Current Medical Diagnosis & Treatment in Psychiatry

Cognitive & Cognitive-Behavioral Interventions

Cognitive & Cognitive-Behavioral Interventions
One of the major changes in behavioral approaches in the past several decades has been the emergence of the cognitive and cognitive-behavioral interventions. Based largely on social learning theory, these approaches posit that organisms are not just the passive recipients of stimuli that impinge on them but instead interpret and try to make sense out of their worlds. These approaches don’t reject more traditional classical and operant perspectives on learning; rather, they suggest that cognitive mediation plays a role in coloring the way those processes work in humans and other higher vertebrates.

Roots of Cognitive Therapy

The roots of cognitive therapy can be found in the early writings of the Stoic philosophers Epictetus and Marcus Aurelius, and in the later works by Benjamin Rush and Henry Maudsley, among others. It was Epictetus who, in the first century A.D. , wrote that “People are disturbed not by things, but the view which they take of them.” Benjamin Rush, the father of American psychiatry, wrote in 1786 that by exercising the rational mind through practice, one gained control over otherwise unmanageable passions that he believed led to some forms of madness. A century later, Henry Maudsley reiterated the notion that it was the loss of power over the coordination of ideas and feelings that led to madness and that the wise development of control over thoughts and feelings could have a powerful effect. In more modern times, Alfred Adler’s approach to dynamic psychotherapy was cognitive in nature, stressing the role of perceptions of the self and the world in determining how people went about the process of pursuing their goals in life. George Kelly is often accorded a central role in laying out the basic tenets of the approach, and Albert Bandura’s influential treatise on learning theory provided a theoretical basis for incorporating observational learning in the learning process.

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