CBT, or cognitive behavioral therapy, is one of the most popular forms of therapy in the field of Psychology (Beck & Beck, 2011). You may remember our recent article on Positive CBT, where we break down just how positive psychology is finding its way in this division of psychotherapy.
To appreciate where Positive CBT is heading, we must first look at how CBT began and what a typical CBT therapist is like. Therein we can find ways that positive psychology may be added, incorporated, and integrated into this fascinating form of therapy.
What is Cognitive Behavioral Therapy
In short, cognitive behavioral therapy treats the client as a person whose maladaptive thinking has lead to changes in their emotions and behavior (Beck & Beck, 2011). These changes affect the relationship that clients have with themselves and others.
The goal of CBT is to see beyond the diagnosis and to look at the person as a whole to decide what needs to be “fixed” (Kaplan & Saccuzzo, 2013).
The basic steps of Cognitive-Behavioral Assessment include identifying critical behaviors, determine whether their behaviors are excesses or deficits, and evaluate critical behaviors for frequency, duration, or intensity. If the critical behaviors are in excess, attempt to decrease the frequency or intensity; if there is a deficit, attempt to increase behavioral frequency, intensity, and duration.
CBT Pioneers: Dr. Aaron T. Beck and Albert Ellis
Dr. Aaron T. Beck
CBT was pioneered by Dr. Aaron T. Beck, a psychiatrist at the Univeristy of Pennsylvania during the 1960s. Dr. Beck was originally practicing psychoanalysis, but then later designed and carried out several experiments to test psychoanalytic concepts on depression (Beck Institute, 2015). To his surprise, the experimental results left the psychoanalytic fundamental concepts invalid.
In response to his findings, Dr. Beck looked at other ways to conceptualize depression. His most important finding was that patients had a stream of negative thoughts that seemed to arise spontaneously without the patient’s control; He called this “automatic thoughts.” (Beck Institute, 2015).
Dr. Beck used this new concept to help patients identify and evaluate their automatic thoughts to allow patients to think more realistically. As a result, their thoughts affected their behavior and emotions and were able to to behave more functionally (Beck Institute, 2015). When patients successfully changed their thoughts, it changed their beliefs about themselves, the world, and other people in the long-run.
Dr. Beck called this new approach “Cognitive therapy” and it later became known as “Cognitive Behavioral Therapy.”
Dr. Albert Ellis
The first intentional therapeutic approach to distance itself from Psychoanalysis was Rational Emotive Therapy (RET), originated by Albert Ellis, Ph.D. Ellis developed this approach because he found Psychoanalytic therapy to be inefficient and “non-directive” in nature (National Association of Cognitive-Behavioral Therapists, 2008).
RET was influenced by Behaviorism, Asian, Greek, Roman, and modern philosophers (Ellis, 1994). It focuses on resolving emotional and behavioral disturbances to help people lead happier lives (Ellis, 1994).
Ellis developed and popularized the ABC model of emotions based on the RET assumption. The ABC model of emotions can be simply described as such:
How to become a CBT therapist
A typical CBT session consists of face-to-face sessions between the patient and therapist. Sessions are made up of about 6-18 sessions and they last for around an hour with a gap of 1-3 weeks between each session (Beck & Beck, 2011). Since CBT allies itself with the scientist-practitioner model, the therapist approaches each issue like a scientist would.
The CBT Therapist operationalizes the problem, emphasizes what measurement should be used to evaluate the patient’s cognitive thoughts and behavior, and works with the patient on how to meet their goals. The goals are usually met through the help of homework assignments that the patient will have to complete before the next session. Each homework assignment indicates to the therapist the progress of the patient and his compliance and desire to change.
Effective CBT therapy is heavily dependent on the therapeutic alliance formed between therapist and patient. The patient is very involved in what occurs during therapy sessions so there is a certain amount of flexibility and willingness on how to approach each issue at hand.
This differs from other forms of therapy where one works as the authority figure.
CBT versus Coaching
Coaching, like CBT, is also a partnership between a coach and client where the coach provides exercises, active listening, and homework to help a client move towards his or her goals (Springman, 2012).
The one-on-one format of coaching is similar to therapy, but therapy tends to focus on feelings and experiences related to past events and coaching tends to focus on goal setting and moving forward in the future. A therapist also works with more dysfunctional behaviors and thoughts and a coach tends to work with a functional person who is focusing on self-improvement (Springman, 2012).
CBT versus Positive Psychology
Watch this brilliantly informative and short video of Dr. Aaron T. Beck explaining the main differences and similarities between CBT and positive psychology.
Can you think of ways to include CBT in your practice? Sound off below!
Beck Institute. (2015). Beck's Cognitive Therapy. Retrieved from http://www.beckinstitute.org/history-of-cbt/
Beck, J. S., & Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond. New York: Guilford Press.
Ellis, A. (1994). Reason and emotion in psychotherapy. Secaucus, NJ: Carol Pub. Group.
Kaplan, R. M., & Saccuzzo, D. P. (2013). Psychological testing: Principles, applications, & issues. Belmont, CA: Wadsworth, Cengage Learning.
National Association of Cognitive-Behavioral Therapists. (2008). History of Cognitive-Behavioral Therapy. Retrieved from http://nacbt.org/historyofcbt.htm
Springman, K. (2012). Research Paper: Cognitive-Behavioral to Improve Self-Esteem for Coaching Clients. Retrieved from http://www.icoachacademy.com/blog/coaching-resources/research-papers/kylie-springman-cbt-to-improve-self-esteem/