Brief Overview of Cognitive Therapy

   Studies of clinical significance have demonstrated that cognitive therapy  provides effective treatment for depression and produce clinically significant benefits for a substantial number of clients (Persons, J., Davidson, J., & Tompkins, M). Many studies have reported that cognitive therapy has greater long-term effects than drug therapy (Beck, A & Weishaar, p.201). Cognitive therapy has become more and more popular over the years because it is a short-term form of psychotherapy that is cost-effective and tend to present empirically validated results.

    The immediate goal of cognitive therapy is to  address symptom relief, including behavioral problems and distortions in logic.Its ultimate goal is to eliminate systematic  Cognitive Distortions. It is often critical  to focus on a very specific problem and provide rapid relief in the first session. It works best in cases where the problems can be delineated and cognitive distortions are apparent. It produces the best results for patients who can recognize the relationships among thoughts, behavior, and feelings and take responsibility of self-help.The main emphasis of cognitive therapy is on realism and not optmism. The goal is to become "more accurate in one's self assessments and perceptions of the world and the future" (Hollon, S. D., Thase, M. E., & Markowitz, J. C. p. 61).

       The client's beliefs are treated as testable hypotheses to be examined through behavioral experiments agreed upon both by the client and the therapist. The role of the therapist is  to ask questions in order to elicit the meaning, function, usefullness, and consequences of the patient's beliefs. It is up to the patient to ultimately decide whether to reject,  modify, or maintain personal beliefs by weighing the emotional and behavioral consequences.It is never the intent of the therapist  to exhort or cajole the patient to adopt a new set of beliefs.Unlike what many people think, cognitive therapy is not the substitution of negative beliefs by positive ones. Cognitive therapy does not maintain that problems are imaginary either. It is the patients biased views of themselves, their situations, and resources that jeopardize their well-being. The role of emotions in cognitive change is to enhance learning of new ways to cope with environmental stressors, but the emphasis is always on the primacy of cognition in promoting therapeutic change. During the initial sessions, the therapist builds rapport with the client and focus on eliciting essential information. A list of defined problems is generated  and misconceptions about therapy are clarified by the therapist (Beck, A., & Weishaar, M., p.299).
 

    Three Fundamental Concepts of Cognitive Therapy are:

Collaborative empiricism: therapist and client become investigators by examining the evidence to support or reject the patient's cognitions.
Empirical evidence is used to determine whether particular cognitions serve any useful purpose.

Socratic Dialogue:the major therapeutic device is questioning through the Socratic method, which involves the creation of a series of questions to a)clarify and define problems, b) assist in the identification of thoughts, images and assumptions, c)examine the meanings of events for the patient, and d) assess the consequences of maintaining maladaptive thoughts and behaviors.

Guided Discovery:therapist elucidates behavioral problems and faulty thinking by designing new experiences that lead to acquisition of new skills and perspectives. Through both cognitive and behavioral methods, the patient discovers more adaptive ways of thinking and coping with environmental stressors by correcting cognitive processing.

In a nutshell: "Cognitive therapy is present-centered, directive, active, problem-oriented."
 
 

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