认知疗法和行为疗法治疗原则的异同

1. Introduction介绍
 

认知疗法和行为疗法是治疗精神问题的重要途径和方法。两者之间的差异有显著性，但两者的治疗有明显的差异，两者之间存在一些相似之处。本文将试图找出两者之间的差异和相似之处。Both cognitive therapy and behaviour therapy are popular and important approaches for curing mental problems. Though there are significant differences between the principles underlines the two therapies, some similarities also exists between the two. This essay will try to figure out the discrepancies and similarities between the two therapies.

 

2. Definition and Primary Characteristics定义和基本特征
 

认知疗法被发现是在精神疾病治疗中的有效性和一些医疗问题（Beck，2005）。这种技术最早是由贝克，M. D.抑郁症1960。这是一个动态的，指令，控制的相互过程，敏感的时间。另一方面，Hersen和贝拉克（1999）认为，行为疗法是一种在实证基础治疗方法。这种方法是有效的各种心理障碍，如情绪障碍，焦虑症，以及物质使用障碍。它也能帮助缓解生活中的各种问题，如体重管理，儿童行为问题，和吸烟问题。Cognitive therapy was revealed to be effective in treating psychiatric disorders and some medical problems (Beck, 2005). This technique was first developed by Beck, M. D. for depression in 1960. It is a dynamic, directive, controlled mutual process, sensitive to time. On the other hand, Hersen and Bellack (1999) suggest that behaviour therapy is a method on the basis of empirical treatment. This approach is effective for various psychological disorders such as mood disorders, anxiety disorders, as well as substance use disorders. It can also assist the remission of various ‘problems with living’, such as weight management, childhood behaviour problems, and smoking problems.

 

3. Differences between Principles of Cognitive Therapy and Behaviour Therapy认知疗法和行为疗法的原则差异
 

认知疗法是在认知模型的基础上形成的。该模型强调，你觉得你的思考方式。这表明，而不是由事件本身造成的，心理障碍一般是从意义上的个人附加到事件的结果。所附的含义会影响到以下的情感反应的具体事件。同样的事件会给不同的人不同的意义，这些意义生成的核心信念和假设根据人们的学习经验（derubeis，唐，和Beck，2001）。The Cognitive therapy is formed on the basis of cognitive model. This model emphasises that you feel the way you think. This indicates that instead of being caused by the events per se, psychological disorders generally result from the meanings individuals attach to events. The attached meaning would impact on the following emotional response to the specific event. The same event will be given different meanings by different individuals, as those meanings are generated from the core beliefs and postulations according to people’s learning experiences (Derubeis, Tang, & Beck, 2001).#p#分页标题#e#

 

The crucial characteristic of cognitive therapy is to identify and modify core cognitions that give rise to negative reactions. Those core cognitions involve the unprompted thoughts that come to one’s mind, and his/her beliefs of the world around and other individuals. Core cognitions differ depending on disorders and individuals. According to Beck (1995), the depression is caused by the negative self schema, the biased view of self, the world and the future. Specifically, one who has the negative self schema tend to recognize negative stimulus and information about himself/herself, and will add negative judgment to his/her self schema. As such, the problem will get worse as time goes by.

 

The most significant characteristic of cognitive therapy is that therapists work based on the cognitive conceptualization. They interpret clients’ difficulties in terms of cognition. Therapists begin to conceptualize clients and their problems once contacting, and will go on to refine this conceptualization until this relationship is over (Beck &Tompkins, 2007). Beck (1995) indicates that through conceptualization, therapists can assist clients to recognize critical problems and key dysfunctional way of thinking and behaviour

 

Nonetheless, instead of focusing on the cognitive process, the behaviour therapy only fixes on the behavioural aspect irrespective what happens in the ‘black box’. There are two major theories underlining the behaviour therapy. It was first proposed based on the classical conditioning principles proposed by Pavlov (1927), who put emphasis on the learnt association between stimulus and response. Specifically, an arbitrary stimulus is presented to a subject. It has no obvious relationship with the response of the subject. This stimulus is called the conditioned stimulus (CS). Usually, the CS is followed by another stimulus, which will spontaneously induce certain response (unconditioned response, UR) of the subject. This stimulus is called unconditioned stimulus (US). After several times of this pairing, the CS will begin to evoke a part of the US irrespective of the presentation of US. 

 

The therapeutic approaches include Graded exposure/Systematic desensitisation, Flooding, Counter-conditioning/reciprocal inhibition. Graded exposure/Systematic desensitisation will eliminate fear response by way of a fear hierarchy. Flooding will expose the clients to their feared stimulus, and the time period for exposure will be prolonged. Counter-conditioning/Reciprocal inhibition will present feared stimulus and new response at the same time. Aversion therapy will impose problem stimulus with aversive outcome, and this is predicted to deter the engagement of this problem stimulus. 

