2. Cognitive Therapy

Summary

This chapter describes the theory, practice, and empirical status of cognitive therapy. After highlighting the main conceptual axioms of the cognitive model and its treatment techniques, the role of mindfulness- and acceptance-based strategies are discussed. Although emphasized less than direct cognitive change strategies, some notions of acceptance have, for some time, served a function in cognitive therapy (e.g., Beck, Emery, & Greenberg, 1985). Mindfulness- and acceptance-based approaches may hold some philosophical assumptions that differ from those of traditional cognitive therapy, but these newer treatment strategies are compatible with and complementary to cognitive therapy and represent logical extensions in its evolution. The primary focus of cognitive therapy is on cognitive change (ideally at the level of deeper cognitive structures), which we maintain is possible through direct cognitive restructuring, behavioral strategies (e.g., behavioral activation, exposure), and psychological acceptance. We contend that awareness and acceptance is only one step towards the crucial change that improves symptoms and well-being, namely cognitive change.