2 Cognitive Therapy DAVID J. A. DOZOIS AND AARON T. BECK
More than 45 years ago, Beck (1963, 1964) introduced his conceptual model of the role of cognition in depression and its treatment. Today, the main tenets of cognitive theory are well-supported by the empirical literature. Moreover, cognitive therapy (and generic cognitive-behavioral therapy) is one of the most actively researched psychotherapies (Butler, Chapman, Forman, & Beck, 2006), is consistently listed among the empirically supported therapies for a host of mental health problems and conditions (Chambless & Ollendick, 2001; DeRubeis & Crits-Christoph, 1998), and is believed to be as effective or superior to other dominant treatments, including antidepressant medication for depression (DeRubeis, Webb, Tang, & Beck, 2010). This chapter describes cognitive theory and therapy with an emphasis on Beck’s cognitive model. We begin by highlighting the main conceptual axioms of the cognitive model and its treatment techniques. Following this overview, we discuss the role that mindfulness- and acceptance-based strategies have played in the development of this model over time. As the reader will discern, our contention is that some notions of acceptance have, for some time, played a role (albeit a minor one relative to direct cognitive change strategies) in cognitive therapy (e.g., Beck, Emery, & Greenberg, 1985). Although mindfulness- and acceptance-based approaches may hold some philosophical assumptions that differ from that of traditional cognitive therapy, these newer forms of therapy are compatible with and complementary to cognitive therapy and represent logical extensions in its evolution (Hofmann, 2008a, Hofmann & Asmundson, 2008). In addition, we argue that achieving awareness and acceptance is only one step towards the crucial change that improves symptoms and well-being, namely cognitive change. The chapter concludes with a review of the empirical evidence of cognitive theory and therapy.
THE COGNITIVE MODEL OF PSYCHOPATHOLOGY AND TREATMENT Cognitive Theory The original formulation of the model underlying cognitive therapy has its roots in the philosophy of Immanuel Kant (1781/1929), who argued that the mind actively 26
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