COGNITIVE-BEHAVIOURAL THERAPY Cognitive-Behavioural Therapy (CBT) now has quite a long history. It should be noted that the approach did not begin as a new theoretical orientation in its own right but gradually absorbed a variety of heterogeneous concepts from other approaches that had developed in various historical periods. The second part of the name (‘behavioural’) relates to Behaviourism, a theoretical perspective which developed in the early twentieth century following the work of the researchers John B. Watson and I.P. Pavlov. Psychologists who adhered to behaviourist concepts and ideals restricted their attention to behaviour that was observable. They studied human responses to certain environmental stimuli and tried to ascertain how these responses could be modified by introducing conditioning factors (see glossary). Cognitivism on the other hand, the term from which the first part of the name derives, developed in the 1960s. This field of study focuses on the mental processes which allow us to structure and make sense of our experiences, comparing and relating them one to the other. Within the clinical sphere, the cognitivist perspective proposes that underlying a great number of psychological disorders there are systematic distortions of thought, which generate erroneous assumptions and irrational convictions. In time, these distortions become transformed into relatively stable thought patterns or mental schemes that draw an individual into a self-perpetuating vicious circle. For example, a person who believes he/she simply has to be perfect in every enterprise he/she undertakes will tend to experience extremely negative feelings every time he/she happens to make a mistake. Underlying such negative emotions there is an error in reasoning and in the interpretations of reality of the subject affected. In the 1960s, the psychotherapist Albert Ellis developed what he referred to as Rational-Emotional Therapy (RET), which addresses these distorted thoughts in particular, helping patients to challenge their convictions and replace them with other more useful ideas, such as: <<Even though it would be just great not to make any mistakes, that still doesn’t mean I have to be perfect>>. In this way, a person who up until that time had only seen things from one point of view - and a maladaptive one at that – may gradually learn to adopt different types of reasoning based on different interpretations of his/her experiences and reality.
A further fundamental aspect of this therapeutic approach is the work on the emotions carried out by the patient with the aid of the therapist, through which the subject learns to recognise and control his/her feelings. The emotions are in fact considered as the direct product of an individual’s cognitions and interpretation of reality. At the same time, CBT intervenes directly on the patient’s behaviour; new thoughts, now re-elaborated and rendered more functional, are accompanied by coherent behaviour. It thus becomes possible for the person to construct new paradigms of interpretation and behaviour, which will be maintained over time as, with practice, the new way of thinking and reasoning and, consequently, of behaving becomes consolidated. Another effective form of therapy is that developed by the psychiatrist A.T. Beck. The chief characteristics of CBT can be summarised as follows:
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Research carried out in this field was later found to be particularly fruitful for the treatment of phobias, and eventually led to the introduction of effective techniques used to desensitize individuals with respect to feared objects or situations.
