As previously mentioned, cognitive type therapies have grown out of the tradition of behavior therapy. Therefore they all still contain the use of behavioral strategies and continue to emphasize the importance of behavior change. However, beyond behavior change, cognitive therapy emphasizes the importance of changing self-defeating and/or unrealistic thinking patterns as much or even more than the need for behavior change. The idea that “thinking” (cognition) is of central importance to our emotional life is as ancient as the Romans and Classical Greeks. Epictetus, a famous roman stoic philosopher is often quoted by traditional cognitive therapists..”men are not disturbed by things, but by what they think about things”.
All traditional forms of cognitive therapy also rely on behavioral change and interventions. Therefore, for practical purposes the term “cognitive therapy”, is largely interchangeable with the term, “cognitive-behavior therapy”. Some of the general hallmarks of traditional Cognitive-behavior therapy are; they are empirically based treatments (scientifically based in their theories and scientifically proven in their results), they are generally shorter-term, they expect the active and equal involvement of both therapist and patient. CBT encourages goal setting, goals often include the changing of both behavior and thinking patterns, they set session agendas; they emphasize the present over the past, and encourage a mutual effort at identifying, challenging, and testing the beliefs which guide our lives.
Cognitive Therapy (CT) technically refers to a specific type of cognitive-behavior therapy invented by Aaron Beck MD in the early 1960’s (www.beckinstitute.org). He is often considered one of two founding fathers of cognitive type therapies. Albert Ellis, PhD, is the other founding father of traditional cognitive therapies. He was working at the same time as Dr. Beck, and is also given credit for emphasizing the role of ‘cognitions” (thinking) in our emotional and behavioral reactions. Both Dr. Beck’s Cognitive-Therapy (CT) and Dr. Ellis’s, Rational Emotive Behavior Therapy (REBT), along with several similar traditions are what is meant when people refer to “Cognitive Behavior Therapy (CBT).
The differences among traditional cognitive behavior therapies seem academic to those not intimately familiar with the fine details of either theory.
For those who are curious about the differences among traditional Beckian (CT) or Ellis’s (REBT) cognitive therapies, the major differences are as follows; both would acknowledge the importance of behavior change. Both theorize the central role of changing ones thinking for improving quality of life and mental health. Both see distorted and/irrational thinking maintain, as worsening, maintaining and possibly even causing some mental disorders. The differences can be seen in how one goes about changing thinking. Rational Emotive Behavior Therapists (REBT) Dr. Ellis and therapists practicing his type of cognitive behavior therapy, they don’t mind more forcefully pointing out and arguing with the universal irrational ideas that all patients are likely to bring into therapy. They believe most humans repeatedly tell themselves all sort of childish things and then believe that these irrational ideas are true and necessary in life. A REBT therapists styles vary but Dr. Ellis was famous for confronting his patient’s irrational ideas head on, sometimes shocking his patients out of their demanding, obsessive ideas with direct and forceful disputation.
In Dr. Beck’s Cognitive Therapy (CT), the therapist acts as a Socratic guide, in a mutual effort to identify and then test out a thoughts accuracy and usefulness. The CT therapist has no predetermined set of irrational thoughts to be argued away and replaced with a set of rational ideas. The decision about which thoughts are distorted is determined by how well mutually collected evidence supports various identified thoughts. Types of thoughts to test could include; predictions, expectations (if y then x), appraisals, attributions and assumptions, even thoughts about thoughts (meta-thoughts). Traditional Beckian CT is unique in emphasizing this “hypothesis testing” strategy to assess the accuracy and usefulness of out thinking. Dr. Beck has started an association, the Academy of Cognitive Therapy (www.academyofct.org), which has begun to officially standardize and certify therapists who are officially doing this form of cognitive therapy. We are fortunate two have staff who have become members of the Academy of Cognitive Therapy in both our Brooklyn & Long Island offices. For more info on CT & Dr. Beck, see our “New Articles” section for both reading and a great NPR audio broadcast on Cognitive Therapy.