Critically evaluate the use of Becks Cognitive Theory and identity its strengths and weaknesses.

Clearly identify its historical perspectives and underlying philosophy.

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Cognitive therapy was originally developed by Dr Aaron Beck, an American psychiatrist, in the 1960s. Aaron Beck was born in Providence, in 18 July 1921, the third and youngest child of three descendents. Beck started as a psychoanalyst, however through is career he started to question the effectiveness of psychoanalysis in the treatment of various mental disorders. (Hough, 2001) Furthermore, his doubts about the psychoanalytic model started when he tried to find empirical support for some psychodynamic prepositions about depression. Yet he found some irregularities in the psychoanalytic model. In particular, the psychoanalytic tenet suggested that depressed persons exhibited masochism or need to suffer. (Alford and Beck, 1997) However contrarily to what he has expecting the outcome of laboratory studies have shown that depressed individuals tended to improved by doing graded task assignments rather than resist. The findings from the past studies lead Beck and his colleagues to do further research and clinical observations in order to understand the irregularities found previously. The final result from these subsequent studies was the development of the cognitive therapy of depression. (Alford and Beck, 1997) He ended up rejecting psychoanalysis because he thought this approach ignored the cognitive factors involved with depressive illness. (Hough, 2001) A Central principle of Becks cognitive therapy is the idea that faulty thinking underpins many psychological problems. In order to help clients cope with their thinking difficulties, Beck designed procedures whereby distorted patterns of thought, which create emotional problems or interfere with a persons social functioning, are identified and changed. (Hough, 2001)

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Beck defended the premise that the human mind is not submissive to its nature and nurture, but instead the individuals thoughts are actively responsible for constructing his own reality. (Neenan and Dryden, 2004) This line of thinking can be traced back from stoic philosophers of the fourth century. In particular Beck acknowledge Edictetus statement Men are disturbed not by things, but by the views which they take of them. (Dayringer and Eicher, pag 72, 1995) Furthermore, to understand the emotional distress attached to a particular situation it is necessary to find out the persons views of the event. (Neenan and Dryden, 2004) For example, two different persons may have different perceptions about one particular situation; one thinks that she will never cope after the boyfriend left her, while the other might think that its her own fault that the relationship did not last due to her bad temper. . (Neenan and Dryden, 2004) Even though the situation is the same it has different emotional responses because these are mediated by the individuals personal view of the event. Thus in order to change negative feelings about a particular event it is essential to change the person view about them. (Neenan and Dryden, 2004) This does not mean that emotional problems are solely created by the person thoughts but that the impact of unpleasant life experiences can be aggravated by the persons irrational thoughts

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and beliefs that interfere with the ability to cope with such experiences (e.g. I shouldnt have fail the exam. Im useless; I will never pass an exam again). (Neenan and Dryden, 2004) Cognitive therapy helps clients to develop different points of view so they learn how to cope better with aversive events. Developing more positive points of views highlights the main principles of the cognitive theory, that there is always other alternative ways of interpreting life experiences. (Neenan and Dryden, 2004) Beck originally focused his theory and research in the treatment of depression, however over the years the theory has been redefined, and it has been successfully adapted to a great variety of different disorders and populations. (Beck, 1995) The conceptualization of the theory has been adapted accordingly to a particular mental disorder changing the focus, the different techniques used, and length of treatment, but the theoretical underlined assumptions themselves have remained constant. In overall, the cognitive model suggests that dysfunctional thinking is a common aspect to all psychological disorders. (Beck, 1995) The Cognitive Theory is based on an information-processing model which postulates that psychological distress a persons thinking becomes more rigid and dysfunctional, mental evaluations become over-generalized and absolute, and the persons basic beliefs about the self and the world become fixed (Weisharr, 1996:188). In his model Beck (1967) distinguished three different levels of cognition, which probably have an effect in depression and its treatment. The three levels are: automatic thoughts, schemas, and cognitive distortions. (Mahoney, 2000)

