CBT [Cognitive Behaviour Therapy] –
A MISUNDERSTOOD TERM ?

It is clear to me that increasingly many people [including health professionals who should know better] think that CBT is a single type of therapy developed by the American Aaron T. Beck. Actually it is not. Why is this important ? Amongst other reasons I believe that you have the right to know what type of therapy you are thinking of engaging in. So let me try and clear up some misconceptions for you.

CBT is a term describing a collection of therapies which have as their fundamental guiding principles the experimentally proved notion that neurosis are generated largely from certain distortions of reality based on erroneous presumptions and assumptions, and that these incorrect conceptions originate in defective learning during the person’s development.

Whilst the philosophical underpinnings of CBT go back thousands of years it was only in the 1950’s, with the development of behaviour therapy and cognitive psychology that certain influential practitioners of therapy started to formulate their ideas, largely as a reaction to what they considered to be the ineffective and inefficient results being obtained by the practice of psychoanalysis.

The Department of Health recommend CBT as a treatment of choice for psychological difficulties and suggest that psychological treatment should routinely be considered as an option when assessing such difficulties.

Amongst the most widely used forms of CBT today are:-

REBT [ Rational Emotive Behaviour Therapy.]
CT [Cognitive Therapy.]
Attributional Therapy
Stress Inoculation Therapy.

I will concentrate on only the first two of these.

REBT AND CT

REBT:- Founder Albert Ellis [ b.1913]
CT :- Founder Aaron T. Beck. [b. 1921]

In the UK I think it is accurate to report that REBT and its founder, Albert Ellis have not received the recognition they deserve. Ellis was the first therapist and psychologist in the 1950’s to develop ideas about CBT and within this general framework he first called his therapy Rational Therapy and then Rational Emotive Behaviour Therapy. Today other forms of therapy, within the CBT discipline, continue to develop and use many of Ellis’s ideas which he started half a century ago. I share the views of others that Ellis is a giant in the therapeutic world – a startling original and influential thinker whose work will continue to be recognised amongst the very best in this field.

Shortly after Ellis began developing and writing about REBT Aaron T. Beck, another American began working on what he labelled Cognitive Therapy [CT]. It is generally accepted that Ellis and Beck coincidentally developed their ideas separately. Whilst there are some important distinctions between CT and REBT they nevertheless share fundamental ideas too.

Beck’s CT has become the most popular and best validated form of CBT. There are a number of complex reasons why this is the case, but I don’t want to complicate the issue by a speculative discussion on the matter. What is beyond doubt is that Ellis and Beck are the leaders in the field of CBT and we owe them both a debt of gratitude for their seminal work.

Both REBT and CT share important ideas about what are the basic reasons for all human’s predispositions to disturb themselves. Differences emerge in the specific concepts each theory employs and in the type of clinical interventions utilised. I like to think of the important difference between REBT and CBT as follows:-

Ellis (REBT) would probably agree with most of Beck’s (CT) ideas about psychological disturbances, but whereas Beck would suggest that it’s people’s core beliefs and schemas which are the drivers of disturbances Ellis might say “yes. I agree to some extent, but it’s the demanding dogmatic or ‘musting’ part of the belief or schema, which is the main problem and its this which needs to be changed to produce elegant results.”

I turn now to describe in a little more detail the ideas and clinical interventions used in REBT and CT.

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www.cbtuk.co.uk