The classification of cognitive therapies shows us that the common feature of all interventions is to consider cognition as a determinant of behavior.
However, therapies differ on the basis of the importance given to the different cognitive processes involved. These can be activated by the same ones that motivate human learning.
Cognitive therapies always offer treatments based on a cognitive approach to the problem. Furthermore, they consider that learning is much more complex than the simple stimulus-response association. Starting from the therapeutic intervention, cognitive processes are considered as the main determinants of behavior.
The therapies are different and do not present a single theoretical framework that can bring them together in a general theoretical model. However, in the classification of cognitive therapies they are considered to be part of the same group: cognitive-behavioral therapies.
Classification of cognitive therapies
Three main classes of cognitive therapies have been proposed (Mahoney and Arnkoff, 1978):
- The methods of cognitive restructuring. They assume that emotional problems are a consequence of maladaptive thoughts. The use of these methods is aimed at establishing more adaptive thought patterns.
- Coping strategies. These therapies try to develop skills in the patient that allow him to cope with stressful situations.
- Problem solving therapies. They are a combination of the two previous approaches and aim to get the patient to develop general strategies for dealing with a wide range of personal problems. These therapies consider the active collaboration between therapist and patient to be very important.
Cognitive therapies based on cognitive restructuring
These therapies are aimed at identifying and changing the patient’s erroneous beliefs : irrational beliefs, distorted thoughts, negative self-verbalizations.
Among the many, the most representative are: Ellis’ Rational Emotional Behavioral Therapy, Aaron Beck’s Cognitive Therapy and Marvin Goldfried’s Emotional Restructuring Therapy.
Rational Emotional Behavioral Therapy (REBT) by Albert Ellis
This theory holds that most psychological problems are due to the presence of maladaptive (irrational) patterns. People largely control their destiny, and their behavior is heavily influenced by beliefs and values.
Rational Emotional Behavioral Therapy (REBT) is a brief psychotherapeutic intervention that helps patients identify negative thoughts and emotions that lead to self-defeat. Additionally, it analyzes and tests the rationality of these negative beliefs by replacing them with more productive and constructive thoughts.
REBT’s approach focuses primarily on the present to help patients understand the mechanisms, thought patterns, and beliefs that caused discomfort and discomfort.
A malaise which, in turn, leads to behaviors and actions that are harmful and that interfere with the achievement of goals or emotional balance.
Aaron Beck’s Cognitive Therapy
Emotional and / or behavioral disturbances would be the result of an alteration in the processing of information caused by the activation of latent patterns. The central elements of this theory are:
- The development in childhood of a series of basic patterns that people use to organize their cognitive system.
- Automatic thoughts or mental representations without having first elaborated a reasoning.
- Cognitive distortions and errors in information processing.
- Stressful life episodes that can activate dysfunctional basic patterns.
Marvin Goldfried’s Rational Systemic Restructuring Therapy
This theory develops from Ellis’ REBT and aims to be more specific in order to be adapted to a self-control procedure . Therefore, the goal of the theory is to teach patients the skills through which they can face and manage problem situations. By doing so, they can find more reasonable solutions to situations that make them uncomfortable.
Meichenbaum self-education therapy
This theory is based on the work of Luria and Vygotsky on the importance of “inner language” in the regulation of behavior. The historical precedent of the self-instruction training technique dates back to the work done in the 1960s with aggressive and hyperactive children.
Unlike Rational Emotional Behavior Therapy, in this case the focus is more on the ability to change behavior and emotions through self-verbalization and less on the patient’s system of irrational beliefs and ideas. The procedure to be followed should consist of:
- Loud external guide.
- Give self-instructions aloud.
- Self-instruction in a low voice.
- Masked self-instructions.
Cognitive therapies based on coping skills
These therapies are meant to teach skills so that the person can adequately cope with problem situations.
The most relevant are: Meichenbaum’s stress inoculation therapy and Suinn and Richardson’s theory of anxiety management.
Meichenbaum stress inoculation therapy
It is based on the development of skills and abilities that can allow patients to reduce / cancel tension and physiological activation. It also allows you to replace previous negative interpretations with a series of positive thoughts that help cope with stress.
In the practice of stress inoculation, three phases can be distinguished which sometimes overlap with each other. These stages are:
- Skills acquisition and training.
- Application of acquired skills.
Suinn and Richardson’s Theory of Anxiety Management
The goal of this therapy is to teach the patient to relax them and use other skills. The aim, therefore, is to control the anxious reactions that arise in various situations.
The effects of this therapy seem positive, and not only with regard to generalized anxiety. It is also useful for countering anxiety about an exam or fear of public speaking.
According to the authors, this therapy would seem superior to systematic desensitization as it causes positive effects in the three response channels (affective, behavioral and somatic). It also lowers blood pressure, improves performance, and scales problematic cognitions.
Classification of cognitive therapies: problem-solving therapies
These therapies aim to correct the way people deal with problems. In addition, they provide a systematic method for solving problem situations.
Problem solving therapy by D’Zurilla and Golfried
It aims to teach the person a systematic method for solving problems. It therefore provides methods for analyzing and evaluating possible opinions on a problem. Furthermore, it offers a particular perspective from which to interpret the world around us.
It is very effective in combination with the other techniques. Furthermore, it is the most widely used problem-solving therapy with the most applications and experimental studies.
Interpersonal Problem Solving Technique by Myrna B. Shure and George Spivack
The goal of this therapy is to improve adaptation and social skills. To achieve this, we work on the skills that allow us to solve interpersonal problems.
Let’s first define what we mean by problem: a problem occurs when you don’t have an immediate and effective answer to deal with a situation.
The skills that measure social adaptation are alternative thinking and causal thinking. There are also strategic or half-end thinking (ages 8-10 through adolescence) and consequential thinking (during adolescence).
Mahoney’s personal science
This therapy aims to train the subject to diagnose and control his own confrontational behavior as if it were his doctor.
The means used are: modeling, systematic reinforcement, gradual completion of tasks and the acquisition of self-assessment skills. It is perhaps the most tempting therapy for people who appreciate and love science, control and competition.