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Automatic thoughts are specific to a particular event and emerge to the individual mind when he is experiencing emotional distress. (Neenan and Dryden, 2004) They appear to be at a surface level of cognition, even though the individual is not immediately aware of them. However with the help of a clinician these can be brought into the clients attention. (Mahoney, 2000) Central to Becks cognitive theory of depression is the negative triad: negative view of self, world and future. (Dayringer and Eicher, 1995) According to Beck, negative cognitive evaluations of events lead to negative beliefs of the self, world and future. People suffering from depression commonly see themselves as worthless, unwanted, and incompetent. This negates the idea that evaluations are core beliefs of personal views of the self. Negative views of the self are somehow interrelated with low self-esteem. Individuals with low self-esteem will have a negative view of the self and thus will not know how to focus on their potential but instead they will focus on what they think is wrong with their personality. ( Zauszniewksi and Rong, 1999) Beck (1979) argued that negative views of the self interfere with the individual capacity to solve problems and achieve goals. In addition, people suffering from depression tend to increase their negative thoughts and ultimately it will have an impact on their performance. Past research on depression, have shown that the severity of the illness is highly correlated with low self-control, low self-esteem, and poor performance. ( Zauszniewksi and Rong, 1999) Depressed people do not only have negative views about themselves but they also see the world and the future in a negative way. Their thoughts about the world and their life experiences are usually extremely pessimistic. These negative evaluations are related with perceptions of vulnerability and low self-control. ( Zauszniewksi and Rong, 1999)
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Studies indicate that depressed persons see the world as being something out of their control, and life as a journey full of problems that can never be solved. Due to the fact that these negative views are so embedded in their cognitive process, tasks are seen has something extremely negative and out of their control, considering themselves less skillful to perform them than healthy individuals. ( Zauszniewksi and Rong, 1999) Views of the future are also very negative. This are based on present difficulties and thus depressed people believe that the same problems will going to persist in the future. The view of the future is related with negative views of hopelessness, which is associated with the anticipation of failure as one of its consequences. ( Zauszniewksi and Rong, 1999) Hopelessness also interferes with motivation levels, leading to a reduction of the individual drive to engage in any activity to ameliorate the depressive symptoms. ( Zauszniewksi and Rong, 1999) However the notion of negative triad is mainly used for depression, other mental disorders are described of having distinct thoughts. For example, people suffering from a phobia frequently experience symptoms of fear and consequently have numerous thoughts involving alleged danger. These kinds of thoughts are defined as automatic thoughts due to the fact that they usually arise spontaneously. (Mahoney, 2000) Automatic thoughts manifest the persons evaluation of a particular event rather than the actual event, and they have an immediate response on the person emotional state and behaviour. The emotional and behavioural responses will be negative to the degree that the persons evaluations of the event are distorted or exaggerated, which will happen when culminate from the dysfunctional schemata. (Mahoney, 2000)
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Beck suggested that experiences are categorized by cognitive schemas. (Dayringer and Eicher, ) He established the notion of schemas into cognitive therapy. In his first book he recognized the work of the Swiss philosopher Jean Piaget (1948) as the pioneer for introducing the word schema to explain cognitive structures. (Padesky, 1994) However, Beck developed his own definition for the word schema. According to him a schema is a structure for coding personal beliefs and assumption. It is the process by which the world is organized into relevant cognitive structures of meaning. These are also responsible for coding and retrieving information, as well as allowing new information to be linked old information. (Padesky, 1994) The schemas that are of main importance for cognitive therapy are those who are related to emotional states and behavioural patterns. Schemas do not obligatory cause emotional distress or behavioural problems. Nevertheless, they contribute to the persistency of chronic disorders regardless of the causes of the problem. (Padesky, 1994) Depressive schemas are developed through childhood and are influenced by various factors culture, experience and parents or role models. As consequence of developing depressive schemas the individual builds a negative generalization about the self, world and future. (Dayringer and Eicher, 1995) Schemas have a major influence in the individual cognitive wellbeing because they determine what is remembered by the individual, what information the individual attends to or not and what he or she notices. (Padesky, 1994) When an individual faces a stressful event that is encountered as a negative experience, negative schemas are activated and influence information processing, leading to cognitive distortions.
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Cognitive distortions are the connection between schemas and automatic thoughts. (Mahoney, 2000) Beck (1976) identified eight distinct types of cognitive distortions that tend to be common to individuals suffering from emotional distress. These are: dichotomous thinking, over generalizing, selective abstraction, mind reading, personalizing, should statements, catastrophizing and minimizing. Even though there is a distinction between different kinds of cognitive distortions and they may be theoretically separated, thoughts can reveal more than one kind of distortion. (Mahoney, 2000) The first objective of the cognitive theory is to reduce the symptoms of the respective mental disorder. This is done by challenging the clients automatic thoughts, which in turn lead to an increase in the clients awareness of the automatic thoughts. In order for the therapy to be effective and the client changes enduring it is essential that a reconstruction of dysfunctional attitudes takes place especially in later therapy. (Mahoney, 2000) In cognitive therapy, the key features of the therapeutic relationship between the therapist and the client is rather different from other therapies. Beck (1967) described cognitive therapy as therapeutic method of collaborative empiricism, through which, the therapist and the client work alongside to establish goals, set a plan of action for each therapeutic session, continuously gather information about the clients beliefs system and examine existing evidence that support or refute those beliefs by using hypothesis testing. (Mahoney, 2000) The use of hypothesis testing is done by utilizing the Socratic method of questioning, instead of using direct methods to challenging the clients thoughts and beliefs. The client is guided by the therapist to facilitate discoveries and to create behavioural tests to assess the accuracy of his or
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her automatic thoughts. However the therapist might as well adopt a more directive approach, taking the role of an educator and skills trainer. (Mahoney, 2000) Even thought cognitive therapists in general employ a great variety of behavioural tools, like activity scheduling, problem solving, and relaxation exercises, these are mainly seen as methods to help clients examine and change beliefs about themselves. Cognitive therapy also has its unique therapeutic methods. In the early stage of the therapy Clients are asked to record their negative thoughts in regular basis and to attend to the relationship between events, thoughts and feelings. Through the Socratic method of questioning, the therapist helps the client to assess and evaluate negative thoughts in order to generate alternatives thoughts. In any case the success of the cognitive therapy depends if the clients expectations about the objectives of the therapy are congruent with the ones of the therapist. It is also very important that the client and the therapist share mutual trust, as it is extremely important with any health professional. The collaborative nature of planning therapeutic objectives or goals is one of principal aspect of the cognitive theory. (Beck, Freeman and Davis, 2004) The qualifications of the therapist are also a main factor for an effective delivery of the therapy. One cannot imagine what would happen to a client if someone was delivering the therapy without undertaking training or having a recognized qualification. Therapist is obliged to undergo professional training, and to have supervision as well as acting according to the ethics of their profession. (Barber, Liese and Abrams, 2003)

