Cognitive and Behavioral Therapies

The cognitive and behavioral therapies have evolved as an alternative to more traditional nondirective and insight-oriented modes of psychotherapy. The family of cognitive and behavioral therapies includes a diverse group of interventions. Nevertheless, the treatments share several pragmatic and theoretical assumptions. First, these therapies emphasize psychoeducation: patients learn about the nature of their difficulties and are provided reasons for use of particular treatment strategies. Second, the cognitive and behavioral therapies typically employ homework and self-help assignments to provide patients the opportunity to practice therapeutic methods that enhance the generalization of newly acquired skills outside the therapy hour. Third, objective assessment of psychiatric illness is an integral part of treatment, and the selection of therapeutic strategies derives logically from such assessments. Fourth, the therapeutic methods used are structured, and as such require a high level of therapist activity that is typically described in treatment manuals. Fifth, for most disorders, the cognitive and behavioral therapies are time-limited interventions. Sixth, and perhaps most important, these therapies are built on empirical evidence that validates their theoretical orientation and guides the choice of therapeutic techniques.