Psychotherapy Services in South West London

The origins of CBT Cognitive Behavioural Therapy

CBT’s origins can be traced back over 60 years, to the beginning of behaviourism, a time when the psychoanalytic paradigm, concerned with the internal, conscious and unconscious dynamics of the mind, was dominant. The behaviourists put great importance on evidence and observable, measurable behaviour and proposed that here was no need to refer to such hypothetical constructs as the mind at all. The therapeutic implications of this meant a radical change, with behavioural therapy focusing on activities such as retraining via direct experience and using concepts such as behavioural activation, exposure, and de-sensitisation. These remains on many forms of CBT today. The field of cognitive psychology, which developed largely as a response to the behaviourists, brought the focus back onto internal mental process, with Beck (1967-1976) postulating that the source of human distress was maladaptive thinking. He found that directing therapy towards cognitive processes produced significant therapeutic change. Subsequently, cognitive therapy adopted the concepts of core beliefs and rules for living which were seen as sources for biases in automatic thoughts (Padesky, 2004). Thus therapy shifted from interpretation of the unconscious in psychoanalytic therapy and behavioural change in behavioural therapy to psycho-education, Socratic questioning and ever-evolving formulations in cognitive therapy. Key principles included collaboration and openness between client and therapist, guided discovery and the exploration of alternative thoughts and ideas that not only relieved current distress but also built longer term resilience. The integration of cognitive and behavioural therapies CBT produced a stronger more effective therapy.

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