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Key concepts of CBT (and where RET, etc fits in)
Jim Pretzer · 6/29/97 at 4:20 PM ET
When you ask about the key concepts and major philosophies of RET and Cognitive Behavioral Therapy (CBT), it is difficult to answer concisely. CBT refers to a number of approaches to understanding and treating mental health problems (as well as understanding and modifying human behavior in general). These approaches share a number of concepts and philosophies but there are also major differences among them.
As the name implies, cognitive behavioral approaches take a behavioral understanding of human behavior and add cognition. This may sound simple and straightforward, however, it can be done in a variety of very different ways. Under the heading of CBT you can find a broad range of approaches from radically behavioral approaches which understand cognition as covert verbal behavior stimulus-response conditioning to approaches (such as RET) which emphasize cognition so much that it sometimes sounds as though behavioral principles such as operant conditioning are irrelevant.
You phrased your question as though RET and CBT are synonymous. However, RET is only one of many CBT approaches. I will not try to summarize the key concepts of RET since it is not an approach I use (proponets of RET are hereby invited to contribute their comments). However, here is a summary of the key concepts and major philosophies of another CBT approach, Becks Cognitive Therapy, which I condensed from a chapter I wrote with Aaron Beck (published in Major Theories of Personality Disorder):Cognitive Therapys basic philosophical orientation is phenomenological. It assumes that the individual's perception and interpretation of situations shapes the emotional and behavioral responses to the situation. This is hardly a radical view. Thinkers from Buddha and the ancient Stoic philosophers up to the present have emphasized the idea that humans react to their interpretation of events, not to the actual events themselves and have argued that misperceptions and misinterpretations of events result in much unnecessary distress.
Cognitive Therapy is based on the proposition that much psychopathology is the result of systematic errors, biases, and distortions in perceiving and interpreting events. These cognitive factors are seen as resulting in dysfunctional responses to events which, in turn, may have consequences which serve to perpetuate the dysfunctional cognitions.
The idea of collaborative empiricism is central to the practice of Cognitive Therapy. In the course of therapy, the Cognitive therapist works with his or her client to collect detailed information regarding the specific thoughts, feelings, and actions which occur in problem situations. These observations are used as a basis for developing an individualized understanding of the client which provides a basis for strategic intervention. Collaborative empiricism continues to play an important role as the focus of therapy shifts from assessment to intervention. Many of the specific techniques used to modify dysfunctional thoughts, beliefs, and strategies emphasize using first-hand observation and behavioral experiments to test the validity of dysfunctional automatic thoughts or dysfunctional beliefs and to develop more adaptive alternatives. Rather than relying on the therapists expertise, theoretical deductions, or logic, Cognitive Therapy assumes that empirical observation is the most reliable means for developing valid conceptualizations and effective interventions. In order for the Cognitive therapist to intervene effectively, he or she must endeavor both to understand the individuals subjective experience and to perceive objective reality accurately.
In considering the role of cognition in psychopathology, Cognitive Therapy uses the term cognition broadly to refer to much more than verbal thought of which the individual is self-consciously aware. Cognition is treated as synonymous with information processing and no assumption is made that all important aspects of cognition are verbally mediated, are easily accessible to the individual's awareness, or are subject to the individual's volitional control.
Above all, Cognitive Therapy is a practical approach which has emphasized effective treatment rather than abstract theory. We emphasize basing interventions on an individualized conceptualization of the clients problems not because of any inherent commitment to theory, but because strategic interventions based on a clear conceptualization are more efficient and more effective. Similarly, Cognitive Therapys emphasis on the here-and-now is a matter of practicality rather than philosophy. We find that time spent investigating the factors which perpetuate the psychopathology in the present is usually more productive than time spent investigating the individual's past. This does not mean that Cognitive therapists ignore the individuals past. In fact it can be quite valuable for therapist and client to recreate past traumatic events at times. Cognitive therapists, however, attempt to focus on the past only to the extent that this contributes to understanding and/or modifying the factors which perpetuate the disorder in the present.
Cognitive Therapy and RET have a lot in common both in theory and practice but have some major differences as well. My view is no doubt biased, but RET appears to rely on the therapist confronting the client and convincing the client that his or her beliefs are irrational. It often sounds as though RET believes that rational thinking will eliminate all problems. In Cognitive Therapy we try to work with the client to help them to look critically at their perceptions and beliefs and help them to identify and modify the perceptions and beliefs which contribute to their problems. We also focus on much more than just cognition. It is often important to help clients master the skills they need to cope with problematic situations, to help them cope with intense emotions, and to help them change (or leave) dysfunctional relationships.
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