 

Skinner (1927) expanded behavioural approaches to operant conditioning principles. According to Skinner, the frequency of a response will be strengthened if a reward follows. In addition, the frequency of a response will decline if a punishment follows. There is a difference between the classical conditioning and operant conditioning. With respect to operant conditioning, the relation between the response and the reinforcer will change the subject’s future behaviour. However, the relation between the CS and the US will alter the future behaviour. #p#分页标题#e#

 

Based on operant conditioning, the principles of behaviour therapy is that the problems might be induced by the rewarding factors that follow the problems, while the positive change might be prevented by negative or punishing factors. Behavioural therapists should let clients learn these principles during the sessions. They should also adopt the rewards or reinforcers to build new health behaviour, and employ punishment or negative consequences to decrease problematic behaviours. 

 

4. The Similarities between Principles of Cognitive Therapy and Behaviour Therapy认知疗法和行为疗法原理的相似性
 

Even though the cognitive therapy highlights the cognitive processes, while the behaviour therapy focuses on the factors that cause the problems, there are some similarities between the two. 

 

First, both the cognitive therapy and behaviour therapy call for the strong therapeutic alliance. Cognitive therapy underscores the collaboration between the therapists and clients because such alliance will be developed by employ basic counselling skills, involving empathy and concern. It also will derive from the mutual process of decision making, the care of clients’ changes in affect during the session, and the feedback offered when sessions are over (Beck, 1995). This alliance is also important for the effectiveness of behaviour therapy. In behaviour therapy, both the therapist and client will collaborate to find the factors that maintain the problems. After that, they will design strategies to assist the client to discontinue the problematic behaviours and/or induce new adaptive ones. 

 

Moreover, both therapies will be time-limited. Sessions in cognitive sessions are usually structured (Beck &Tompkins, 2007). Therapists will set schedules with clients on the basis of the mood check and assessment of the week. They will concentrate on critical problems of clients. Clients will show their problems with their mood states as well as managing at home or work. During the discussion of clients’ problems, therapists will teach core skills to clients. Those skills involve the way of appraising and reacting to the dysfunctional cognitions, regulating emotions, and modifying behaviours. Clients will practice with those skills and new interpretations. Behaviour therapy is also time-limited. Despite simple problematic behaviours (such as a phobia of certain animals), some complex problematic behaviours can be treated in no more than 20 sessions. 

 

Furthermore, both of these therapies are goal-directed. The goal of cognitive therapy involves several respects. When the therapy is over, clients are expected to be able to develop consistent habits in daily life. They should improve self-care such as managing their sleep, eating and hygiene. They can handle well the relationships with their family, friends, as well as colleagues. Besides, clients should have the ability to control the impulsive behaviour and deleterious habits, accept and cope better with others and contexts that are unchangeable. The aim of the behaviour therapist is to free clients from his/her disorder and prevent future relapse. During this process, therapists will teach clients to build specific behavioural objectives, which they can accomplish by their homework. This therapy will not spend time on finding the origin of the problem from the childhood. Instead, it concentrates on the factors that currently maintain the problem. It also endeavours to seek for factors to alter those maintaining factors, so that the problematic behaviour will be ameliorated.#p#分页标题#e#

 

Both of the therapies will depend on the homework. Clients in cognitive therapy will be encouraged to test ideas that they cannot test in the therapist’s office. When the session is over, therapists or clients will sum up critical aspects of this session. As for behaviour therapy, it also depends much on the homework, which means that much will happen outside of sessions. Clients are generally assigned homework to practice with. They are even encouraged to embrace chances to work on their problems beyond the homework.

 

5. Conclusion总结
 

In sum, the cognitive therapy concentrates on the cognitive process that lead to the problematic behaviour, whereas the behaviour therapy put great emphasis on the factors that will induce or prevent the problematic behaviours. Even though the major characteristics of those two therapies are different, there are some similarities between the two approaches. Both of those therapies will direct focuses on the problem, and endeavour to find out the reason (cognitive factors, reinforcer or punishing factors) that cause the difficulties. The interactions during the sessions are important for those two methods. The clients are active part rather than the passive subject, they will collaborate with the therapists to find out the problem. Both of those therapies call for less time as they directly concentrate on the origin of the problems. Besides, they are goal-oriented and accentuate on the present. Finally, homework plays an important role in both of them, and clients are encourage to practice even beyond the homework.

 

References文献

 

Beck, A. T. (2005). The current state of cognitive therapy: A forty year retrospective. Archives ofGeneral Psychiatry, 62:953–959.

Beck, S. J., & Tompkins, A. M. (2007). Cognitive therapy. InN. Kazantzis&L. LĽAbate (Eds.),Handbook of Homework Assignments in Psychotherapy:Research, Practice, and Prevention(pp. 51-63). New York: Springer.

DeRubeis, R. J., Tang, T. Z., & Beck, A. T. (2001). Cognitive therapy. In K. S. Dobson (Eds.),Handbook of cognitive-behavioral therapies (2nd ed.). New York: Guilford Press.

Hersen, M.,& Bellack, A. S. (1999). Handbook of comparative interventions for adult disorders(2nd ed.). New York:Wiley.

Pavlov, I. P. (1927).Conditioned Reflexes. Oxford, England: Oxford University Press.

Skinner, B. F. (1938).The Behavior of Organisms: An Exper-imental Analysis. Englewood Cliffs, NJ: Prentice-Hall.