Food for thought and discussion...

[foreverbull]

No I don't, at least not on the top of my head, maybe gestalt therapy? Cognitive theory did exist before CBT. The thing is Hayes and people who subscribe to the waves of behavioral therapy describe the history as behavior therapy plus cognitive theory components to result in CBT. It was my understanding that therapists did use therapies based on the cognitive model before CBT was developed. That doesn't mean that behavioral components weren't involved, but it wasn't Becks classic CBT. Maybe we are getting stuck on terminology. There is a difference between the umbrella term of Cognitive Behavior Therapy and the classic Cognitive Behavior Therapy developed by Beck in the 70's. In that paper they refer to Becks CBT as CT, and I think that is making this a bit confusing.

Do we have a cognitive therapist around???

Many counseling theory textbooks place CT and REBT (and ACT) in the CBT chapter—most likely to avoid the ensuing confusion of separating them all out.

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[bcliff]

Language: a prison for us all...

When I say CT, I am describing Beck's "traditional CBT," which falls under a larger umbrella of cognitive behavioral interventions -- I think the difference in the theoretical foundations of these two interventions is pretty stark. When I'm implementing ACT, I am trying to achieve behavior change in a way that meaningfully differs from implementation of CT. I'm approaching the client with a different set of assumptions and guiding principles. I think an appreciation for theory is key to being an effective provider (Kurt Lewin, anyone?), if for no other reason than it provides a framework to turn to if an initial intervention is ineffective.

It was my understanding that therapists did use therapies based on the cognitive model before CBT was developed.

To the highlighted point, Conk, I think you're mistaken -- I don't think there is a "pre-Beck" cognitive therapy, and I also don't think there is a "post-Beck" cognitive therapy devoid of behavioral activation. Not my area of expertise, so please correct me if I'm actually the one mistaken.

 

[foreverbull]

Language: a prison for us all...

When I say CT, I am describing Beck's "traditional CBT," which falls under a larger umbrella of cognitive behavioral interventions -- I think the difference in the theoretical foundations of these two interventions is pretty stark. When I'm implementing ACT, I am trying to achieve behavior change in a way that meaningfully differs from implementation of CT. I'm approaching the client with a different set of assumptions and guiding principles. I think an appreciation for theory is key to being an effective provider (Kurt Lewin, anyone?), if for no other reason than it provides a framework to turn to if an initial intervention is ineffective.



To the highlighted point, Conk, I think you're mistaken -- I don't think there is a "pre-Beck" cognitive therapy, and I also don't think there is a "post-Beck" cognitive therapy devoid of behavioral activation. Not my area of expertise, so please correct me if I'm actually the one mistaken.

I’m not an expert in CT, but my understanding is this as well—it is synonymous with traditional CBT as we know it. This was a huge point of confusion when students went to write theory papers—I had to clarify that if they planned to write about Beck’s model, THAT is traditional CBT as we know it, and any other CBT approach they wanted to write about they needed to name specifically (REBT, ACT). In research, people specify if it’s NOT Beck’s CBT, because it is assumed that CBT research is based on Beck’s model, from what I’ve seen, so there doesn’t seem to be a meaningful distinction between CT and traditional CBT, that I can tell.

Feel free to chime in if anyone is a Beck expert...

 

[beginner2011]

Certainly not an expert on cognitive therapy, but I had a number of professors during grad school who had stories about the big kerfuffles between the "Cognitive" therapists and the "Behavioral" therapists back in the late 20th century. A quick google shows Beck's "Cognitive Therapy for Depression" coming out of an effort to empirically test the application of psychoanalytic techniques to patients presenting with depression. I think it's a mistake to assume that cognitive therapy = cognitive behavioral therapy.

Also of note, my understanding is that Jacobsen's dismantling study that demonstrated the non-inferiority of BA compared to CT was pretty groundbreaking at the time.

 

[foreverbull]

Certainly not an expert on cognitive therapy, but I had a number of professors during grad school who had stories about the big kerfuffles between the "Cognitive" therapists and the "Behavioral" therapists back in the late 20th century. A quick google shows Beck's "Cognitive Therapy for Depression" coming out of an effort to empirically test the application of psychoanalytic techniques to patients presenting with depression. I think it's a mistake to assume that cognitive therapy = cognitive behavioral therapy.

Also of note, my understanding is that Jacobsen's dismantling study that demonstrated the non-inferiority of BA compared to CT was pretty groundbreaking at the time.

Certainly there are difference between isolated behavior therapy and CBT, but that wasn’t the argument being made.

Beck’s institute website says:
“Cognitive Therapy (CT), or Cognitive Behavior Therapy (CBT) ,was pioneered by Dr. Aaron T. Beck in the 1960s, while he was a psychiatrist at the University of Pennsylvania.”

