Cognitive Therapy

Cognitive therapy is based on the idea that beliefs determine feelings and behavior. Albert Ellis, who along with Aaron Beck pioneered the cognitive approach to therapy, favored this quote by the Stoic philosopher Epictetus (first century A.D.): “What disturbs people's minds is not events but their judgments on events.” Cognitive therapists use a variety of techniques and approaches to identify and then modify the cognitive distortions and irrational beliefs that clients bring to counseling. Thoughts are typically defined as distorted or irrational when they do not square with reality or cannot be supported with objective evidence, and when they cause emotional problems such as depression and anxiety.

Cognitive therapists utilize the counseling relationship to educate their clients about how thinking affects feelings and behaviors. Cognitive therapists formally or informally assess clients' patterns of thinking and how their beliefs have contributed to their current problems. A variety of techniques can then be employed to help clients challenge and modify problematic cognitions. For example, the counselor and client often discuss the veracity of the client's beliefs and whether they can be defended rationally. Clients also may be asked to keep records of irrational thoughts, read books or articles about the principles of cognitive therapy, and participate in role-plays with the therapist that challenge beliefs about inadequacies clients perceive in their relationships with other people. The underlying goal of these interventions is to modify the irrational or distorted thoughts that are causing problems for the client.

Over the past several decades, cognitive therapy has been increasingly integrated with behavior counseling into a broad category labeled cognitive-behavioral therapy (CBT). Both cognitive and behavioral counseling were developed during the mid-20th century, in part because of the dissatisfaction by some with Sigmund Freud's psychoanalysis and because of emerging research on human cognition and behavior. [Page 509]Classic behavioral approaches initially rejected any attempt to incorporate the role of clients' thoughts into counseling, but eventually were strongly influenced by the science of cognitive psychology. In a similar way, cognitive therapists such as Ellis and Beck initially focused very little attention on their clients' behaviors and increasingly incorporated more and more behavioral elements into their approaches.

Ellis pioneered cognitive therapy with his original formulation of what he called rational-emotive therapy because of what he saw as the limitations and myths associated with psychoanalysis. He has gradually reshaped it to be an integration of both cognitive and behavioral counseling, and fittingly relabeled it rational emotive behavior therapy (REBT). Beck initially developed his brand of cognitive therapy to explain the psychological processes that led to depression. While Aaron Beck acknowledged Ellis's influence in the development of cognitive therapy, today Beck's approach remains unique in its primary emphasis on cognitive factors in therapy. Many theorists have influenced the development of cognitive therapy in addition to Ellis and Beck, so it has much less historical cohesion than theories dominated by a single theoretician. The remainder of this entry will focus on the counseling models of Ellis and Beck, cognitive therapy's two most prominent theorists, and will conclude with a brief review of research and current trends in cognitive therapy.

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