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Introduction

Cognitive Therapy
Two people were very significant in the development of cognitive therapy. Aaron Beck worked with people with depression during the 1960's and developed a theory based on observations of the nature and structure of the depressed person's own behaviours and thoughts. Martin Seligman, was a psychologist who worked with animals on the study of helplessness and loss of individual control in the 1970's.

This work has resulted in a form of active therapy where the therapist seeks to collaborate with the patient to work on thoughts and behaviours in the 'here and now' that are causing difficulty for the patient. The past is only explored when it is relevant to help explain current habitual modes of behaviour or thought.

Although cognitive therapy is used in many other areas, its most common application is with people with depression or anxiety and the underlying assumption is that these illnesses have resulted from distortions in the person's thought processes. Therefore, so the theory goes, any improvement in the level of depression must be accompanied by changes in thinking patterns. In other treatments, such as drug treatment or psycho-dynamic counselling these changes occur as a side effect; in cognitive therapy these 'distortions of thought' are faced up to and dealt with directly by the patient and therapist together.

Cognitive therapy is quite different from counselling and has a quite distinct set of characteristics that structure the sessions. The sessions have an agenda that is set between the patient and therapist. This agenda indicates the points that will be discussed during the sessions. It may also include a review of work set during the previous week or month. The therapist structures the session time and maintains a suitable balance between the main issues and any side issues that may arise. The therapist summarises regularly through the sessions and the patient offers their reaction to the summary. Any misperceptions are discussed and the therapist seeks guidance from the patient on any problematic aspects.

The sessions are characterised by a questioning approach by the therapist who will also assign 'homework' based on issues from the session. Often the patient is asked to summarise the session and to highlight any topics which may have been difficult.

Generally there is a strict limit to the number of sessions. On average this is 6 sessions however, this is dependent on the presenting difficulty and is agreed between therapist and patient. Many people require fewer sessions as control usually increases very quickly. I also have a help line for patients if they need support between sessions.

This is only a brief overview of cognitive therapy, there are many variations and much depends on the personality of the therapist.

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