Aaron Beck

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Aaron Beck is the American psychiatrist often labeled the father of Cognitive Therapy (CT). For many years he has taught at the University of Pennsylvania, where he founded the Center for Cognitive Therapy now known as the Beck Institute. The Beck Institute is a research and training center specializing in Beck's model of CT.

Born in 1921, Beck, like many psychologists of his generation, grew dissatisfied with the dominant psychoanalytic model still largely based on Freud's work. Influenced by the scientific turn within psychology, he decided to conduct empirical research to into the psychoanalytical conception of depression. He had been practicing psychoanalysis himself until that point, and was surprised when the results of his studies seemed to falsify the theory of depression within the model.

Aaron T. Beck is one of the "founding fathers" of cognitive therapy. Beck's daughter, Dr. J. S. Beck, is the current director of the highly influential Beck Institute for Cognitive Therapy and Research. A. T. Beck's ideas about cognitive therapy have had ground-breaking, far-reaching, and long-lasting impacts on the field of psychotherapy, continuing to reshape the discipline and its approaches even today. Whereas other psychotherapeutic models-including the behaviorism models that prevailed at the time that Beck's theories first emerged-hold that anxiety and depression contribute to the development of negative self-images, Beck's model of cognitive therapy revolutionized psychotherapy by advancing the notion that the cognitive symptoms of anxiety and depression precede the affective and mood symptoms. As such, Beck's cognitive therapy explains psychopathology as the consequence of deep-rooted negative thought patterns, rather than of the hormonal changes or low rates of reinforcement postulated by other theorists

Beck's Influence

Central to Beck's theory is the principle that distorted but automatic thought patterns combine and interact with unpleasant emotional or physical symptoms to form maladaptive cycles that tend to sustain and exacerbate initial problematic symptoms and lead anxiety, depression, and other emotional disorders. Given this view, the primary targets of change from this perspective are the maladaptive thought patterns that contribute to the development of emotional disorders. By uprooting and aggressively addressing these maladaptive patterns, cognitive therapy seeks change how patients think, behave, and respond emotionally to potentially problematic individuals and events.

From the perspective of Beck's cognitive therapy, the therapeutic relationship is solidly grounded in team work between the therapist and the patient. Therapists employing the Beck model collaborate intensively with their clients, within a time-limited, problem-oriented framework that typically focuses primarily on the client's current situations in order to prepare them to more effectively confront potentially challenging situations that might develop in the short-term, the middle-term, and into the distant future. Whereas psychoanalysis and other therapeutic approaches may involve the therapist, or more specifically the "analyst," as the main party in evaluating the client's thoughts, the Beck model emphasizes the active participation of clients in all stages of the therapeutic process, including the evaluation and modification of their distorted thoughts. After all, the Beck model stipulates that the principal vehicle for change is the client's own thoughts

Cognitive Therapy

Using depression as a test case, Beck eventually formulated his own theoretical model designed to be more in line with recent scientific knowledge. The CT method of therapy aims to help patients identify and change distorted or dysfunctional modes of thought. For depression in particular, Beck found that hyperbolic beliefs as a response to negative experiences contributed to the disordered condition; depressed people would infer from minor difficulties or criticism that they were utterly worthless, yet would minimize the significance of any success or praise. Cognitive Therapy is widely used in the treatment of depression based on its demonstrated efficacy, thanks to the years of effort by Aaron Beck.

To accomplish the critical goals that drive cognitive therapy, the therapeutic relationship focuses on imparting to the client the tools and skills necessary for altering his/her negative thought patterns. The Beck model views the positive modification of how clients structure their experiences as the most efficacious means of rectifying disordered emotions and behaviors. Recognizing that all individuals have distinctive vulnerabilities that potentially predispose them to psychological distress, the therapeutic relationship seeks to reorder the client's unique "personality structure": their disordered fundamental beliefs about themselves and about the world around them. These disordered structures shape each individual's "cognitive schemata," or, how they psychologically organize themselves and the wider world.

Each individual possesses an assortment of cognitive schemata that in turn combine to form a "cognitive set" that informs how s/he should respond to given situations. At a certain level, therefore, Beck's model of cognitive therapy does allow for unconscious variables in the development and maintenance of anxiety, depression, and other emotional disorders: as the individual repeatedly uses specific cognitive sets to respond to similar potentially distressing situations, these sets direct behavioral responses at a somewhat automatic level. When these distorted sets combine, they may result in disordered "cognitive modes" such as anxiety or depression.

The key principles of Beck's cognitive therapy model decisively shape the common methods and procedures that are employed in this form of therapy. For instance, whereas psychoanalysts and therapists who employ other forms of psychotherapy take a long-term approach that seeks to identify and address the early childhood manifestations of emotional disorders, therapists adhering to Beck's principles take a more restrictive, problem-focused approach that aims mainly to identify and resolve current emotional and behavioral problems by empowering the client to effectively identify distorted thought patterns and replace them with more rational and realistic cognitive processes. As such, psychotherapy is often limited to only six to eight weekly session, although some clients remain in cognitive therapy for several months.

Typically, the client-therapist relationship begins with clients completing surveys that seek to evaluate their moods. Beck's Depression, Anxiety, and Hopelessness Inventories are often employed to provide the therapist with a means of objectively evaluating the client's initial state and of assessing their progress as the relationship continues over several weeks. The therapist generally begins each therapeutic session with a "mood check" to determine the client's current state of mind and emotion and to compare these with conditions reported in earlier sessions. The therapist would them ask the client what of consequence happened during the previous week and what specific problem s/he would like the session to focus on, attempting in the process to elucidate connections between this problem and issues dealt with in the past.

The "typical" cognitive therapy session then proceeds with a combined focus on evaluating the client's thoughts surrounding a specific problem and on devising appropriate and effective problem-solving responses. The therapist-client team will then work on sharing new skills that would empower the client to overcome and abandon habitual distorted thought patterns and behavioral responses to the identified problematic situation and to employ more efficacious cognitive and behavioral responses. The team would then recapitulate the most important points of the current session and discuss how the client might practically and actively apply the insights gained from the session during the following week.