Cognitive therapy

Domain II · Behavioural & cognitive · Aaron Beck, Rush, Shaw · 1976

What it is

Source coverage. Covered: the chapter structure of J. Beck 2021 and Beck et al. 1979 (publisher tables of contents), so chapter citations below now match real chapters; the 3rd-edition session structure, "action plan" terminology, credit list, therapy notes and decatastrophising (Beck Institute…

Format

• Format and dose.
• Individual, 45–50 minute sessions, typically weekly. The 1979 manual prescribes starting twice weekly in the early phase (for moderate–severe depression), then weekly. A course of roughly 15–20 sessions over about 12–16 weeks is typical of trials run on the manual (e.g. 12–20 sessions of 45 minutes…

Who practises it, and how they are trained or regulated

• Monitoring. Standard self-report measures each session are completed before the session and reviewed briefly at the mood check (Beck Depression Inventory, Beck Anxiety Inventory, Beck Hopelessness Scale; or the freely available PHQ-9/GAD-7, which the CDP names for CBT for depression); describe and use under licence, do not copy items. The 1979 manual's appendix includes the Beck Inventory and the Scale for Suicide…

Evidence status, as the guide reports it

• Cognitive therapy (CT, "Beckian CBT") is a structured, time-limited, present-focused psychotherapy. Its core idea is the cognitive model: it is not situations themselves but how people interpret them that shapes emotion, behaviour and physiology. In emotional disorders, interpretations are…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• high anxiety (grade it).
• "it's different for me" (explore what makes it different).
• invalidating real adversity by treating it as a distortion.
• images stopping at the worst moment (keep going to coping and survival).
• steps the client cannot picture (they likely need breaking down further).

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.