Cognitive Behavioral Therapy

GinaMarie Guarino, LMHC

Cognitive Behavioral Therapy

According to the concepts of cognitive behavioral therapy, distorted thinking accounts for emotional issues. Distorted or negative thinking causes behavioral and interpersonal issues. It also causes issues with self-esteem and one’s outlook on the world and the future.

Cognitive behavioral therapy is a form of therapy that is based on the principles of cognitive theory. It adopts the concepts of the cognitive model, which focuses on three components:

  • Thoughts
  • Feelings
  • Behavior

Dr. Aaron Beck: The Founder of Cognitive Therapy

Dr. Aaron Beck
Dr. Aaron Beck

Cognitive behavioral therapy was developed by Dr. Aaron Beck in the mid-1960’s. Aaron Beck is an American psychiatrist. He developed cognitive behavioral therapy to help with depression and anxiety disorders.

Through his studies, Beck discovered that depression and anxiety stem from negative thoughts. In his patients, negative thoughts were habitually experienced. They caused a negative stream of self-talk.

The negative thoughts people experienced are referred to as ‘automatic negative thoughts’. Automatic negative thoughts tend to focus on the self, the world and the future. These three components are referred to as the cognitive triad.

Beck discovered that if his patients are able to identify their automatic negative thoughts, they can learn how to challenge them. They can challenge their automatic negative thoughts with the objective reality of a situation. When done correctly, their emotional and behavioral reactions become less intense.

With this discovery, Beck developed cognitive behavioral therapy. Cognitive behavioral therapy adopts the core concepts of the cognitive model. It is a form of therapy that derives from cognitive psychology.

How Cognitive Therapy Works

The basic concept of cognitive behavioral therapy revolves around the cognitive model. The cognitive model consists of a person’s thoughts, feelings and behavior. It suggests that each are interconnected. Cognitive behavioral therapy focuses on life stressors in the moment, and is an approach geared toward problem solving.

Cognitive Model

Cognitive behavioral therapy maintains that present problems should be the focus of therapy. It teaches that while past experiences are valid, the present is in the control of the patient.

The goal of cognitive behavioral therapy is to learn how to change the present perceptions. It aims to target and challenge automatic negative thoughts. With success, the patient learns how to re-shape how they view themselves, the world and the future.

Cognitive behavioral therapy looks for unhealthy patterns of thinking. It pinpoints areas where negative thoughts are affecting the patient. By focusing on thoughts in the present, the patient can identify how their thought patterns are affecting them.

Cognitive behavioral therapy shows a person how their automatic negative thoughts cause unhealthy thinking. With this realization, they become open to learning healthier thought patterns.

Contributions Of Dr. Albert Ellis

Dr. Albert Ellis is best known for his work with the Rational Emotive Behavior Therapy (REBT). Ellis believed that therapy should focus on resolving emotional and behavioral issues. He took a cognitive approach to resolving issues with this patients.

In his work, Ellis developed a process to help patients identify and modify their negative beliefs. The goal of REBT is to change negative beliefs that trigger automatic negative thoughts. In doing so, a person learns how to challenge their negative thoughts and assumptions about the world.

According to Dr. Ellis, when people have negative assumptions about the world, they can behave irrationally. They have intense emotional reactions that cause them to act inappropriately. Ellis believed that if people could change their irrational thoughts, then their emotions and reactions would be less problematic.

The ABC model was originally developed by Dr. Ellis. Similar to cognitive behavioral therapy, REBT uses the ABC model as a blueprint for how people react to challenges. Ellis believed that people make this critical mistake in thinking:

People tend to think that the challenging situation is the reason for their emotional upset. According to REBT, it is not the challenging situation that is causing the upset, but the person’s perception of the situation.

REBT maintains that a person’s interpretation of events cause emotional upset and negativity. The upset does NOT come from the situations themselves. Ellis assumed that if one could change the way they see challenging situations, their reaction would be less upsetting.

