Cognitive therapy
Aaron Beck (1921-)
o Born in Rhode Island
o Completed a psychiatry rotation against his wishes
o Began his research into depression in 1950s
Rejected psychoanalytical account based on data
o Currently professor Emeritus of the Beck institution for cognitive therapy and
research
o Authored/co-authored over 375 articles and many books
o Developed important tests used throughout clinical psychology, including
beck depression inventory (BDI)
Basic principles of CT
o Information processing critical for survival
o Covers how we feel and behave, based on how we perceive and structure our
experiences (cognition)
o Schemas
They’re fundamental beliefs and assumptions about self, others and
goals
Develop early in life through experiences
Can be adaptive or maladaptive
Selection and preparation of incoming information
Psychological distress
o Evolutionary, biological, environmental and developmental factors all
contribute to potential for psychological distress
o Because of our schemas, we all have a set of unique cognitive vulnerabilities
which predispose us to distress
o Psychological disorders lead to dysfunctional schemas -> systematic bias in
information processing
o Systematic bias – shift to rigid, absolutist thinking
o Characterised by ‘logical errors’ – cognitive distortions
Distorted biases
o Dichotomous thinking – evaluating experiences as extremes – no grey area
just extremes
o Arbitrary inferences – drawing conclusions without evidence
o Magnification/minimization – evaluating events as far more or less important
than they are
o Selective abstraction – drawing conclusions based on only a selection of
evidence – cherry picking evidence
o Personalisation – evaluating events as related to the self when it sometimes
isn’t – over dramatizing events relating it to your self
o Over-generalisation – drawing conclusions from a single event
, Automatic thoughts
o Involuntary, recurring words or images that occur rapidly at the edge of
awareness
o Similar to Freud’s ‘preconscious’ and Ellis’ ‘self talk’
o Reflect schema content
o In psychological disorder: negative automatic thoughts (NATS)
o E.g. something terrible is going to happen. I cant cope I’m useless. Ill never
get out of this mess.
Cognitive model: depression
o Systematic bias toward negative information in 3 areas: the cognitive triad
Self – I’m worthless
World – no one likes me
Future – ill never amount to anything
o As depression worsens > depressive schema more activated > increase in
cognitive distortions – like a self-deprecating prophecy.
Part two
Beck’s cognitive therapy
Goals of Therapy - Correct faulty information processing
o Symptom relief – remove systematic biases. Mo;dify fundamental beliefs &
assumptions that predispose to future distress.
o Treat beliefs and automatic thoughts as testable hypotheses
o Learn to become own therapist
o Some similarities with Elis’ REBT
Process
o In-depth initial session: functional and cognitive analysis
o Drawing up ‘problem lists’ – what’s the most important problems and how
will we address these
o Weekly, 5-16 sessions – less intense than other approaches e.g. REBT
o Homework
o Rogerian therapeutic style (unlike Ellis)
o Therapist acts as coinvestigator – collaborative empiricism
o Therapist acts as a guide – not about disputing beliefs more guiding them to
discovering the changes needing to be made
Cognitive interventions
o Replace distorted NATs and beliefs with more realistic information processing
Elicit and identify NATs- providing reasons for thoughts, encourage
engagement, self monitoring
reality-test and correct NATs – Socratic dialogues, de catastrophising
& decentring and forming more adaptive responses to situations
and identify and alter NATs – Socratic dialogues (questioning),
hypothesis testing and refashioning beliefs
behavioural interventions
o lay foundation for cognitive interventions
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