Cognitive Restructuring

Description of the Strategy

Cognitive restructuring is a broad term encompassing a variety of procedures designed to eliminate maladaptive thinking patterns and increase the frequency of constructive thoughts and beliefs. The roots of cognitive restructuring may be traced to cognitive psychology. Cognitive theorists proposed that most learning in humans is cognitively mediated (i.e., thoughts influence perceptions and behavior). A major tenet of cognitive therapy is that through the modification of clients' thought processes, their belief systems will be altered, and this ultimately will result in changes in overt behavior and emotional processing.

The work of Albert Ellis was quite influential with respect to the development and proliferation of cognitive and cognitive-behavioral therapies. Ellis termed his approach “rational emotive therapy (RET).” According to Ellis, psychological disorders are the product of irrational thinking patterns. For Ellis, irrational thoughts are those that could be considered self-defeating in that they reduce opportunities for fulfillment and adaptive functioning. Categories of irrational thoughts include thinking that one must receive approval from everyone—all the time, one must succeed in every task, that it is catastrophic when something does not go one's way; and that things will always be the same, nothing will ever get better. Treatment involves the therapist challenging these faulty beliefs and assisting the client in substituting more rational thoughts.

Other theorists whose work was highly influential in setting the stage for the development of cognitive restructuring procedures included Aaron Beck and Donald Meichenbaum. Each emphasized the importance of cognitive processes to socioemotional functioning and the need to address maladaptive cognitions in an effort to reduce symptoms of psychological disorders. In 1974, Goldfried and colleagues detailed a more structured form of RET, which they referred to as systematic rational restructuring (SRR). Essentially, SRR was a set of specific operational procedures for obtaining the type of cognitive change noted as essential within RET. Subsequently, in their text on therapeutic strategies, Cormier and Cormier classified strategies designed to effect cognitive change under the umbrella term “cognitive restructuring.” The term has been used since that time to refer to various techniques intended to enhance more adaptive thinking on the part of clients.

A typical cognitive restructuring procedure includes the following elements: the therapist provides the client with the theoretical rationale underlying the procedure and outlines how the therapy will take place; through formal assessment and discussion, the therapist identifies the client's maladaptive thoughts, perceptions, and beliefs; the therapist models more adaptive coping thoughts; the client practices adaptive coping thoughts when faced with the occurrence of irrational thoughts; and ultimately the client is taught to go beyond coping, to the induction of more pervasive positive self-talk intended to enhance self-concept. Imagery and role play may be used to facilitate cognitive rehearsal. Homework assignments typically are a routine part of cognitive restructuring therapy in an effort to increase generalization and maintenance. Self-monitoring logs or diaries assist the client in identifying irrational thoughts as well as antecedents and consequences. Two complementary goals of cognitive restructuring are (a) to help clients learn to cope more effectively when in stressful situations and (b) to alter clients' belief systems so that situations that once would have been perceived as stressful will no longer be seen as such, should they arise in the future. It is the second goal that would be indicative of successful “restructuring” per se.

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