Cognitive Therapy & Therapeutic Approach

Cognitive Therapy is a broad, psychological theory / paradigm that differs somewhat from psychoanalysis. It is more evidence based, and more change orientated. Most psychological theories, loosely speaking, agree on how psychological / emotional issues are created. Cognitive therapists will language things differently from, say, Freudians or Jungians or Object Relations therapists. However, there is a general, shared understanding of how genetics and early environment combine to produce vulnerabilities, that are later confirmed or disconfirmed by environmental events. Where the larger differences occur is in how psychological issues are resolved.
Cognitive therapy is:
- Research-based and evidence driven. We will adopt pretty much any technique in line with our cognitive conceptualization of emotional and behavioral problems, provided there is compelling evidence to support it. Generally speaking, placebo, double-blind, large data sample studies are the best.
- Cognitive therapists work both in the client’s past and in the present. Perhaps the difference in terms of how we examine a client’s past though, is that we spend time there when there is a good reason to be there (for example to increase understanding or re-interpret a memory). These reasons and rationales are also communicated to our clients! Different cognitive strategies spend different amounts of time in the client’s past, but more about this later.
- Cognitive therapists tend to spend a higher proportion of time in a client’s present, than in traditional psychoanalysis. This is because we believe that even if important work has been done to understand and rework a person’s past, the issue remains trapped in their present! We are a system of cognitions (just a fancy word for all levels of thought / belief), behaviors (including avoidant behaviors), physiology / neurochemistry and emotions, and these work together to maintain the equilibrium that they have created. Thus, a vital component of long-lasting change in any individual / couple / group is to create enough change within these various areas to help the person to shift their state of equilibrium. Without this, change in any one area (including gaining insight into their past) only creates temporary change, and then the old equilibrium reasserts itself.
- Cognitive therapists, in line with seeing the person as complex system of components, are also more focused on lifestyle changes in addition to internal change. These might include interests, exercise, eating habits, sleep cycles, social interactions and other existential support.
- Cognitive therapy has a stronger focus on creating unique models for helping people with their problems. Cognitive models / conceptualizations exist for most diagnoses and also specific problems within diagnoses. This is not designed to give the therapists a model to follow blindly, but rather the beginnings of a formulation, as well as a good understanding of what tends to help with particular issues. This helps us to not have to reinvent the wheel, so to speak. Ultimately though, these conceptualizations are merely grist for the mill in constructing a bespoke, idiosyncratic treatment plan for each client.
Cognitive therapy is:
- Research-based and evidence driven. We will adopt pretty much any technique in line with our cognitive conceptualization of emotional and behavioral problems, provided there is compelling evidence to support it. Generally speaking, placebo, double-blind, large data sample studies are the best.
- Cognitive therapists work both in the client’s past and in the present. Perhaps the difference in terms of how we examine a client’s past though, is that we spend time there when there is a good reason to be there (for example to increase understanding or re-interpret a memory). These reasons and rationales are also communicated to our clients! Different cognitive strategies spend different amounts of time in the client’s past, but more about this later.
- Cognitive therapists tend to spend a higher proportion of time in a client’s present, than in traditional psychoanalysis. This is because we believe that even if important work has been done to understand and rework a person’s past, the issue remains trapped in their present! We are a system of cognitions (just a fancy word for all levels of thought / belief), behaviors (including avoidant behaviors), physiology / neurochemistry and emotions, and these work together to maintain the equilibrium that they have created. Thus, a vital component of long-lasting change in any individual / couple / group is to create enough change within these various areas to help the person to shift their state of equilibrium. Without this, change in any one area (including gaining insight into their past) only creates temporary change, and then the old equilibrium reasserts itself.
- Cognitive therapists, in line with seeing the person as complex system of components, are also more focused on lifestyle changes in addition to internal change. These might include interests, exercise, eating habits, sleep cycles, social interactions and other existential support.
- Cognitive therapy has a stronger focus on creating unique models for helping people with their problems. Cognitive models / conceptualizations exist for most diagnoses and also specific problems within diagnoses. This is not designed to give the therapists a model to follow blindly, but rather the beginnings of a formulation, as well as a good understanding of what tends to help with particular issues. This helps us to not have to reinvent the wheel, so to speak. Ultimately though, these conceptualizations are merely grist for the mill in constructing a bespoke, idiosyncratic treatment plan for each client.
Cognitive therapy is a comprehensive theory-based, research driven umbrella corporation for many different skill sets and therapeutic techniques. Below, I shall unpack a few of the ones that I utilize in my therapy, depending on the needs of my clients.
First, though, it is worth recognizing that there are only ever really two broad ways to deal with any situation we are not happy with. Acceptance. Or change. Obviously, all competent therapeutic strategies have the flexibility to incorporate both elements of past and present, as well as change and acceptance. However, some of the therapeutic modalities described below have a greater focus on either the past or the present. And some have a greater focus on either acceptance or on change. I am merely going to synthesize the main features of the various treatment modalities that fall within Cognitive Therapy.
The Therapeutic Modalities I utilize
Therapeutic modalities that I utilize, within Cognitive Therapy, depending on the needs of my clients, include the 6 below.
All these therapeutic modalities can be clustered under the broad heading of Cognitive Therapy, and there are naturally large areas of overlap and expansion between them. They represent a very complete toolset for the comprehensive and flexible treatment of any issues you might present with!

