).
Schemas = basic templates or rules for information processing that underlie the more
superficial layer of automatic thoughts. They take shape in early childhood and are influenced by
a multitude of life experiences, including parents, education, peer experiences, traumas and
success. Schemas are needed to manage the large amounts of information that people encounter
each day, to make timely and appropriate decisions. There are three main groups of schemas:
1. Simple Schemas → rules about physical nature or practical management that may have
little or no effect on psychopathology (→ “a good education pays off).
2. Intermediary Beliefs → conditional rules such as if-then statements that influence
self-esteem and emotional regulation (→ “I must be perfect to be accepted”)
3. Core Beliefs about Self → global and absolute rules for interpreting environmental
information related to self-esteem ( → “I am a failure”)
The goal in CBT is to identify and build up the adaptive schemas while attempting to reduce or
modify the influence of maladaptive schemas.
Stress-Diathesis Hypothesis = the relationship between schemas and automatic thoughts in
depression and other conditions: maladaptive schemas may remain dormant until a stressful life
event activates the core belief. The maladaptive schema is then strengthened to the point that it
stimulates and drives the more superficial stream of negative, automatic thoughts.
Information Processing in Depression & Anxiety
Pathological information processing in depression and anxiety disorders:
, Predominant in Depression Predominant in Anxiety Common to Both Disorders
Hopelessness Fears of Harm or Danger Heightened Automatic Processing
Low Self-Esteem Increased Attention to Maladaptive Schemas
Information about Threats
Negative View of Environment Overestimates Risk Scenarios Increased Frequency of Cog. Errors
AT’s with Negative Themes AT’s with Danger, Risk, Etc. Reduced Problem Solving Capacity
Misattributions Underestimates of Ability to Increased Attention to Self, Perceived
Cope with Feared Scenarios Deficits or Problems
Overestimates of Negative Feedback Misinterpretations of Stimuli
Impaired Performance on Cognitive
Tasks with Effort/Abstract Thinking
Attributional Style in Depression = depressed people assign meaning to life events that are
negatively distorted in three different domains:
1. Internal vs. External → depression is associated with making attributions to life events
that are biassed in an internal direction (e.g. taking excessive blame for negative events).
2. Global vs. Specific → instead of viewing negative events as having only limited
significance, depressed people may conclude these have far-reaching implications.
3. Fixed vs. Changeable → in depression, negative or troubling situations are viewed as being
unchangeable and unlikely to be able to be improved in the future.
Learning, Memory & Cognitive Capacity = depression and anxiety disorders have been
associated with significant impairments in ability to concentrate, reductions in problem-solving
capacity and task performance. In CBT, these cognitive performance deficits are addressed with
interventions, designed to enhance learning and assist clients in improving these skills.
Key Methods of CBT = problem-oriented focus, individualised case conceptualisation,
collaborative-empirical therapeutic relationship, socratic questioning, use of structuring,
psychoeducation and rehearsal to enhance learning, eliciting and modifying automatic thoughts,
uncovering and changing schemas, behavioural methods to reverse patterns of helplessness,
self-defeating behaviour and avoidance, building CBT skills to prevent relapse
Therapy Length & Focus = CBT is often delivered in a short-term format, lasting from 5 - 10
sessions for uncomplicated depression or anxiety. For personality disorders, psychosis, bipolar
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