Cognitive-behavioural therapy is used in psychotherapy by appropriately qualified and trained professionals in a variety of health care settings, such as: psychotherapy, clinical and forensic psychology, psychiatry, nursing and social work, to address psychological disorders, as well as emotional and behavioural difficulties. Information regarding eligibility to practice as an Accredited CBT Psychotherapist can be found here:
Cognitive therapy emerged from the work of Albert Ellis (1955) and Aaron. T. Beck (1963, 1964 and 1979) who are considered to be the founders of cognitive therapy. Ellis went on to create what became known as Rational Emotive Behaviour Therapy (R.E.B.T.), with its emphasis on irrational beliefs, stemming from a person’s inferences and evaluations about situations that in turn contribute to emotional disturbances. Further reading and information can be found at www.arebt.org Cognitive therapy evolved to incorporate behavioural therapy, becoming CBT, with the “Beckian model” being the most widely known. The “third wave” of CBT has since developed to include mindfulness CBT, schema focussed therapy, acceptance and commitment therapy and cognitive analytical therapy, for example. Further information and suggested reading can be found at www.babcp.org
CBT stresses the importance of the interaction between cognitions (thoughts), emotions, physiology and behaviours in the development and maintenance of psychological disorders, emotional or behavioural difficulties. Whilst CBT does not dwell on the past, it does take relevant historical factors and a person’s particular childhood environment into consideration.
The way in which we process information is influenced by thinking styles, particularly cognitive biases that are most active at times of emotional distress. In anxiety the most prominent theme is one of threat or danger, particularly overestimating danger and underestimating ones ability to cope with the particular threat or danger. An example would be one person having catastrophic thoughts about a pending social event, "not knowing” what to say to others and “knowing” that people will think that they are “stupid”. Another person going to the same event, who does not experience social anxiety, will view it as an opportunity to meet new people. In depression, the prominent theme is one of hopelessness in relation to the self, the future and the person’s particular world. Hopelessness can lead to inactivity, self defeating behaviours like overeating, social isolation and increased hopelessness; which forms a vicious cycle or a maintenance cycle. Other difficulties are addressed using the basic CBT theoretical framework, but taking their particular perpetuating thoughts and behaviours into account.
Therapy addresses unhelpful styles of thinking, erroneous and irrational beliefs that are driven and maintained by inaccurate inferences and evaluations of a person’s particular situation. Self defeating and harmful behaviours are similarly addressed.
The rationale of the cognitive therapies is, therefore, to establish a more accurate, helpful and rational evaluation of difficulties that we all experience from time to time. At the end of therapy, you will have the skills and knowledge to meet life’s adversities in a more balanced and rational manner.
How do we know it works? CBT is one of the most widely researched psychological therapies and there is a firm research base which demonstrates its efficacy and effectiveness. It is for this reason that it is the most widely used psychological therapy in the NHS. You may wish to read more about this in The National Institute for Health and Care Excellence (NICE) guidelines, which are followed in the NHS and by Accredited CBT Psychotherapists working in the independent sector. Please see: