Reference · Intervention and Practice

Cognitive behavioral therapy (CBT)

The short answer

In CBT, developed by Aaron Beck, thoughts, feelings and behaviors interact, and automatic thoughts and cognitive distortions keep distress going.[1][2] It is structured, short-term, collaborative and present-focused, using agendas, homework, thought records, behavioral activation and exposure.[1][2] Fears are treated with graduated exposure, and DBT teaches four skills modules: mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness.[2][3]

The key ideas

  • Cognitive behavioral therapy core model

    Developed by Aaron Beck: thoughts, feelings and behaviors interact; automatic thoughts and cognitive distortions maintain distress. Structured, short-term, collaborative; uses agendas, homework, thought records, behavioral activation and exposure. Strong evidence for depression and anxiety.[1][2]

  • Systematic desensitization and exposure

    Client builds a fear hierarchy and pairs each step with relaxation (Wolpe), a classical-conditioning counterconditioning method; exposure therapy and flooding confront feared stimuli directly.[2]

  • Dialectical behavior therapy: four skills modules

    Linehan's DBT teaches four modules: mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness. Mindfulness and distress tolerance are acceptance skills; emotion regulation and interpersonal effectiveness are change skills. Comprehensive DBT adds individual therapy, skills group, phone coaching and team consultation; developed for chronic suicidality and borderline personality disorder.[3]

How the ASWB exam tests it

  • Identify cognitive distortion and the CBT technique (restructuring, behavioral experiment). CBT is directive and present-focused, unlike psychodynamic work.[1][2]
  • Phobia treatment: graduated exposure.[2]
  • Choose the module: urges to self-harm in the moment = distress tolerance; managing anger/mood = emotion regulation.[3]

The common trap

Choosing an insight answer, like exploring childhood roots, on a CBT question. CBT is directive and present-focused: identify the cognitive distortion and restructure it.[1][2]

Related explainers

Sources

  1. 1.NCBI Bookshelf (StatPearls). www.ncbi.nlm.nih.gov/sites/books/NBK470241/
  2. 2.OpenStax Psychology 2e (Rice University). openstax.org/books/psychology-2e/pages/16-2-types-of-treatment
  3. 3.PubMed Central (peer-reviewed). www.ncbi.nlm.nih.gov/pmc/articles/PMC5021701/

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