The CT vs. CBT labels seem to be causing a lot of confusion, but the Beck Institute claims both labels for the same theory.

 

[beginner2011]

Certainly there are difference between isolated behavior therapy and CBT, but that wasn’t the argument being made.

Beck’s institute website says:
“Cognitive Therapy (CT), or Cognitive Behavior Therapy (CBT) ,was pioneered by Dr. Aaron T. Beck in the 1960s, while he was a psychiatrist at the University of Pennsylvania.”

The CT vs. CBT labels seem to be causing a lot of confusion, but the Beck Institute claims both labels for the same theory.

I mean, I think that may be some revisionist history, but I agree it's mostly semantic in practice for our moment in history. I'd be shocked if in 1967 Aaron Beck was basing his psychotherapeutic approach on behavioral principles. Happy to be corrected on this if I'm mistaken.

 

[bcliff]

I mean, I think that may be some revisionist history, but I agree it's mostly semantic in practice for our moment in history. I'd be shocked if in 1967 Aaron Beck was basing his psychotherapeutic approach on behavioral principles. Happy to be corrected on this if I'm mistaken.

Beckian CT has always included behavioral activation, and dismantling studies (at least the few I've read; I cited one particularly salient paper earlier) have indicated that the BA components are the "active ingredients" of that treatment package. In other words, Beck misattributed behavior change caused by behavioral activation to the cognitive components of CT, hence the "rebranding" as CBT.

At its core, standalone BA is the "B" of "traditional CBT." In practice, most BA protocols I'm familiar with align themselves with the third-wave behavior therapies and incorporate values work (e.g., bundled reinforcers), mindfulness (e.g., self-monitoring), and other Hayesian terms. When I'm implementing BA, I often incorporate principles of acceptance and distress tolerance, which gets to my earlier point of having a hard time differentiating between when I'm "doing BA" from when I'm "doing ACT." My understanding of the third-wave therapies is that that flexibility is a feature rather than a bug (i.e., it's a flexible/principles-based intervention approach rather than a rigid/manualized approach).

I remember hearing about internal drama when ABCT changed its name from AABT -- Like, should it be the Association for Behavioral and Cognitive Therapies *or* Cognitive and Behavioral Therapies. I think some folks felt adamant that behavior should come first since it was the mechanism of action. 😆 Not sure how accurate those stories are, but they've stuck with me nonetheless.

 

[conky124]

Language: a prison for us all...

When I say CT, I am describing Beck's "traditional CBT," which falls under a larger umbrella of cognitive behavioral interventions -- I think the difference in the theoretical foundations of these two interventions is pretty stark. When I'm implementing ACT, I am trying to achieve behavior change in a way that meaningfully differs from implementation of CT. I'm approaching the client with a different set of assumptions and guiding principles. I think an appreciation for theory is key to being an effective provider (Kurt Lewin, anyone?), if for no other reason than it provides a framework to turn to if an initial intervention is ineffective.



To the highlighted point, Conk, I think you're mistaken -- I don't think there is a "pre-Beck" cognitive therapy, and I also don't think there is a "post-Beck" cognitive therapy devoid of behavioral activation. Not my area of expertise, so please correct me if I'm actually the one mistaken.

Ok, maybe there isn't, what is clear is we are all unclear about whether there is a Cog Therapy separate from Beck. What we were reminded in this thread that Beck created a cognitive theory to test psychoanalytic theory. The wave narrative goes from purely behavioral therapies to classic cognitive behavior therapy to third wave approaches like ACT, DBT, and others. So there doesn't need to be a cognitive therapy outside of Beck, like I said, he and others brought cognitive, social, and emotional principles into behavioral conceptualizations that radical behaviorists claim was a mistake.

My original point in all of this is criticizing the position of a group of ACT supporters and radical behaviorists that ACT techniques are purely behavioral and are not cognitive as well as the position that ACT is an entirely different approach that classic CBT. I think I challenged those points pretty well earlier before we got caught up in the weeds.

Also, my SN in conkey, it refers to the imaginary hand puppet friend of the character Bubbles from trailer park boys. Put some respek on it.

 

[conky124]

Also Im very disappointed that there are no opinions about one of my other original points that the Marine corps is pirate school and US marines are essentially swashbuckling pirates. Lets get to the important debate already!

 

[bcliff]

Ok, maybe there isn't, what is clear is we are all unclear about whether there is a Cog Therapy separate from Beck. What we were reminded in this thread that Beck created a cognitive theory to test psychoanalytic theory. The wave narrative goes from purely behavioral therapies to classic cognitive behavior therapy to third wave approaches like ACT, DBT, and others. So there doesn't need to be a cognitive therapy outside of Beck, like I said, he and others brought cognitive, social, and emotional principles into behavioral conceptualizations that radical behaviorists claim was a mistake.