Challenging Irrational Beliefs

The first step in challenging irrational beliefs is to identify the source of irrational beliefs. Ellis found that these kinds of beliefs manifested in 3 ways:

  • “I must”
  • “I can’t”
  • “I should”

Each of these statements that people tend to tell themselves cause a lot of negative self-talk. They imply incompetence and failure, and trigger emotional upset and distress. They also cause avoidance and feelings of hopelessness.

These statements cause unrealistic expectations for ourselves. The unrealistic expectations can prevent growth, acceptance and embrace of the challenge ahead.

In order to challenge negative thoughts, a person must first overcome and conquer their negative beliefs. Ellis believed that a therapist should help their patients learn how to challenge their negative beliefs.

Finding the underlying source of the negative belief can help to learn how to challenge it. It is also important to learn how to identify negative thought patterns, just like in cognitive behavioral therapy.

Identifying and challenging negative beliefs is not easy. Even though it is not easy, it is a critical part of learning how to challenge negative thoughts. Learning how to challenge negative thoughts in response to challenging situations takes practice. It is a habit that requires a great deal of patience. It also requires an open mind and willingness to challenge your negative beliefs.

If the goal is reached in REBT, a person will be able to react more rationally to challenging situations. Their thoughts will be less negative and more objective. They will take their time in reacting, and process their emotions in a healthy way. They will learn how to forgive themselves for their mistakes, and accept that they are working hard to feel better. REBT set the path for cognitive behavioral therapy in understanding the ABC model, and how to apply it to help people.

Key Components of Cognitive Behavioral Therapy

Cognitive behavioral therapy consists of key components. These components are used to help understand how cognitions affect beliefs about the self and the world.

The following are key components in cognitive behavioral therapy:

The ABC Model

The ABC Model

The ABC model was developed by Dr. Albert Ellis in the mid-1950’s. It breaks down how a person interprets a challenging situation into 3 steps:

  • Activating event
  • Belief
  • Consequences

When someone has automatic negative thoughts, they see things through a negative lens. This causes them to take an objective situation and view it as being negative. They have automatic negative thoughts in reaction to how they believe they are affected by the situation. As a consequence, they feel and act based on their negative thoughts about the situation.

Dr. Ellis believed that a person’s negative view of a situation is what causes negative feelings and unhealthy behavior. The situation itself is not responsible for the person’s negative thoughts, feelings and behavior. It is the patient’s negative interpretation of information that causes the negative reaction.

The Cognitive Triad

Cognitive behavioral therapy reshapes how people receive and interpret information in the cognitive triad.

The cognitive triad consists of 3 main components:

  • The self
  • The world
  • The future

This model implies that the three components will directly affect each other. If a person has a negative self-image, they will also have a negative view of the world and their future.

Cognitive Triad

The cognitive triad suggests the following:

The lens in which a person sees one component affects the way they see the other two components. If a person has a negative image of the world, they also have a negative issue of the future and themselves. If they have a negative image of the future, they also have a negative image of themselves and the world, and so on.

Cognitive Bias

The cognitive triad causes a cognitive bias. This means that a person’s view of the three components can affect how they interpret individual situations. If a person has a negative view of their cognitive triad, they will have a negative lens on life situations. The cognitive bias causes the person to have distorted thinking. This distorted thinking causes a misinterpretation of information about the situation. It causes a person to ignore the positive and distort information into the negative. This can cause depression, anxiety, panic, and interpersonal issues.

A cognitive bias often involves cognitive distortions. A cognitive distortion is an erroneous pattern in thinking. Cognitive distortions cause you to think in the negative. They cause negative thoughts and fuel negative beliefs. When you think with cognitive distortions, you perceive a situation as negative. It causes you to get down on yourself. It also prevents you from seeing challenges objectively. They cause upset emotions and unhealthy behavior.

Cognitive Distortions

There are several different types of cognitive distortions. Each cognitive distortion will negatively affect a person’s thoughts, feelings and behavior. Everyone experiences cognitive distortions sometimes. Typically people will have at least two cognitive distortions that they experience regularly.

The following are the different types of cognitive distortions a person may experience:

All Or Nothing Thinking (Always Or Never Thinking).

All or nothing thinking causes you to think in extremes. It is either always or never, everybody or nobody, or all or nothing.

