There are many different approaches to psychotherapy. Some therapists identify with a particular orientation, while others are more eclectic, drawing from different orientations. Many therapists use some forms of cognitive or cognitive-behavioral therapy at times.
Cognitive therapy seeks to help people change how they think about things. Albert Ellis's Rational Emotive Behavior Therapy is an example of this. Ellis considers strong emotions to result from an interaction between events in the environment and beliefs and expectations which we have. Some of these beliefs are too strong or rigid (such as the belief "Everyone should like me."). The patient or client learns to modify the belief so that it is less extreme and less likely to get in the way (such as "I like for people to like me, but I realize that not everyone is going to.").
Aaron Beck developed a treatment for anxiety and depression based on cognitive theory. Patients tune into their internal dialogue in order to change maladaptive thinking patterns. Beck developed specific procedures to help challenge a depressive client's assumptions and beliefs. Patients learn how to change their thinking.
John Cook summarizes Beck's approach to therapy for anxiety in the following quote:
This theory describes the role of faulty thinking in making us anxious, and suggests a way to recover from it through cognitive restructuring. According to Beck and Emery, the way we process information is governed by structures called schemata. These schemata are made up of rules for explaining incoming information, and for retrieving what we have already learned. They are capable of exerting powerful effects on how we experience and relate to the world. For example, the schemata of a person with a social phobia cause them to become anxious and avoidant by explaining incoming information and memories in terms of social threat. Treatment consists of correcting faulty or illogical thinking by repeatedly confronting cognitive schemata with discrepant information from role-playing and homework assignments. (John Cook, Ph.D., Principles of Treatment - formerly available Online)
It has been difficult to research the effectiveness of psychotherapy, since the term can refer to so many different activities. Cognitive therapy lends itself well to research. It tends to be short- to moderate-term, in contrast to some other orientations.
Depression and anxiety can be treated with medications, or psychotherapy, or both. Some research has shown that the combination of medications and therapy can be particularly effective. While some anxiety medications can result in dependence, this is rarely true of antidepressants.
Managed care companies sometimes encourage family doctors to prescribe medications rather than refer to a mental health professional for psychotherapy. There are times when this may be appropriate, but there are other times when psychotherapy is clearly indicated. If you are taking an antidepressant or an anxiety medication and you believe that part of the problem is not being addressed, consider seeking help from a mental health professional.
Self-Help Books that utilize a Cognitive approach:
Feeling Good : The New Mood Therapy by David D. Burns The book Feeling Good was one of the first self-help books providing cognitive techniques to help depressed people when it was published in 1981.Paperback.
The Feeling Good Handbookby David D. Burns The follow-up to Feeling Good. This book provides more information in a format which is easier to use. Paperback
Last updated 11/05/05
