cbt_article - From Practicing Cognitive Therapy: A Guide to...

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Leahy: Introduction 1 From Practicing Cognitive Therapy: A Guide to Interventions Edited by Robert L. Leahy © Jason Aronson Publishing. www.Aronson.com CHAPTER 1 INTRODUCTION: FUNDAMENTALS OF COGNITIVE THERAPY Robert L. Leahy, Ph.D. Cornell University Medical College and The American Institute for Cognitive Therapy, NYC Twenty years ago cognitive therapy was identified with the treatment of depression. Aaron Beck’s seminal work in the 1970's proposed that depression is the consequence of the conscious negative thoughts of the depressive who viewed self, experience and the future as bleak and empty. Beck proposed that specific cognitive content characterized each psychiatric disorder and that the goal of therapy was to identify and modify the patient’s distortions or biases in thinking and the patient’s idiosyncratic cognitive schemata. The cognitive model suggested that neurotic functioning was maintained and aggravated by the self-fulfilling negative information processing of the patient. In a similar orientation, Abramson, Seligman and Teasdale (1978) advanced the attributional model of depression which proposed that depression is the consequence of negative explanatory style. Depressive pessimism and low self-esteem were seen as the consequence of attributing negative events to lasting personality traits of the self that led the depressive to generalize failure to other tasks and to future events. Similar to Beck’s cognitive model, the attributional model stressed the conscious thought processes of depressed individuals, but focused on the patient’s attributions of causality for failure and success and the patient’s disposition to generalized negatives across situations and over time. Beck, Shaw, Rush and Emery (1979) published the treatment manual, Cognitive Therapy of Depression , which not only provided clinicians with detailed guidelines for the treatment of patients, but also provided researchers with a standardized treatment protocol for outcome studies of cognitive therapy of depression. Since the publication of the treatment manual, an overwhelming number of outcome studies have demonstrated that cognitive therapy is as effective as medication in the treatment of depression and may have long-term preventative advantages. In addition to the substantial empirical support for the treatment model, the cognitive model of depression has also received wide empirical support, demonstrating that depression is characterized by the distortions in information processing that Beck and his colleagues had first proposed (Dobson, 1989; Hollon, DeRubeis, & Evans, 1996). Beck’s cognitive model of psychopathology was never limited to a specific diagnostic category. Rather, the cognitive model posits that different psychopathological conditions are characterized by specific cognitive schemata. Thus, depression is associated with negative schemata of failure, loss, and emptiness, anxiety is characterized by threat, imminence, and danger, and
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cbt_article - From Practicing Cognitive Therapy: A Guide to...

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