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MAJOR CONSTRUCTS

Because cognitive-behavioral theories are an amalgamation of behavioral and cognitive approaches, the cognitive-behavioral theoretical constructs contain aspects of both behavioral and cognitive theory. Considering the separate behavioral and cognitive roots may illustrate the key constructs in cognitive-behavioral theories. Kendall and Hollon (1979) considered the treatment target, treatment approach, and treatment evaluation for behavioral, cognitive, and cognitive-behavioral theories (see Table 9.1). For behavioral interventions, purely behavioral terms such as behavioral excesses or deficits, learning theory, and observed changes in behavior are used. Likewise, the cognitive interventions are based on purely cognitive terms such as cognitive excesses or deficits, semantic interventions (cognitive), and changes in cognitions.

Cognitive-behavioral interventions are considered to encompass a range of approaches limited by the purer behavioral and cognitive interventions (Kendall & Hollon, 1979). Treatment targets range from behavioral excesses and deficits to cognitive excesses and deficits, and cognitive-behavioral interventions target both cognitive and behavioral excesses and deficits. The treatment interventions also range from an emphasis on behavioral interventions, to an emphasis on cognitive interventions with some behavioral strategies included, to a full integration of cognitive and behavioral strategies. The evaluation strategy

Table 9.1. General Characteristics of Cognitive-Behavioral Interventions

Treatment Target

Treatment Approach

Treatment Evaluation

Behavioral excesses or deficits

Behavioral "learning theory" interventions. Environmental manipulations (e.g., token economies, contingency management)

Observed changes in behavior with rigorous evaluation

Behavioral excesses or deficits

Behavioral interventions, skills training, information provision (e.g., modeling, role playing)

Observed changes in behavior with rigorous evaluation

Behavioral and cognitive excesses or deficits

Broadly conceived behavioral and cognitive methods

Observed changes in behavior and cognition with methodological rigor

Cognitive excesses or deficits

Cognitive interventions with adjunctive behavioral procedures

Examination of cognitive and, to a lesser extent, of behavioral changes

Cognitive excesses or deficits

Semantic interventions

Changes in cognitions, "integrative changes," often, but not always, nonempirically evaluated

Note. From "Cognitive-Behavioral Interventions: Theory and Procedure," by S. D. Hollon and P. C. Kendall, 1979. In P. C. Kendall and S. D. Hollon (Eds.), Cognitive and Cognitive-Behavioral Interventions: Theory, Research, and Procedures. Oxford, England, Elsevier Ltd. Copyright 1979 by Elsevier. Reprinted with permission.

associated with cognitive-behavioral counseling and psychotherapy interventions ranges from an emphasis on behavior changes to an emphasis on cognitive changes, and in the middle are observed changes in behavior and cognition with methodological rigor. What cognitive-behavioral theories provide, given this amalgamation model, is greater flexibility in treatment targets and interventions, with an emphasis on rigorous standards in measurement of change and research evaluation (Kendall & Hollon, 1979).

 
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