Cognitive behavioural therapy (CBT) is one of the most popular forms of talking therapy. It is the treatment of choice for depression and anxiety and is a staple of public healthcare systems, such as the NHS and the Australian Medicare system. CBT’s understanding of mental illness and therapeutic techniques is already part of the mainstream – accusations of “catastrophising” and pleas to “reality check” beliefs can be found everywhere. As a Washington Post article put it: “For better or worse, cognitive therapy is fast becoming what people mean when they say they are ‘getting therapy’.”
One of the reasons for CBT’s runaway success is the reams of evidence that support its effectiveness at treating a host of mental health disorders. Although there is evidence for CBT’s effectiveness, the evidence for its theory, particularly its understanding of mental illness, is far more mixed. To put it another way, we know that CBT works, but we are not sure how or why it works.
CBT’s cognitive model of mental illness, originally developed by Aaron Beck in the 1960s, hypothesised that disorders such as depression were characterised by certain patterns of thought that give rise to the negative emotions and behaviour typical of mental illness. These patterns of thought are referred to as “cognitive distortions” or “negative automatic thoughts”.
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