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By James Cowart, Ph.D. next page
The most important reason for utilizing Cognitive-behavioral Therapy (CBT) is that this type of therapy has been validated more than any other type of therapy as being effective in treating many of the clinical problems that plague the human condition. Different variations of CBT have been shown to be most effective or one of the most effective for problems such as Panic Disorder, Agoraphobia, Social Phobia, Obsessive-compulsive Disorder, Generalized Anxiety Disorder, Post-traumatic Stress Disorder, as well as chronic depression and many other diverse problems. There is no need to review that research here since it has been done much more thoroughly elsewhere. (If you "click on" the link to "Recommended treatments for Anxiety" section of this website, then scroll down to the very bottom of the page and click on the bottom link, you will be directed to a web site maintained by the Clinical Division of the American Psychological Association). There you can review summaries of the research evidence that support the efficacy of CBT).
Another important reason to utilize CBT is because it tends to de-mystify treatment and de-stigmatize the patient. Individuals who want to change can understand how their early life experiences may have "taught" them maladaptive patterns of thinking, feeling and behaving that underlie their current problems and symptoms. CBT is largely based on models of social learning and behavioral learning that have been widely validated by decades of research. CBT is a therapy application of the science of learning. It is based on principles of learning.
These principles first began to be identified when Pavlov did his initial experiments on conditioning, almost 80 years ago. These initial experiments involved reflexes produced by involuntary muscles. Pavlov showed that, after training, "neutral stimuli" also became able to elicit the reflex response. One type of conditioning involves the fear response (also known as the "fight or flight response". Today fear conditioning is quite well understood and helps us to understand how fears and anxiety can spread (or generalize) to new situations that are similar to the original traumatic situation. Likewise, these same learning principles help us to understand how fears become extinguished through step-by-step exposure to the feared situations.
Later on other researchers helped to identify another type of learning principle: involving behavior that is produced by the voluntary muscles. It became clear that behavior that is reinforced will become stronger and more frequent while behavior that is punished or not reinforced will become weaker.
Finally, through the work of Skinner and others, it became more and more clear that thoughts and memories are really just another type of behavior or more accurately "cognitive behavior". Our extensive use of language sets us apart from other animals. Language (or verbal behavior) has many functions. One of those functions can at times be detrimental, since language acquires, through each individual's past experiences, the ability to elicit various emotional states, including fear, sadness, etc. Later on, when the individual automatically or voluntarily produces a thought or memory, the emotion attached to that thought or memory is also produced. That is why adults in therapy are often helped to counteract negative thoughts and memories, in order to "rewrite their toxic script" and feel less anxious or depressed.
An individual's early life experiences, sometimes combined with biological predisposition, can lay the groundwork for later adult disorders. When children are physically, sexually or emotionally abused or when children are simply not paid attention to (neglected) the child typically develops a characteristic method of coping with that traumatic environment. That method of coping serves to buffer the child from some of the emotional pain of living within a dysfunctional environment. Parents, step-parents, siblings and the child's peers at school and in the neighborhood are all important actors in the child's early environment and a child's development may be helped or harmed by individuals from each of these groups.
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