Classification Of Cognitive Therapies

The classification of cognitive therapies is based on the fact that the common feature of all of them is to consider cognition as a determinant element of behavior. However, they differ in the importance they give to the different processes involved. These cognitive processes can be activated in therapy and motivate behavior learning.

Cognitive therapies always design treatments based on a cognitive view of the problem. They consider that learning is much more complex than the formation of stimulus-response associations. From the therapeutic intervention, it is necessary to address the cognitive processes, as these are considered the main determinants of behavior.

The therapies are diverse and lack a unifying theoretical framework that makes them cohesive in a general theoretical model, but it is common for them to be classified within the same group: cognitive-behavioral therapies.

Classification of cognitive therapies

Three main types of cognitive therapies have been proposed (Mahoney and Arnkoff, 1978):

•  Cognitive restructuring methods, which assume that emotional problems are a consequence of maladaptive thoughts and, therefore, their interventions try to establish better thought patterns.
• Coping skills therapies  , which deal with developing a repertoire of skills to help the patient face a series of stressful situations.
• Problem solving therapies , which are a combination of the two previous types and which focus on developing general strategies to treat a wide range of personal problems, stress the importance of active collaboration between the patient and the therapist.

Cognitive therapies based on cognitive restructuring

They are aimed at identifying and changing cognitive patterns, such as irrational beliefs, distorted thoughts or negative self-verbalizations.

The most representative currents would be Ellis’ rational emotive therapy, Aaron Beck’s cognitive therapy and Marvin Goldfried’s emotional restructuring therapy.

Rational Emotive Therapy (TREC) by Albert Ellis

This theory proposes that most psychological problems are due to the presence of maladaptive (irrational) thought patterns. People are largely in control of their own destinies, and their behaviors are heavily influenced by personal beliefs and values.

Rational Emotive Behavioral Therapy (TREC) is a form of short-term psychotherapy that helps to identify the thoughts and emotions that lead to self-defeat. It reviews and tests the rationality of these feelings, replacing them with more productive and convenient beliefs.

TREC’s current focuses mainly on the present to help understand the mechanisms and schemes of thought and beliefs that cause discomfort. A malaise that, in turn, generates harmful actions and behaviors that interfere with the achievement of goals and emotional balance.

Beck’s cognitive therapy

Emotional and behavioral disorders would be the result of an alteration in information processing resulting from the activation of latent schemas. The central elements of this theory are:

• People develop, in their childhood, a series of basic schemas that serve to organize their cognitive system.
• They can have thoughts or mental representations automatically, without the intervention of a previous rationalization process.
• They can commit cognitive distortions and errors in information processing.

• Stressful life events can trigger dysfunctional basic schemas.

Goldfried’s Systemic Rational Restructuring Therapy

It was developed from Ellis’ TREC, as an attempt to get a higher specification and adapt it to a self-control procedure. The objective is to teach clients coping skills and managing problematic situations that allow them to adopt more reasonable perspectives on disturbing events.

Meichenbaum self-instruction therapy

This theory is based on the work of Luria and Vygotsky on the importance of internal language in the regulation of behavior. The historical antecedents of the technique of training in self-instructions go back to the work done in the 60s with hyperactive and aggressive children.

Unlike rational emotive therapy, this training focuses more on the ability to modify behavior and emotions through self-verbalizations. The patient’s system of irrational beliefs and ideas is less important.

The procedure would be as follows:

• Modeling.
• External guide out loud.
• Self-instructions out loud.
• Self-instructions in low voice.
• Covert self-instructions.

Cognitive therapies based on coping skills

These therapies are about teaching the skills so that a person can adequately face problematic situations.

The most relevant are Meinchenbaum’s stress inoculation therapy and Suinn and Richardson’s anxiety management theory.

Meichenbaum Stress Inoculation Therapy

This therapy is based on developing or providing subjects with skills and dexterities that allow reducing or canceling tension and physiological activation and replacing previous negative interpretations with an arsenal of positive thoughts for coping with stress.

Stress inoculation training involves three phases, which sometimes overlap with each other. These phases are:

• Conceptualization phase.
• Skills acquisition and training phase.
• Application phase of acquired skills.

Suinn and Richardson’s Theory of Anxiety Training and Management

The aim of this therapy is to teach the client to use relaxation techniques and other skills in a wide variety of situations, in order to control their anxiety reactions.

The results of this therapy seem to be positive, not only in relation to generalized anxiety, but also in relation to anxiety about facts such as evidence or fear of public speaking.

In the author’s judgment , it also seems superior to systematic desensitization, causing favorable effects in the three response channels – affective, behavioral and somatic -, reducing blood pressure, improving performance and decreasing problematic cognitive processing.

Cognitive Therapies Based on Problem Solving

These are aimed at correcting the way in which the person approaches problems, providing a systematic method to resolve any type of situation.

Problem Solving Therapy by D’Zurilla and Golfried

It intends to teach the person a systematic method for solving problems. It provides methods for the person to analyze and evaluate possible opinions and offers a particular perspective for interpreting the world.

It is effective when combined with other techniques and is the most used problem-solving therapy, with the greatest number of applications and experimental studies.

Spivack and Shure’s interpersonal problem solving technique

The goal of this therapy is to increase fit and social competence. To do this, work on interpersonal problem solving skills.

It is necessary to define what constitutes a problem : a problem arises when an effective response is not immediately available to deal with the situation.

Skills that improve social adjustment would be alternative thinking, causal thinking (from age 8 or 10 to adolescence) and consecutive thinking (during adolescence).

Mahoney’s Personal Science

The therapy is designed to train the subject as a personal scientist in diagnosing and managing his own conflicted behavior.

The means for this are modeling, systematic reinforcement, gradual completion of tasks and the acquisition of self-assessment skills. It is perhaps the most attractive option for people who value science, control and competence.