The History of Cognitive Behavioural Therapy (CBT)

Cognitive behavioural therapy (CBT) is a popular psychological treatment which has been shown to be effective in treating common disorders such as anxiety and depression.

CBT is not a new therapy by any means and it has a practical structure which makes it easily measurable. These factors have resulted in a large body of successful clinical trials which, more recently, have secured its position as one of a range of recommended treatments on the NHS.

What is CBT?

Cognitive behavioural therapy is a type of talking therapy which involves identifying and challenging unhelpful thoughts.  It works to help people learn alternative thinking patterns and behaviours which can then improve the way they feel. CBT explores the relationship between feelings, thoughts, and behaviours, and evolved from two distinct schools of psychology: behaviourism and cognitive therapy. Its roots can be traced to these two approaches.

Behavioural Therapy Roots

Behavioural treatment for mental disorders has been around since the early 1900’s. Key proponents like Skinner, Pavlov, and Watson developed theories of change and behavioural treatments.  Behaviourism is based on the idea that behaviours can be measured, modelled, and changed.

The first wave of behavioural therapy came about in the 1930/40s in response to the emotional impacts faced by the many WWII veterans returning from war. This need for effective short-term therapy for depression and anxiety coincided with a build up of behavioural research regarding how people learn to behave and react to life situations.  Behaviourism offered an alternative to the dominant model of that time, psychoanalysis.

Cognitive Therapy Roots

American psychologist Albert Ellis was one of the key figures who developed cognitive therapy.  He stressed the importance of thoughts/feelings and behaviours and devised a theory called rational emotive behaviour therapy (REBT) in the 1950s. This is now considered one of the earliest forms of cognitive psychotherapy. It is based on the idea that a person’s emotional distress arises from their thoughts about an event rather than the actual event itself.

In the 1950s and 1960s, American psychiatrist Aaron T. Beck noticed patterns with his depressed clients.  They seemed to hold negative views of self, others and their future, and no matter how much exploration of their past occurred, these negative views did not shift.   This led him to start researching whether holding negative views about self, others and the world, might be part of the reason somebody was depressed.  Cognitive therapy was up and running.

Automatic Thoughts in Cognitive Therapy

Beck understood the importance of the link between thoughts and feelings, and he coined the term “automatic thoughts” to describe the thoughts that pop up in people’s minds. He discovered that although people aren’t always aware of these thoughts, they can learn to identify and report them. He found that people who were upset had negative thoughts that tended to be unrealistic, and by uncovering and challenging these thoughts, long-lasting and positive change can result. In essence, CBT helps people to recognise their thoughts and test them out.  This then allows the possibility of finding alternatives and opens up choice.

By the 1960s, a number of empirical studies into how cognitions affect behaviours and emotions were carried out. This period became known as the cognitive revolution. It emphasised the role that conscious thinking plays in psychotherapy.

Combining the Approaches

Behavioural therapies were successful in treating a number of conditions, including phobias and anxiety.  As the popularity of cognitive therapies began to soar, therapists started to use behavioural techniques and incorporate these to successfully treat disorders.  Although each of these schools of thought has a different emphasis, both are concerned with what is happening to the individual in the here and now.

CBT can be Helpful in Treating a Range of Issues

CBT continues to evaluate it’s techniques and treatments.  This has built up a large body of  research about its effectiveness for use with  a broad range of psychological issues.   It has been shown as an effective form of therapy for treating a range of conditions, including:

• Anxiety
• Panic Disorder
• Depression
• OCD – Obsessive Compulsive Disorder
• Phobias
• Irritable Bowel Syndrome
• Chronic Fatigue
• Eating Disorders

CBT and Other Therapies

Today, a number of therapies blend cognitive and behavioural elements into their approach, including:

• Integrative Psychotherapy
• Reality therapy
• Multimodal therapy
• Eye movement desensitisation and reprocessing
• Cognitive processing therapy
• Acceptance and commitment therapy
• Dialectical behaviour therapy

Further Reading on CBT and Issues it Can Help With

How Cognitive Behavioural Therapy Can Help Treat Anxiety Disorders

How Can Cognitive Behavioural Therapy Help to Treat Depression?

Panic Attacks: How Can Cognitive Behavioural Therapy Help?

Cognitive Distortions and Thinking Errors – How Can CBT Help?

CBT Therapy in London