Example: Travis, who feels that he can never get things right when dating.

“Why does this always happen to me?! Every time I try to make things work in a relationship I always say the wrong thing and mess it all up!”


Labeling is placing an assumed label onto yourself, someone or something. The label causes you to have negative assumptions and expectations.

Example: Dan, who finds himself not feeling like it is worth it to study, because not matter what he feels he is dumb.

“There is no point in studying. I am a stupid person.”

Focusing On The Negative (Filtering).

Ignoring the positive or neutral information about a challenging situation. People who filter only focus on what is perceived as negative.

Example: Ashley, who feels she has to be the center of attention to make friends, not remembering all of the friends she made just by mingling with the crowd.

“People only want to be my friend when I am the center of attention. Otherwise, I am boring and nobody is interested in me.”

The Shoulds.

Telling yourself that you should be / do, or should not be / do. It can extend to things should (or should not) be / happen this way. This implies that you are less than, or lack worth. It implies that you are helpless and not good enough. It causes frustration when situations are challenging or do not meet expectations.

Example: Corina, who constantly finds herself feeling like she should be better and should not feel bad feelings because her life is not that hard.

“I should be better at this.” “I should not feel this way.”


Blaming things that are not responsible for an upsetting situation.

Example: Lorraine, who blames everything around her for her misfortunes.

“It wasn’t my fault I was late! I hit every light and the guy in front of me was driving really slow!”

Predicting The Future.

Assuming the worst will happen. This can include fantasizing about possible worst case scenarios.

Example: Paul, who assumes that there is no way he can find success as a musician.

“If I move to Nashville to pursue my music career I will fail. I will not have money to feed myself. I will be a loser and my family will be ashamed of me.”


When you create impressions of an entire population based on your experiences with a small sample of individuals. This can be about anything, people, places, institutions, etc.

Example: Amanda, who assumed that all dogs are mean when the neighbor’s dog bit her leg.

“Get that dog away from me! It is going to hurt me, don’t let it come near me!”

Example: Whitney, who was cheated on by two of her ex-boyfriends.

“All men are cheaters and pigs. You can’t trust them.”

Mind Reading.

Assuming you know what others think about you. Mind reading can make you feel like you are on everyone’s radar, and that people are paying more attention to you than they actually are.

Example: Tony, who assumes that everyone is uncomfortable around him in social situations.

“They must all think I am such a freak.”


Assuming that the worst will happen. When you catastrophize, you feel that the worst case scenario will happen. You apply catastrophizing to any potentially challenging situation.

Example: Lauren, who has a big exam tomorrow.

“If I fail this exam I will fail out of school. I will never be able to get a job and die poor and alone.”

Emotional Reasoning.

When you use your emotions to draw conclusions and decide how to react. Emotions are the opposite of reason. Acting purely on emotion will cause problems.

Example: Zach, who has trouble controlling his anger.

“Fine! I don’t care about your reason why. If you’re going to bail on our plans last minute, then this friendship is over!”


When you assume that something is about you even though it has nothing to do with you. People who personalize take everything personally. They assume they are the center of all issues, and they are blamed for all challenges that arise.

Example: Jill, who assumes that Joseph’s short answers are about her, even though she knows that Joseph is having a hard time at work.

“Why is he mad at me?! I didn’t do anything to him, and he shouldn’t be mad at me. If he’s going to be mad at me for no reason, then I can play the same game.”

Jumping To Conclusions.

Jumping to conclusions is when you act too quickly based on your first impression. You draw conclusions based on your initial impression, and do not take the time to think about the situation or how it affects you. You are reactive, and this reactivity causes you to act on initial impulse, rather than reason.

Example: Andrew, who assumes he already knows what his wife is going to say.

“And don’t tell me the leak is my problem because we both own this house!”

Who Cognitive Therapy Can Help

Cognitive behavioral therapy was developed to explain and treat the cognitive process of depression. It has since been discovered that cognitive behavioral therapy can be used for other conditions. The following conditions are also affected by the cognitive triad and can be treated with cognitive behavioral therapy:


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