Cognitive Behavioural Therapy (CBT) - Applying the Assumptions and Evaluating Effectiveness

Sep 4, 2026

Cognitive behavioural therapy (CBT) explains psychological disorders as the result of how events are interpreted rather than the events themselves. CBT challenges irrational thought patterns so clients can think more rationally, then replace unhelpful behaviours with healthier alternatives. The document details cognitive restructuring and behavioural techniques such as role play and homework, including a dysfunctional thought diary. It also evaluates effectiveness using research comparisons with antidepressants and highlights ethical concerns such as patient blame and debates about what counts as “rational.”

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Components of cognitive behavioural therapy

What is CBT?

Examples of CBT components

Evaluating cognitive behavioural therapy

Effectiveness

Ethical considerations

Cognitive behavioural therapy (CBT) Applying the assumptions of the approach to cognitive behavioural therapy Cognitive psychologists believe that irrational thoughts are the root cause of psychological disorders. If an individual thinks rationally about events, then their behaviour would be‘normal’. It is not the event that causes psychological disorders but the way that these events are then thought about, this links to the internal mental processes assumption. Therefore, CBT aims to challenge an individual’s irrational thought patterns. The therapist would help the client to think rationally about their thoughts. For example, asking the client to provide evidence for an irrational thought. This links to the computer analogy as it is the process that is attempting to be changed. CBT will equip the individual with skills and techniques to challenge their irrational thoughts. Once this is done then the individual will replace the abnormal behaviours with normal ones. Components of cognitive behavioural therapy What is CBT? CBT works by trying to combat both the cognitive and the behavioural aspects of the client’s behaviour. For the cognitive element, the key aspect is to replace faulty thought patterns, this is often done through cognitive restructuring. For example, if a client said that no one liked them at work the therapist would challenge this. They may ask them to provide evidence that this is the case. Might it be that one isolated incident may be causing the client to think in this irrational way? This is an example of overgeneralisation, the client may have taken one incident andovergeneralised to other people/areas of their life. For the behavioural element, a therapist will engage the client in role play or set homework (reality testing) . This allows the client to put into practice the ideas they have discussed in the cognitive section. Aaron Beck suggested that CBT could be used to break the negative cognitive triad that depressed individuals have. The negative triad is a cycle which involves individuals having a negative view of themselves, the world around them and the future. CBT aims to break this cycle of negativity. Examples of CBT components Dysfunctional thought diary: this forms part of a client’s homework. A client will record negative thoughts and the events that have preceded the negative thoughts. The client will then rate their belief in these thoughts, this takes the form of a percentage. A rational response is then written next to this and finally, the client rates their belief again. This helps rationalise the client’s thoughts. Cognitive Restructuring: this involves challenging the irrational thoughts of the client. The goal is to replace theirrational thoughts with rational thoughts. Evaluating cognitive behavioural therapy Effectiveness Research evidence Jarrett et al. (1999) compared the effectiveness of CBT with antidepressants (specifically Phenelzine) in 108 patients with severe depression. Participants were randomly assigned to either the CBT group, the antidepressants group, or the placebo group. The study lasted 10 weeks and found that CBT was as effective as the antidepressants and more effective than a placebo. Research evidence Kuyken and Tsivrikos (2009) found that therapist competence (how effective a therapist is) is associated with therapy outcomes. 69 depressed clients were treated by 1 of 18 CBT therapists. Competence was measured for each and those with higher competence achieved greater outcomes for their clients. Ethical considerations An ethical issue: patient blame Patient blame may lead to harm. Cognitive psychologists suggest that psychological disorders are caused by faulty thinking patterns. This suggests that a client is to blame, as it is their thought patterns that are contributing to their psychological issue. An ethical issue: what is rational? The ‘sadder but wiser’ effect suggests that individuals with depression m

FAQs

What assumption does CBT apply when explaining psychological disorders?

Psychological disorders stem not from events themselves, but from the way those events are interpreted through internal thought processes. CBT targets these irrational thought patterns.

How does CBT address the cognitive and behavioural parts of a client’s difficulties?

Cognitively, CBT replaces faulty thoughts through methods like cognitive restructuring. Behaviourally, therapists use role play and set homework such as reality testing to help clients apply the new thinking.

What evidence is cited for CBT’s effectiveness compared with medication?

Jarrett et al. (1999) compared CBT with antidepressants (Phenelzine) and placebo in 108 patients with severe depression, finding CBT was as effective as antidepressants and more effective than placebo.

What ethical concerns does the document raise about CBT?

It discusses potential patient blame, because faulty thinking is framed as a cause of disorders. It also questions what “rational” means, referencing the “sadder but wiser” effect in depression.

Sep 4, 2026

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