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Cognitive therapy has been widely tested since 177, when the fist study testing the theory was published. Controlled studies have shown its effectiveness in the treatment of various types of mental disorders, such as panic disorder, substance abuse, eating disorders, social phobia. (Beck, 1995) Some longer investigations have also found support for some of the tenets of the cognitive therapy. Know and Oei (1992) performed a three month study on the interaction between dysfunctional attitudes and negative situations to predict depressive symptoms. The results have shown that the two components interact with one another and from them it can be predicted depressive symptoms. (Abela and DAlessandro, 2002) One of the theoretical limitations of cognitive therapy is the fact that it is not clear what is the mechanism underlying the affect that schemas might have in the cognitive process. (Wells, 2000) The concept of schema has also been a focus of critic by many. One negative aspect is that Beck does not explain how schemas developed initially. Critics have also argued that research supporting cognitive therapy of depression is at its best meaningless or at worst tautological. Coyne and Gotlib (1083) suggested that high displays of negative cognition on written tests are tautological due to the fact that depressive groups are chosen on the basis of symptom measures. For example selection is made by assessing people symptoms through the Beck Depression inventory (BDI), which is composed at least of some negative cognitive items. Therefore the correlation found between cognition and symptoms may the result of item overlap. At its best, they suggested that these studies are meaningless due to the fact that only evident facts are stated by the researchers like the idea that depressed people hold negative views about themselves and life experiences. (Beck, Freeman and Davis, 2004)
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References

Abela, J. and DAlessandro, D. (2002). Becks Cognitive Theory of Depression: A Test of the Diathesis-stress and Causal Mediation Components. British Journal of Clinical Psychology,41, 111-128. Alford, A. and Beck, A. (1997). The Integrative Power of Cognitive Therapy. New York: The Guildford Press Barber, J., Liese, B. and Abrams, M. (2003). Development of the Cognitive Therapy Adherence and Competence Scale. Psychotherapy Research, 13(2), 205-221. Beck, J. (1995). Cognitive Therapy: Basics and Beyond. New York: Guilford Press. Beck, A., Freeman, A. and Davis, D. (2004). Cognitive Therapy of Personality Disorders. New York: Guilford Press. Dayringer, R. and Eicher, B. (1995). Dealing with Depression: Five Pastoral Interventions. New York: Haworth Press. Esbensen, A. and Benson, B. (2007). An evaluation of Becks cognitive theory of depression in adults with intellectual disability. Journal of Intellectual Disability Research, 51(1), 14-24. Hough, M. (2001). Groupwork Skills and Theory. London: Edward Arnold Lt Jones, R. (2000). Six Key Approaches to Counseling and Therapy. London:Martins the Printers, Ltd. Mahoney, M. (2000). Cognitive Constructive Psychotherapies: Theory, Research, and Practice. New York: Springer Publishing Company. Neenan, M. and Dryden, W. (2004). Cognitive therapy: 100 Key points and Techniques. New York: Brunner-Routledge.

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Wells, Adrian. (2000). Emotional Disorders and Metacognition: Innovative Cognitive Therapy. Chilchester: John Wiley & Sons, Ltd. Padesky, C. (1994). Schema Change Processes in Cognitive Therapy. Clinical Psychology and Psychotherapy, 1(5), 276-278. ( Zauszniewksi and Rong, 1999)

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