Description of CBT

CBT is an active, directive, time-limited and structured treatment approach. The most common form of CBT used in the UK is based upon the cognitive model of dysfunctional information processing in emotional disorders developed by Beck and colleagues (Beck et al., 1979). In the Beck model, cognitions (which can be thoughts or images) are determined by underlying beliefs (termed 'schemas'), attitudes and assumptions. The most basic premise of CBT is that how a person feels and behaves determines the way that person thinks and makes sense of experiences. CBT can be distinguished from other forms of psychotherapy by its emphasis on the empirical investigation of the patient's thoughts, appraisals, inferences and assumptions. This aim is achieved through the explicit use of cognitive and behavioural techniques such as activity scheduling, graded task assignments, problemsolving techniques, thought identification and monitoring, and examining and challenging core beliefs about the self, world and future. Morris and Morris (1991) state the following reasons why CBT can be particularly effective with older people:

(1) The focus is on the 'here and now'; the individual's current needs are identified and interventions are developed to target-specific stressors.

(2) CBT is skills-enhancing and practical; people are taught specific ways to manage their individual stressors.

(3) Sessions are structured; the organised nature of therapy keeps the person oriented to tasks within and across sessions, and homework is used to keep the focus on managing problems.

(4) Self-monitoring is used; the individual is taught to recognise mood fluctuations and emotional vulnerabilities, and to develop strategies that enhance coping ability.

(5) CBT adopts apsychoeducative approach; the connection between thoughts, mood and behaviour is explained.

(6) CBT is goal-oriented; interventions are developed to target and challenge stereotyped beliefs, such as, 'You can't teach an old dog new tricks'.

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