Posted on: 3 November 2021
Pictured left: Dr Chris Whiteley, CNWL’s Chief Psychologist
“CBT approaches are probably the most widely practiced forms of psychological therapy and the most extensively researched.”
“Around 1 million people a year use NHS IAPT services, with the majority achieving a substantial improvement in their problems, more than half at a level regarded as having ‘recovered’. Under the NHS Long Term Plan the ambition is to almost double the number of people receiving effective psychological treatment in IAPT services.”
Dr Aaron T Beck will be known to many for his prominence in the development of Cognitive Behavioural Therapy (CBT) and how it grew to become a widely practiced psychological treatment. Having turned 100 earlier this year many of his important contributions to the research and practice of psychological therapy and beyond have been recently celebrated.
Developed in the 1960s and 1970s CBT was seen as radically different from the common approaches at the time. Beck’s focus on researching the outcomes of CBT helped to bring much greater attention to the importance of evidenced-based treatments into psychological practice. In turn providing powerful arguments for the impact and effectiveness of psychological therapies. In 1977 Beck contributed to the first research trail to show a talking therapy (CBT) to be more effective in the treatment of depression than medication.
In his work as a psychiatrist Beck noticed how commonly service users spoke about their thoughts and how similar the nature and expression of these thoughts could often be. He also drew on his own experiences and how he had overcome them. Beck was drawn to the emerging research into cognition (thinking and the processing of information) to help understand how thoughts might be connected to the experience of depression and also to develop ways to apply this in psychological treatments.
Beck’s work in developing CBT was based on research about how in our day to day lives we think about and process information from the world around us. Including how our interpretation (the meaning) of an event or situation has a strong influence on how we feel emotionally, our bodily sensations and on our behaviour.
Shaped by our experience we build collections of beliefs about ourselves, other people and the world around us. In turn these beliefs can lead us to preference some interpretations of situations over others.
Most of the time these processes are useful to us, helping us make sense of things. In his work Beck developed models of how these processes could also be involved in problems like depression and anxiety.
If hearing a loud sudden unexplained noise we interpret this as a sign of something dangerous about to happen we might feel and react very differently than if we attributed the noise to a firework display. It would make sense that someone who had experienced danger and harm connected to loud noises might be more likely to think an unexplained loud noise was dangerous, feeling and acting accordingly.
Beck used these ideas to develop therapeutic approaches to help people identify where beliefs might have become unhelpful, contributing to problems they were experiencing and to re-evaluate them.
Where, on the basis of this re-evaluation, people shaped or changed their beliefs Beck observed how they often reported feeling better and changes in their behaviour.
Following his work on depression Beck went on to adapt the same key principles to the understanding and treatment of other mental and physical health problems. Work that continues to be taken further by many others to develop more treatments and more effective treatments.
CBT approaches are probably the most widely practiced forms of psychological therapy and the most extensively researched.
Fuelled by that volume of practice and research, much of contemporary CBT approaches might look quite different to the original therapy offered by Beck. Increasing attention to the inequalities in access to and outcomes from CBT, including for people with the greatest need and people from minoritized backgrounds, underlines the importance that current developments continue to adapt and improve CBT and how it is practiced.
Beck’s was some of the work that was influential in the development in the NHS of IAPT (talking therapy) services that saw the significant increase in availability of CBT and a range of other effective psychological therapies.
Around 1 million people a year use NHS IAPT services, with the majority achieving a substantial improvement in their problems, more than half at a level regarded as having ‘recovered’. Under the NHS Long Term Plan the ambition is to almost double the number of people receiving effective psychological treatment in IAPT services.
Visit the Talking Therapies service website (opens link)