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The Importance of Cognitions

The unifying characteristic of cognitive-behavioral counseling and psychotherapy approaches is the fundamental emphasis on the importance of cognitive workings as mediators of behavioral change (Craighead et al., 1995; Dobson & Dozois, 2001). All cognitive interventions attempt to produce change by influencing thinking, which is assumed to play a causal role in the development and maintenance of psychological problems (Dobson & Dozois, 2001). The relationship between thoughts and behavior is a major aspect of cognitive-behavioral theory and counseling and psychotherapy. Thus, all CBTs share these three fundamental propositions: (a) Cognitive activity affects behavior, (b) cognitive activity may be monitored and altered, and (c) desired behavioral change may be affected through cognitive change (Dobson & Dozois, 2001, p. 4).

The Importance of Learning

The cognitive-behavioral model of psychological disturbance asserts that abnormal behavior is learned and developed the same way that normal behavior is learned and that cognitive-behavioral principles can be applied to change the behavior. The importance of this statement lies in the focus on learning as the way behavior is acquired rather than on underlying intrapsychic conflicts. It rejects the psychodynamic and quasi-disease models of development, which assume that underlying intrapsychic conflicts cause maladaptive behavior.

The Importance of Operational Definitions and Functional Analysis

In cognitive-behavioral approaches, problems are viewed operationally. The definition of the presenting problem must be concrete, specific, and observable whenever possible. It is assumed that problems are functionally related to internal and external antecedents and consequences. This assumption means that to understand behavior, it is necessary to know the events that precede (antecedents) and follow (consequences) the behavior. These events may be external and observable behaviors or internal thoughts and feelings. The functional relationship conceptualization of problems necessitates a dear understanding of the internal and external antecedents that contribute to a problematic behavior, as well as the internal and external consequences that maintain the behavior. This also means that the causes and treatments of problems should be multidimensional. Causes might include behaviors, environmental circumstances, thoughts, beliefs, or attitudes. Treatments are addressed in the intervention section of this chapter. Because there is rarely a single cause for a problem, treatments are comprehensive and designed to address the multiple issues.

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