Theory and Research in Counselling and Psychotherapy

Cognitive Therapy & CBT

Beck, A.T. (1963) 'Thinking and Depression: 1. Idiosyncratic Content and Cognitive Distortions', Archives of General Psychiatry 9:324-33.

This early long-term study, using verbatim transcrips of interviews with patients in psychotherapy, reveals systematic distortions of cognition in patients suffering from depression, anxiety and other conditions, ranging from slight innacuracies in the case of mild neurotics to profound misinterpretations and delusions in the case of psychotics. Distortions are specifically related to the individual patient's particular problem and grow in severity with the severity of the distress. Also see Beck (1964).

Beck, A.T. (1964) 'Thinking and Depression: 2. Theory and Therapy', Archives of General Psychiatry 10:561-71.

This is the companion article to Beck (1963).

Beck, A.T. (1972) 'The Phenomena of Depression: A Synthesis', in Offer and Freeman (1972), pp. 136-58.

This correlational follow-up to Beck (1963) shows significant correlation between severity of depression on the one hand and the degree of negative self-evaluation and pessimism on the other. The strong correlation between a negative view of the future and a negative view of the self supports Beck's view of the role of a 'cognitive triad' in depression (negative view of the situation, negative view of the self, and negative view of the future). See Loeb et al. (1971) for further work indicating not just correlation, but causation.

Beck, A.T. (1976/1979) Cognitive Therapy and the Emotional Disorders. New York: Penguin Books.

"In the broadest sense, cognitive therapy consists of all the approaches that alleviate psychological distress through the medium of correcting faulty conceptions and self-signals. The emphasis on thinking, however, should not obscure the importance of the emotional reactions which are generally the immediate source of distress. It simply means that we get to the person's emotions through his cognitions." (p. 214) In this outstanding classic book, the father of cognitive therapy provides an accessible and intuitively appealing introduction to the field, its underlying principles and techniques. Throughout, he compares and contrasts cognitive therapy with psychoanalysis, behavioural approaches, and neuropsychiatry. In addition to the book's exploration of cognitive therapeutic principles, Beck includes specific material on the cognitive processes at work in depression, anxiety neuroses, phobias and obsessions, and psychosomatic disorders and hysteria.

Having read this book, I am somewhat baffled by the almost vitriolic opposition to its ideas voiced by many proponents of the person-centred approach. Yes, there is a sense in which the therapist offers 'expertise' (anathema to die-hard person-centred proponents) in virtue of having some grasp of cognitive psychology; and yes, the cognitive therapist will work directively (but collaboratively) with the client to help the latter deliberately correct distortions in their perceptions of reality; yet cognitive therapy is at the same time wholeheartedly committed to exploring and taking seriously the client's own particular view of the world (also of primary concern to the person-centred therapist). And while the person-centred therapist might not actively set out to correct a client's distortions of reality, there is a prima facie case for believing that at least some success of person-centred therapy may nonetheless be due to its facilitation of a process whereby the successful client does come to alter his or her perception of reality. In other words, in at least some cases, the upshot may be the same. Provided the client is truly taken seriously and is truly engaged with the therapy entirely voluntarily in both instances, why all the fuss? Perhaps person-centred therapists reading about cognitive techniques envision that they could only be applied in a domineering sort of way, rather than a humanistic and respectful way?

Loeb, A.; A.T. Beck and J. Diggory (1971) 'Differential Effects of Success and Failure on Depressed and Nondepressed Patients', Journal of Nervous and Mental Disease 152: 106-14.

In this card-sorting study, depressed patients showed a significant increase in performance and optimism following a successful experience, going some way toward demonstrating the primacy of negative attitudes in depression as in Beck (1963) and Beck (1972) -- i.e., this study begins to show that it is the negative attitudes causing the depression, rather than the other way around. A later follow-up, reported at a conference in 1972, showed that depressed patients showed significantly higher self-esteem and optimism, as well as more positive views of the future, following a successful experience.

Moorey, S. (2002) 'Cognitive Therapy', in Dryden (2002a), pp. 294-323.

After briefly reviewing the historical context of cognitive therapy, this article offers an up-to-date look at its theory and therapeutic method; it includes a good bibliography and a case study which usefully illuminates the approach.

Selmi, P.; M.H. Klein and J.H. Griest (1982) 'An Investigation of Computer-Assisted Cognitive-Behavior Therapy in the Treatment of Depression', Behavior Research Methods & Instrumentation 14: 181-5.

Note the publication year of this study which suggested that computer-based cognitive therapy could be as effective in treating mild depression as face-to-face interaction with a human therapist!

Simos, G., ed. (2002) Cognitive Behaviour Therapy. Hove: Brunner-Routledge.

By its very nature, cognitive behavioural therapy evolves and develops over time, as growing empirical data and clinical experience with specific client populations suggest new tools and techniques, as well as new theoretical constructs, that can usefully be applied within the overall model of CBT. Intended for the cognitive behavioural therapist in practice, this collective volume edited by Gregoris Simos aims to cover some of these specific new developments in CBT treatment approaches. CounsellingResource.com carries a full review of Simos's Cognitive Behaviour Therapy.

Trower, P.; A. Casey and W. Dryden (1988) Cognitive-Behavioural Counselling in Action. London: Sage.

This book sets out clearly and accessibly the basics of its approach. With particular attention to interventions and to homework, the book is -- like others in the series -- very practical, although at times some readers may find themselves wishing for more depth and detail. The book seems to lean more in the direction of the Ellis strand of thinking than the Beck strand.