Biomedical Engineering Reference
In-Depth Information
Starting in the 1960s, behavioral therapy evolved into cognitive-behavioral therapy,
putting greater attention on events internal to the person and to their influence on his
or her behavior in relation to the environment. Bandura was the main contributor to this
approach, and he put forward the theory of a “reciprocal determinism” between the envi-
ronment, cognitive processes, and behavior. The restoration of the subject's active role led
to the formulation of the concept of “self-efficacy,” or the way in which the individual
views his or her capabilities and capacity to act with influence. This consideration deter-
mines the subject's degree of vulnerability against the adversities of life.
At the beginning of the 1960s in this frame, characterized by a strong behavioristic theme,
two new psychotherapeutic theories appeared that set the direction for clinical cognitiv-
ism. The first model is Ellis's (1962) and proposes a linear sequence of cognitive, emotional,
and behavioral processes. According to the rational emotional behavioral therapy (REBT)
beliefs, thoughts and ideas are the causes of the cognitive, emotional, and behavioral
consequences that each subject experiences in relation to environmental events. Therefore
all individuals are guided by their more or less rational, or distorted, beliefs when select-
ing their emotional attitudes and reactions. The absolute rule system deriving from beliefs
is not always confirmed by everyday experiences; nevertheless, people do not succeed in
correcting dysfunctional beliefs because of systematic procedural errors such as arbitrary
deduction, selective abstraction, excessive generalization, tendency to magnify or mini-
mize, personalization, or use of absolutist or dichotomous thought (Beck et al. 1979).
The second model is Beck's cognitive psychotherapy. This model culturally unifies many
previous contributions with Beck's treatment for depression developed on the premise
that the psychological disease and dysfunctional behavior derive from the way the subject
is living and interpreting reality. According to Beck, the quality of thoughts and beliefs
(schemes and core beliefs) conditions psychological status, which may be emotional dys-
function. The guiding principles of standard cognitive therapy are the following:
• Psychological dificulties are due to cognitive maladjusted processes that rule
information processing in a pathological way. Different diagnostic clusters pres-
ent recognizable patterns of abnormal conditions.
• The different patterns are expressed by automatic thoughts and conscious
processing.
• The constructed beliefs and meanings are expressed in thoughts that can undergo
logical analysis and empirical verification connected to used or ignored reality
data.
The standard intervention is aimed at letting the patient became aware of his or her auto-
matic thoughts, because they occur to the subject spontaneously and without control,
appearing obvious and coherent within his or her structure.
Both for Ellis (1962) and Beck (1976), the therapeutic intervention entails the systematic
analysis of representations, schemes, thoughts, and conscious and preconscious beliefs
that precede, accompany, and follow a certain emotional state that the person experiences
as problematic and ego-dystonic (Semerani 2002). However, this approach is flexible and
rather diversified among different theorists and practitioners (Durlak et al. 1991; Gonzalez
et al. 2004). When considered in continuity with more traditional theories and therapies,
the focus is on the present and internal control with the aim of modifying thoughts and
behaviors by means of theory teaching (Rait et al. 2010).
The principal differences between Beck's and Ellis's position are tied either to the refer-
ence theories, a scientific and evolutionary one for Beck and a philosophical theory for
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