Cognitive therapy by Aaron Beck.


Cognitive therapy by A. Beck is one of the most well-known and actively promoted psychotherapies cognitivist tradition. A. Beck comes from the idea that mental disorders associated with the aberration (distortion) of thinking — the distorted cognitive processing of information. The result is a maladaptive cognitions — this is any cognitive content that causes inappropriate affect and maladaptive behavior. br>
Cognitive distortions are automatic, that is, occur spontaneously and are not recognized. Functionally they do not contribute to improving the quality of life and social functioning, but rather to increase the exclusion and the associated risks. Cognitive biases are ego-sinonime: they are not represented to the patient the wrong thing to be questioned and the more pathological ("How can I not weep?"); in a sense, they are perceived by the patient as objectively necessary. Automatic ego-syntonia cognitive distortions based on some "basic ideas", considered as the characteristic features of the patient. Mental disorder occurs, according to A. Beck, in predisposed individuals whose personality structure is vulnerable to certain types of situations. Moreover, the person is considered as a set of stable cognitive schemas. br>
Thus, the basis of cognitive therapy by A. Beck is the hypothesis of the presence of pathogenic distortion of cognitive processes that trigger the actual mental pain. This hypothesis seems quite reasonable. Could not agree more with the fact that the usual content of thought of the patient often represents an extremely complex problem for the physician is that often no less difficult than the behavioural symptoms. It is known, for example, changes that can sometimes be achieved in depressed patients using the behavioral techniques of psychotherapy that do not entail changes in the cognitive structures, and patients remain under constant threat of a relapse: any stress can precipitate essentially destructive cognitive processes by running the usual cognitive pattern for processing new experiences. br>
the Goal of therapy is to correct maladaptive cognitions of the patient. The task of the cognitive therapist is thus to identify disturbed, "unrealistic" cognitive schema and try to correct that wrong, "nonlogical" thinking through repeated confrontation of these schemes with conflicting information obtained in the patient experience in the process of play situations and homework. The expected result of therapy is replacement of maladaptive cognitive schemas, or, at least, an increase in the degree of control of the patient over existing maladaptive cognitive schemas.

Cognitive therapy usually involves four stages:

In the first stage the patient learns to identify maladaptive thoughts. br>
the second step is separation of the patient from the content of thinking, doing patient objective positions in relation to their own maladaptive thoughts. A special difficulty is, according to A. Beck, the achievement of ego-disconnect maladaptive experiences. There are also other difficulties, patients fairly quickly learn to identify non-adaptive content experiences and are quite aware of ego-disconnect of these experiences, their ambiguity, groundlessness, however, persistently reported on the continuing severity of the affect associated with those experiences.

the third stage of therapy is performed checking the validity of maladaptive thoughts. Obtained in the course of such verification, the confirmation of the groundlessness and nastynasty non-adaptive content allows the patient to realize that these thoughts are not related to the actual state of Affairs, and its own personality. br>
In the fourth stage of treatment is replacement of maladaptive cognitions to adaptive. For example, accompanying a panic attack autonomic symptoms — palpitations, tachycardia, hyperventilation, sense of impending inevitable death threats, etc. reinterpreters therapist as the symptoms of anxiety disorders, which in itself is not threatening the patient's life.

the Form of cognitive therapy typically individual, but the group forms, including contraindications for group therapy

Duration of cognitive therapy by A. Beck — about 10-20 sessions for 12-20 weeks, although it may vary within wide limits. However, A. Beck warns novice therapists concerning unrealistic expectations about the speed with sustainable impact. br>
the Success of cognitive therapy depends on the patient took the basic situation of dependence of emotions on thinking. Willingness to cooperate and a tendency to introspection, a research facility of the patient also contribute to the success of the therapy. The indications for cognitive therapy by A. Beck, the lungs are depressive and anxiety disorders, social phobia, panic attacks, obsessive-compulsive disorder, post-traumatic stress disorder, addictive behavior. A. Beck believed also that cognitive therapy can serve as a sufficient means of self-help. The combined use of medication and cognitive therapy gives, as a rule, more stable and fast results compared to isolated use of drugs or isolated application of cognitive psychotherapy. Some of the health care system and insurance funds of several countries based on data from the evaluation of the effectiveness of cognitive therapy, see it as the primary therapy for these disorders and include in insurance plans.

Contraindications to therapy are psychotic disorders and severe depressive episodes, high level of anxiety of the patient, lack of consent of the patient and therapist about the goals of therapy. There are, however, reports of successful application of cognitive therapy by A. Beck when working with schizophrenic patients. It is inappropriate to use cognitive therapy as a standalone intervention for problems in which it is possible to identify issues of personal growth.

Tarutino Elina
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