Cognitive behaviour therapy and psychoanalysis
Cognitive behaviour therapy is a broad term which refers to a group of problem-focused psychological treatments. These share an assumption that problems arise from learned patterns of thinking and acting and that these patterns can be unlearned through active techniques which manipulate behaviour, thoughts and beliefs. While not as diverse and fractured a set of theoretical schools as those found in psychoanalysis, cognitive behaviour therapy (CBT) is still a broad church. At one extreme there are radical behaviourists who believe that thoughts and feelings are simply phenomena that can be conditioned in the same way as behaviours. At the other end of the spectrum there are schema therapists who believe that underlying cognitive structures guide and determine our goals, plans and relationships (Young et al., 2003); these `early maladaptive schemas' have many similarities with psychoanalytic concepts of internalised object relations. The form of CBT best known in Britain is Beck's cognitive therapy (Beck, 1976). This sits in the middle of the continuum: it incorporates behaviour, thoughts and beliefs in its model of human experience and action. This model has, as we shall see, a ¯exibility in its approach to formulation and treatment that allows it to be adapted and shaped for use with a wide range of problems. Cognitive and behavioural techniques are now of major importance in the treatment of anxiety disorders, depression, eating disorders and psychosis and are the primary psychological treatment recommended in the National Institute for Health and Clinical Excellence guidelines for these conditions (www.nice.co.uk).