Cognitive Behavior Therapy (CBT)
Cognitive-behavioral therapy (CBT), developed by Aaron T. Beck, is recognized globally as one of the most thoroughly researched and effective forms of psychotherapy. It creates a supportive, collaborative atmosphere where the therapist and client work together to set specific, measurable goals aimed at addressing the client’s issues. By employing practical, evidence-based techniques, CBT helps individuals disrupt negative thought patterns that contribute to emotional distress and maladaptive behaviors.

Rational Emotive Therapy (RET)
Rational Emotive Therapy (RET) was created by Albert Ellis. RET focuses on helping clients use both inductive and deductive logic. Inductive logic involves gathering and analyzing facts to challenge irrational beliefs. For instance, someone might start with a factual statement like, “I failed that exam,” and through logical analysis, work to avoid jumping to irrational conclusions like, “Therefore, I am a failure.” Deductive logic, on the other hand, involves tracing these superficial thoughts to their logical conclusions, helping to dismantle the negative impact of these beliefs.

Schema Therapy
(ST)
Schema Therapy, developed by Jeffrey E. Young, represents an integrative and comprehensive treatment for various psychological disorders.
Drawing from cognitive behavioral therapy (CBT), psychoanalysis, attachment theory, and emotion-focused therapy, it targets personality issues that often resist other therapeutic methods.

Mindfulness Based Cognitive Therapy (MBCT)
Mindfulness Based Cognitive Therapy (MBCT) seamlessly integrates cognitive therapy with mindfulness practices, creating a powerful therapeutic approach. At its core, mindfulness involves intentional attention—purposefully focusing on the present moment without judgment. It’s about accepting what is, whether positive or challenging. It is thus very much present (moment) focused as well as encouraging of acceptance.

Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy (ACT), developed by Steven C. Hayes, stands on the foundation of relational frame theory (RFT) — a theory of human language and cognition. Grounded in behaviorism, ACT also draws insights from cognitive processes. Here’s what you need to know…

Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy (DBT), developed by psychologist Marsha Linehan, represents a significant departure from traditional Cognitive Behavioral Therapy (CBT) while still sharing some foundational principles. While CBT primarily emphasizes the role of thoughts in shaping emotions, DBT takes a more comprehensive approach—one that acknowledges emotions as central to our human experience.
My Therapeutic Approach
to Cognitive Therapy
As a clinical psychologist working within the Cognitive Therapy paradigm, I embrace a flexible and dynamic approach to therapy, recognizing that each client’s needs are unique. My practice is guided by evidence-based methods and a commitment to creating tailored treatment plans. Cognitive Therapy, a well-established paradigm, emphasizes practical change and evidence-driven techniques, making it central to my approach.
Initially, I focus on behavioral and physiological techniques to establish a foundation of trust and understanding with my clients. This involves engaging with the client’s present circumstances and employing strategies that address their immediate needs and behaviors. The objective is to shift the client’s state of equilibrium by making adjustments in their behaviors, thoughts, and physiological responses, which are often interconnected and reinforce one another. Aspects of cognitive-behavior therapy, as well Mindfulness-based cognitive therapy and dialectical behavior therapy, as well as some of the realities of acceptance and commitment therapy are engaged with here.
As our sessions progress, we delve deeper into cognitive processes using Cognitive-Behavior Therapy (CBT) and Rational Emotive Behavior Therapy (REBT). These therapies help clients challenge and change irrational thought patterns and beliefs. Thought Record Forms and other CBT tools play a crucial role in this phase, facilitating a structured approach to identifying and modifying distressing and repetitive intrusive thoughts.
For more complex and persistent issues, I incorporate Schema Therapy, which explores deeper patterns formed in childhood and their impact on the client’s adult life. This approach not only addresses immediate symptoms but also targets the underlying schemas that influence the client’s sense of self and interpersonal relationships, as well as helping them to adapt and alter their Schema Mode responses.
Each therapy session is designed with the understanding that no single approach fits all. My methodology adapts to include a blend of past insights and present-focused strategies, balancing change with acceptance according to each client’s specific challenges and goals. The approach is structured enough to facilitate and track qualified and quantified therapeutic goals, as well as being flexible and human-centred enough to incorporate whatever new emotional and situational challenges my clients face every week in this amazing, yet tumultuous process of life.
If you are seeking a compassionate, evidence-based, and personalized approach to therapy, I invite you to reach out.
Together, we can explore the various aspects of your experiences and work towards lasting change and improved well-being.
Let’s embark on this journey towards a more fulfilling and balanced life.
Take the first step toward a healthier, happier you.
Let’s work together to explore your mind and stuck behaviors, find solutions, and build the life you deserve. Reach out today! To make an appointment or get advice, contact me hereWant to explore psycho-educational articles?
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