Über die Autorin bzw. den Autor

Frank W. Bond, PhD, is professor of psychology and management at Goldsmiths, University of London, where he is also director of the Institute of Management Studies.He has published widely in the areas of ACT and organizational behavior, and the processes that underpin peak performance and well-being.

Windy Dryden, BSc, DipPsych, MSc, PhD, CPsychol, is Professor of Counselling at Goldsmiths College, University of London. He is the editor or author of over 125 books in the area of counselling and psychotherapy. His primary interests are rational emotive behaviour therapy and disseminating its theory and techniques to the general public, through writing short, accessible, self-help books.

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Brief Cognitive Behaviour Therapy can be applied to the treatment of a wide range of problems in many different settings. In this unique handbook, Frank Bond and Windy Dryden, have brought together a prominent cast of authors, to discuss issues concerning the definition, assessment and, in particular, the practice of brief Cognitive Behaviour Therapy (CBT).

Contents include:
* The difference between brief and regular CBT and evidence for its effectiveness

* How to use brief CBT in your own area of practice

* Applying brief CBT to emotional disorders, anxiety, workplace stress and more
This handbook is accessible to a wide range of readers, including academics, practitioners, psychotherapists, counsellors, and students training in CBT.

Aus dem Klappentext

Brief Cognitive Behaviour Therapy can be applied to the treatment of a wide range of problems in many different settings. In this unique handbook, Frank Bond and Windy Dryden, have brought together a prominent cast of authors, to discuss issues concerning the definition, assessment and, in particular, the practice of brief Cognitive Behaviour Therapy (CBT).

Contents include: The difference between brief and regular CBT and evidence for its effectiveness

* How to use brief CBT in your own area of practice

* Applying brief CBT to emotional disorders, anxiety, workplace stress and more This handbook is accessible to a wide range of readers, including academics, practitioners, psychotherapists, counsellors, and students training in CBT.

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Handbook of Brief Cognitive Behaviour Therapy

John Wiley & Sons

Chapter One

Holly Hazlett-Stevens and Michelle G. Craske Department of Psychology, UCLA, Los Angeles, CA, USA

Over the past 50 years, cognitive-behavioral therapies (CBT) have become effective mainstream psychosocial treatments for many emotional and behavioral problems. Behavior therapy approaches were first developed in the 1950s when experimentally based principles of behavior were applied to the modification of maladaptive human behavior (e.g., Wolpe, 1958; Eysenck, 1966). In the 1970s, cognitive processes were also recognized as an important domain of psychological distress (Bandura, 1969). As a result, cognitive therapy techniques were developed and eventually integrated with behavioral approaches to form cognitive-behavioral treatments for a variety of psychological disorders. In this paper, we review the evidence for brief forms of CBT across various disorders. First, we consider the basic principles of CBT that render such therapies well suited for abbreviated formats.

BASIC PREMISES OF CBT

Although a number of different cognitive-behavioral techniques have been developed to address a variety of specific clinical problems, a set of basic principles and assumptions underlies all of these techniques. First, psychological dysfunction is understood in terms of mechanisms of learning and information processing. Basic learning theory incorporates findings from laboratory research on classical and operant conditioning. For example, certain phobic symptoms may represent a classically conditioned fear response that persists long after the removal of the original unconditioned stimulus. In this event, repeated, unreinforced exposure to the conditioned stimulus without the unconditioned stimulus is assumed to extinguish the conditioned fear response. In a similar vein, operant conditioning explains how undesired symptoms or behaviors are maintained as a function of the consequences that follow. For example, chronic pain behaviors are believed to be maintained in large part by attention from others. Therapies that teach persons to operate in their environment, so as to maximize positive reinforcement for adaptive behaviors and minimize such reinforcement for problematic behaviors, have developed from early operant conditioning research. Cognitive research has shown that distortions in processing information about oneself and the environment are integral to many behavioral and psychological problems. For example, biases toward attending to threatening information or toward interpreting ambiguous situations as threatening contribute to excessive or unnecessary anxiety. Similarly, memory biases for distressing events or negative details of events may contribute to depressed mood. Learning to shift appraisals, core beliefs, and associated biases in attention and memory forms the basis of cognitive therapies.

Second, the cognitive-behavioral approach to treatment is guided by an experimental orientation to human behavior, in which any given behavior is seen as a function of the specific environmental and internal conditions surrounding it (Goldfried & Davison, 1994). Behavior is therefore lawful and can be better understood and predicted once its function is revealed. Because cognitive processes as well as overt behavior are viewed as adaptive and subject to change, the cognitive domain is also appropriate for therapeutic intervention (Goldfried & Davison, 1994). CBTs are therefore designed to target specific symptoms and behaviors that are identified as a part of the diagnosis or presenting problem for treatment. The cognitive-behavioral therapist approaches treatment with the assumption that a specific central or core feature is responsible for the observed symptoms and behavior patterns experienced (i.e., lawful relationships exist between this core feature and the maladaptive symptoms that result). Therefore, once the central feature is identified, targeted in treatment, and changed, the resulting maladaptive thoughts, symptoms, and behaviors will also change. For example, a CBT therapist treating panic disorder might discover that the patient holds the erroneous belief that a rapid heartbeat indicates a heart attack. Treatment would therefore aim to challenge this misconception with education and cognitive restructuring while encouraging the patient to experience intentionally the sensation of a rapid heartbeat in order to learn that a heart attack does not occur.

Third is the premise that change is effected through new learning experiences that overpower previous forms of maladaptive learning and information processing. For example, facing feared objects or situations without escape or avoidance enables new approach behaviors and judgments of safety to be learned. Change can therefore occur in the short term as a result of learning these new thoughts and behaviors, and be maintained over the long term as these newly acquired responses generalize across situations and time. CBT also often involves the teaching of new coping skills (such as assertiveness, relaxation, or self-talk) for more effective response to environmental situations. This is expected to lead to improved outcome over time as the new skills are practiced and repeatedly implemented. Clinical improvement can therefore result from two different pathways. First, as previous maladaptive thoughts and behaviors are replaced with more adaptive responses, new learning occurs as the result of new experiences. Second, the individual may learn effective coping skills that lead to improved functioning over time as these skills are practiced and developed.

Fourth is the value of scientific method for CBT, as reflected in the therapist's ongoing evaluation of change at the level of the individual patient. From their experimental orientation, CBT therapists generate hypotheses about an individual's cognitive and behavior patterns, intervene according to that hypothesis, observe the resulting behavior, modify their hypothesis on the basis of this observation, and so on. Thus, the CBT therapist is not simply bound to a set of techniques, but practices from a basic philosophical position consistent with scientific methods (Goldfried & Davison, 1994). This experimental approach is also apparent in the large number of randomized, controlled psychotherapy outcome research studies of the efficacy of CBT. In 1995, a Task Force of the American Psychological Association's Division of Clinical Psychology reviewed the psychotherapy outcome research literature to determine which treatments were considered effective, according to certain research criteria. By their 1996 update (Chambless et al., 1996), 22 different treatments were deemed "well-established," meeting the most rigorous research criteria for efficacy, while an additional 25 treatments met the less stringent criteria of "probably efficacious treatments." The great majority of these "empirically supported therapies" were cognitive-behavioral treatments for a variety of problems, including anxiety disorders, depression, physical health problems, eating disorders, substance abuse, and marital problems. Thus, much research evidence is available to support the use of CBT to treat a number of specific symptoms and behavioral problems.

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