From Practicing Cognitive Therapy: A Guide to Interventions
Edited by Robert L. Leahy
© Jason Aronson Publishing.
FUNDAMENTALS OF COGNITIVE THERAPY
Robert L. Leahy, Ph.D.
Cornell University Medical College
The American Institute for Cognitive Therapy, NYC
Twenty years ago cognitive therapy was identified with the treatment of depression.
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
, 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