CBT
Core Mechanism
Identifying and restructuring cognitive distortions + behavioral experiments + exposure reduces maladaptive appraisals and avoidance
Ontology
Dysfunctional cognitions (automatic thoughts, core beliefs) that distort appraisal of self, world, and future
Therapeutic Voice
"What evidence do you have for the thought that nobody cares about you?"
View of the Person
A rational agent whose suffering arises primarily from distorted interpretations of experience
Evidence
APA Div 12: Strong/Very Strong for multiple disorders. NICE: recommended for depression, all anxiety, PTSD, OCD, psychosis. VA/DoD: recommended. WHO: recommended.
500+ RCTs — most studied psychotherapy
Dozens of Cochrane and other meta-analyses
Largest evidence base of any psychotherapy. Gold standard comparator in research.
Conditions
Epistemology
Blind Spots
May underemphasize attachment history, relational dynamics, and the therapeutic relationship itself as mechanism of change
Contraindications
Active psychosis with disorganized thinking (standard CBT; see CBTp), severe dissociation where cognitive restructuring may bypass traumatic material, acute mania, clients unable to engage in homework and structured tasks
Training
Standard graduate training includes CBT. Certification available for advanced practice
A-CBT certification; Beck Institute training levels
Graduate coursework; A-CBT: 200+ hrs supervised
$1K-3K for certification
Equity & Cultural Adaptations
Philosophical Roots
Epictetus, Marcus Aurelius (Stoic appraisal theory — it is not things that disturb us but our judgments); Kant (rational autonomy); Popper (falsifiability as therapeutic method); Ellis cited Stoics explicitly
Related Modalities
Clinical Vignettes
See how CBT formulates these cases:
Test Yourself
What is the cognitive triad?
Show answer
Negative views of self, world, and future — Beck's model of depression.