Understanding Psychology (10th Ed)

 Cognitive treatment approaches  teach people to think in more adaptive ways 
by changing their dysfunctional cognitions about the world and themselves. Unlike 
behavior therapists, who focus on modifying external behavior, cognitive therapists 
attempt to change the way people think as well as their behavior. Because they often 
cognitive treatment approaches
Treat-
ment approaches that teach people to 
think in more adaptive ways by 
changing their dysfunctional cogni-
tions about the world and themselves.
 Neuroscience in Your Life:
How Behavioral 
Therapy Changes Your Brain
FIGURE 3 
This fi gure highlights areas of the brain that show a reduced response to highly 
emotionally arousing pictures after behavioral therapy in patients with borderline personality 
disorder. The scans on the left (a) show areas of increased activity (in red, yellow, and orange) 
in those with borderline personality disorder before behavioral therapy as compared to 
participants who do not have this disorder. The scans on the right (b) show this same 
comparison after treatment. The scans on the right (b) contain fewer areas of activation, 
which suggests that after behavioral therapy, the brains of those with borderline personality 
disorder react more similarly to the brains of those who do not have the disorder. 
(Source: 
Schnell & Herpertz, 2007, Figure 3)
(a)
(b)
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 Module 
49 
Psychotherapy: Psychodynamic, Behavioral, and Cognitive Approaches to Treatment 
553
use basic principles of learning, the methods they employ are sometimes referred to 
as the  cognitive-behavioral approach  (Beck & Rector, 2005; Butler et al., 2006; Fried-
berg, 2006). 
Although cognitive treatment approaches take many forms, they all share the 
assumption that anxiety, depression, and negative emotions develop from maladap-
tive thinking. Accordingly, cognitive treatments seek to change the thought patterns 
that lead to getting “stuck” in dysfunctional ways of thinking. Therapists systemati-
cally teach clients to challenge their assumptions and adopt new approaches to old 
problems. 
Cognitive therapy is relatively short term and usually lasts a maximum of 20 
sessions. Therapy tends to be highly structured and focused on concrete problems. 
Therapists often begin by teaching the theory behind the approach and then continue 
to take an active role throughout the course of therapy by acting as a combination 
of teacher, coach, and partner. 
One good example of cognitive treatment,  rational-emotive behavior therapy, 
attempts to restructure a person’s belief system into a more realistic, rational, and 
logical set of views. According to psychologist Albert Ellis (2002, 2004), many people 
lead unhappy lives and suffer from psychological disorders because they harbor 
irrational, unrealistic ideas such as these:
• We need the love or approval of virtually every signifi cant other person for 
everything we do.
• We should be thoroughly competent, adequate, and successful in all possible 
respects in order to consider ourselves worthwhile.
• It is horrible when things don’t turn out the way we want them to.
Such irrational beliefs trigger negative emotions, which in turn support the irra-
tional beliefs and lead to a self-defeating cycle. Ellis calls it the A-B-C model in which 
negative activating conditions (A) lead to the activation of an irrational belief system 
(B), which in turn leads to emotional consequences (C). For example, if a person 
experiences the breakup of a close relationship (A) and holds the irrational belief (B) 
that “I’ll never be loved again,” this triggers negative emotions (C) that in turn feed 
back into support of the irrational belief (see Figure 4 ). 
Rational-emotive behavior therapy aims to help clients eliminate maladaptive 
thoughts and beliefs and adopt more effective thinking. To accomplish this goal, 
therapists take an active, directive role during therapy and openly challenge patterns 
of thought that appear to be dysfunctional. Consider this example: 
Martha: The basic problem is that I’m worried about my family. I’m worried 
about money. And I never seem to be able to relax. 
Therapist: Why are you worried about your family? . . .What’s to be concerned 
about? They have certain demands which you don’t want to adhere to.