The Development Of Cognitive Behavioral Therapy

Aaron Beck pioneered Cognitive Behavioral Therapy (CBT) in the 1960’s. He named fleeting, involuntary thoughts we have “Automatic thoughts” and realized being negative they could be harmful. Beck’s work was influenced by various people including Wilhelm Wundt, who developed experimental psychology, forming ‘The Institute for Experimental Psychology’ at the University of Leipzig in Germany in 1879. Saul McLeod said: “Wundt concentrated on three areas of mental functioning; thoughts, images and feelings. These are the basic areas studied today in cognitive psychology. This means that the study of perceptual processes can be traced back to Wundt. Wundt’s work stimulated interest in cognitive psychology.” McLeod, S (2008).

Ivan Pavlov discovered ‘Classical Conditioning’ in the 1890’s while researching digestion in dogs. The dogs were fed when a bell was rung, Pavlov noticed the dogs began salivating when they heard the bell, even before seeing the food. He deemed this was a learned response rather than automatic. In the 1950s John B. Watson established the psychological school of Behaviorism, Behavioral Therapy (BT). This was in response to ongoing problems people had following the Second World War. Watson put more emphasis on people’s behavior assuming that all behavior is learned from the environment because of classical and operant conditioning.

Behaviorists believe because behavior is learned it can be unlearned. BT was found to be one of the most effective therapies to help people suffering from poor mental health. Watson applied Pavlov’s theory to humans in 1921, studying an infant called Albert who was introduced to various stimuli and showed no fear. One of the stimuli was a white rat, when a loud noise was introduced along with the rat Albert became frightened. The noise induced fear in the child and he became scared of any furry animal. Watson concluded that classical conditioning, learning by association resulted in people developing phobias. He said: “Everything we have been in the habit of calling an 'instinct' today is a result largely of training — belonging to man's learned behavior.”

Watson, J. B. (2017). Burrhus Frederic Skinner's theory of ‘Operant Conditioning’, was influenced by Edward Thorndike’s ‘Law of effect’, which states that behavioral responses which produce a satisfying outcome in a particular situation are likely to reoccur in a similar situation, and uncomfortable or negative responses are less likely to reoccur. Skinner thought that learning by positive and negative reinforcement placed more emphasis on the scientific study of observable behavior rather than introspection. He believed this type of learning led to conditions like eating disorders. He thought classical conditioning oversimplified human behavior and the best way to understand it is studying the cause of people’s actions and their consequences. He conducted animal experiments using a ‘Skinner Box’ to study operant conditioning and determined: “Operant conditioning is a method of learning that occurs through rewards and punishments for behavior. Through operant conditioning, an individual makes an association between a particular behavior and a consequence.” Beck developed his theory from Albert Ellis’s work on Rational Emotive Behavioral Therapy (REBT) in the 1950’s. Ellis questioned Freud’s Psychodynamic approach for treating depression, he realized patients of psychoanalysis became aware of their problems but this did not necessarily lead them to change their behavior.

After the ‘Cognitive Revolution’ of the 1960s, Behavioral therapists who adapted Cognitive theories in the 1970s called their therapy ‘Cognitive Behavior Therapy.’ Unlike Psychoanalysis, CBT can be measured and is evidence-based. The British Association for Counseling and Psychotherapy state: “CBT has a good evidence base for a wide range of mental health problems in adults, older adults, children, and young people. This research has been carefully reviewed by the National Institute for Health and Clinical Excellence (NICE), who provide independent, evidence-based guidance for the NHS on the most effective ways to treat disease and ill health.”

Modern adaptions of CBT classed as the 3rd wave include Accept and Commitment Therapy as well as mindfulness. I like CBT as I find it effective, recently my counselor taught me techniques to help me avoid letting ‘Toxic’ people affect me in my work. I believe CBT can be effectively integrated to other humanistic theories using Egan’s three part model. Building a therapeutic relationship with the client using Roger’s core conditions is important. Rory Lees-Oakes said: “The core conditions in CBT are necessary but they're not sufficient. So in CBT, they really help build a therapeutic alliance, really help build a trusting relationship, and a working relationship, but they're not everything, whereas in person-centred therapy, they are necessary and sufficient.”