My original point in all of this is criticizing the position of a group of ACT supporters and radical behaviorists that ACT techniques are purely behavioral and are not cognitive as well as the position that ACT is an entirely different approach that classic CBT. I think I challenged those points pretty well earlier before we got caught up in the weeds.

Also, my SN in conkey, it refers to the imaginary hand puppet friend of the character Bubbles from trailer park boys. Put some respek on it.

To be clear, I feel confident that there is not a CT separate from Beck but am assuming a position of openness to being disproven because I'm not an expert on the topic.

Also, I think its inaccurate to credit Beck with bringing "cognitive, social, and emotional principles into behavioral conceptualizations" -- If anything, I'd give that honor to Skinner's Verbal Behavior, Sidman's work with stimulus equivalence, and (more recently) Hayes' relational frame theory. Again, this is a topic I'm knowledgable on but am not an expert, so I defer to others' expertise.

 

[conky124]

To be clear, I feel confident that there is not a CT separate from Beck but am assuming a position of openness to being disproven because I'm not an expert on the topic.

Also, I think its inaccurate to credit Beck with bringing "cognitive, social, and emotional principles into behavioral conceptualizations" -- If anything, I'd give that honor to Skinner's Verbal Behavior, Sidman's work with stimulus equivalence, and (more recently) Hayes' relational frame theory. Again, this is a topic I'm knowledgable on but am not an expert, so I defer to others' opinion on this as well.

Sounds good, I dunno either. Can we get back to whether marines are pirates??

OK, sounds like a good discussion that could be a great new thread. Lets also be clear that I wasn't crediting him for it solely either. If you quoted me a few words sooner I did make that clear when I said "...he and others brought cognitive, social, and emotional principles into behavioral conceptualizations that radical behaviorists claim was a mistake."

 

[futureapppsy2]

Sounds good, I dunno either. Can we get back to whether marines are pirates??

OK, sounds like a good discussion that could be a great new thread. Lets also be clear that I wasn't crediting him for it solely either. If you quoted me a few words sooner I did make that clear when I said "...he and others brought cognitive, social, and emotional principles into behavioral conceptualizations that radical behaviorists claim was a mistake."

Agreed with my behaviorist colleague @ClinicalABA that it’s a common misconception that Skinner didn’t consider thoughts (“private verbal behavior”) or emotions in behaviorism. He totally did—he was just opposed to using the concept of emotions as waystations or treating thoughts as somehow separate from the principles of behavior. It is a worthy criticism that his verbal behavior work was sometimes lacking in empirical data to compliment the philosophy.

 

[conky124]

Agreed with my behaviorist colleague @ClinicalABA that it’s a common misconception that Skinner didn’t consider thoughts (“private verbal behavior”) or emotions in behaviorism. He totally did—he was just opposed to using the concept of emotions as waystations or treating thoughts as somehow separate from the principles of behavior. It is a worthy criticism that his verbal behavior work was sometimes lacking in empirical data to compliment the philosophy.

Yeah I think Hayes's wave narrative considers Skinner's contributions to be in the first wave. This is also a weird position given the common misconception you noted and that Skinner's contributions definitely overlap with at least the beginning of what they would consider to be the second wave.

I think Beck and Skinner have made tremendous contributions. I think that the debate and kerfuffle between cognitive leaning and radical behavioral therapy leaning people is an outdated and pointless. I think of them simply as different lenses that each are useful to conceptualize cases.

now to sling a little mud...
Didn't Skinner make a bunch of money training pigeons to guide missiles for the US military??

Watson was a serious scum bag of a person if you dig into the history about him. Also, who'd want to train a baby to be horribly frightened of a white fluffy rabbit. I like to tell the little Albert story when I get to co-lead PTSD skills groups. At one of these groups a retired gangster client we had (a genial and good client actually) would joke, "oh I think I know Albert, I've see him real messed up out on the streets."

 

[ClinicalABA]

I'd encourage caution with how you use and interpret the term "radical behaviorism." The "radical" part is trud to its meaning of "root", rather than "extreme." Often, people use the term to -erroneously- refer to views that would be more in line with methodological behaviorism.

 

[conky124]

I'd encourage caution with how you use and interpret the term "radical behaviorism." The "radical" part is truectonits meaning of "root", rather than "extreme." Often, people use the term to -erroneously- refer to views that would be more in line with methodological behaviorism.

Oh don't worry I was taught that the "radical" in radical behaviorism means all encompassing