Classification Of Cognitive Therapies

The classification of cognitive therapies shows that the common feature of all of them is to consider cognition as a determining element of behavior. However, they differ in the importance they give to the different processes involved. These cognitive processes can be activated by the same ones that motivate human learning.

Cognitive therapies always design treatments based on a cognitive formation of the problem. They consider that learning is much more complex than the formation of stimulus-response associations. From the therapeutic intervention, it insists on addressing the cognitive processes as it is the main determinant of behavior.

Therapies are diverse and lack a unifying theoretical framework that unifies them as a general theoretical model, but they are frequently collected within the same group: cognitive behavioral therapies.

Classification of cognitive theories

Three main classes 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 more adaptive thinking patterns.
• Coping skills therapies  , which try to develop a repertoire of skills to help the patient cope with a series of stressful situations.
• Problem-solving therapies , which constitute a combination of the two previous types and which focus on the development of general strategies to treat a wide range of personal problems, insisting on the importance of an active collaboration between the patient and the therapist.

Cognitive therapies based on cognitive restructuring

They are aimed at the identification and change of cognitions, such as irrational beliefs, distorted thoughts or negative self-verbalizations.

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

Rational Emotional Therapy (RET) by Albert Ellis

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

Rational Emotional Behavioral Therapy (RBT) is a short form of psychotherapy that helps identify the thoughts and emotions that lead to self-defeat. Review and test the rationality of these feelings, replacing them with more productive and convenient beliefs.

The TREC approach focuses primarily on the present to help understand the mechanisms and patterns of thought and beliefs that cause discomfort. A discomfort that, in turn, leads to harmful actions and behaviors that interfere with the achievement of goals or emotional balance.

Beck’s cognitive therapy

Emotional and / or behavioral disorders would be the result of an alteration in the processing of information as a result of the activation of latent schemes. The central elements of this theory are:

• People develop in childhood a series of basic schemes that help them organize their cognitive system.
• They can have thoughts or mental representations automatically, without the intervention of a previous reasoning process.
• They can make cognitive distortions and errors in information processing.

• Stressful life events can activate dysfunctional basic schemas.

Goldfried’s systemic rational restructuring therapy

It is developed from the Ellis TRE, as an attempt to achieve a higher specification  and adapt it to a self-monitoring procedure. The goal is to teach clients coping and problem management skills that allow them to adopt more reasonable perspectives on upsetting events.

Meichenbaum Self-Instruction Therapy

This theory is based on the works of Luria and Vygotsky on the importance of “internal language” in the regulation of behavior. The historical antecedents of the self-instructional training technique can be traced back to work carried out in the 1960s with hyperactive and aggressive children.

Unlike Rational Emotional Therapy (RET), the training focuses more on the ability to modify behavior and emotions through self-verbalizations and less on the patient’s irrational belief system and ideas.

The procedure would be as follows:

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

Cognitive therapies based on coping skills

These therapies try to teach skills so that a person can adequately cope with problematic situations.

The most relevant would be Meichenbaum’s stress inoculation therapy or Suinn and Richardson’s anxiety management theory.

Meichenbaum Stress Inoculation Therapy

It is based on developing and / or equipping subjects with abilities and skills that allow them to reduce / cancel tension and physiological activation and replace the previous negative interpretations with an arsenal of positive thoughts for coping with stress.

In stress inoculation training, three phases can be distinguished that sometimes overlap each other. These phases are:

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

Suinn and Richardson’s anxiety management training theory

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

The results of this therapy appear to be positive, not only in generalized anxiety but also in test anxiety or fear of public speaking.

In the author’s opinion, 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 cognitions.

Cognitive therapies based on problem solving

They are aimed at correcting the way in which the person deals with problems, providing them with a systematic method to solve these types of situations.

D´Zurilla and Golfried problem solving therapy

It aims to teach the subject a systematic method for solving problems. It provides methods for the client to analyze and evaluate possible opinions and offers a particular perspective to interpret the world.

It is effective in combination with other techniques and is the most widely used problem-solving therapy, with the largest number of applications and experimental studies.

Spivack and Shure Interpersonal Problem Solving Technique

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

You have to define what a problem consists of; A problem arises when an effective response is not immediately available to deal with the situation.

The skills that measure social adjustment would be alternative thinking, causal or means-ends thinking (from 8-10 years to adolescence) and consequential thinking (throughout adolescence).

Mahoney’s personal science

The therapy is intended to train the subject as a personal scientist for the diagnosis and control of his own conflictive behavior.

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