12 Principles Of Cognitive Behavior Therapy (2024)

If you’re wondering which principle underlies cognitive therapy, this extensive guide is for you.

Which Principle Underlies Cognitive Therapy
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Below, you’ll discover 12 basic principles of cognitive behavioral therapy (CBT) to help you understand what this form of therapy focuses on and how it works. 

The principles of cognitive behavioral therapy are often used in life coaching sessions as well as traditional therapy sessions. 

That’s why I’m keen to share this guide with you. 

So, let’s dive in.  

Which Principle Underlies Cognitive Therapy? Thoughts Affect Actions

Cognitive behavioral therapy refers to a type of talking therapy focused on freeing people from mental illnesses such as anxiety disorders, eating disorders, depression and substance abuse. 

It’s backed by scientific research and clinical expertise. Research suggests it’s one of the most reliable therapies for overcoming these types of mental health conditions. 

This principle underlies cognitive behavioral therapy: your thoughts influence emotions, which influence your actions.

This idea is often referred to as the cognitive triangle or cognitive triad.

It’s called a triangle because you’ll often experience a cycle where your actions reinforce your thoughts, whether positive or negative.  

Here’s a basic example that you might experience at a social event. 

  • Positive Thought: People are friendly. They’ll be excited to meet me. 
  • Positive Emotions: Excitement, glee. 
  • Positive Action: A friendly confident greeting

More often than not, this will lead to a positive reaction reinforcing the initial thought.  

  • Negative Thought: People are unfriendly. They don’t want to talk to me.
  • Negative Emotions: Fear, bitterness, sadness, anger. 
  • Negative Action: He greets the group in a cold unconfident manner, most likely leading to a frosty reaction (or he doesn’t greet them at all) 

Either way, it reinforces his original thought. 

That principle underlies cognitive behavioral therapy, so CBT teaches patients that their thoughts matter.

In cognitive therapy sessions, the patient will learn how to flip their automatic negative thoughts and recognise how that leads to a positive outcome.  

With time, they will begin to do that automatically and their mental health will begin to improve.

If a patient is suffering from mild anxiety or depression, they can expect to see improvements to their mental health within a handful of CBT sessions.

Those with more severe mental illnesses might need more therapy sessions before they begin to experience behavioral changes. 

Related: What Kind Of Therapy Do I Need – 7 Types Easy Explained

12 Principles Of Cognitive Behavioral Therapy

If someone asked what principle underlies cognitive behavioral therapy, most people who understand it will mention the cognitive triangle.

However, there are other principles that shape what CBT aims to achieve. 

1.  The Three Levels Of Cognition

These three cognitive terms are:

  • Core Beliefs. Core beliefs are learned in early childhood experiences and often remain rooted in your psyche throughout adulthood. These affect your thoughts, emotions and actions. These rigid beliefs mostly concern yourself, the environment around you and the future. 
  • Dysfunctional Assumptions (Cognitive Distortions). These occur when we’re consumed by negative thinking. Negative thoughts can create a distorted perception of reality, leading to dysfunctional beliefs. 
  • Automatic Negative Thoughts. Automatic negative thoughts pop up involuntarily. As we’ve explored, these impact your emotions, which influence your actions. Cognitive therapy aims to reduce Automatic Negative Thoughts or at least prevent them from ruining your experience of life.

2. Beck’s Cognitive Model

This essentially is a structure for the idea that your thoughts influence your emotions, which influence your actions. 

  • Beck’s cognitive model begins with a situation or a ‘trigger’.
  • The situation sparks your thoughts. 
  • Your thoughts influence your emotions. 
  • Your emotions influence your choice of actions (which usually reinforce your original thoughts).  

3. CBT Is Based On An Ever-Evolving Formulation Of Patients’ Problems And An Individual Conceptualization Of Each Patient In Cognitive Terms

This principle confirms that CBT patients’ problems are different and are always changing. The initial sessions will involve a brief review to discover the patient’s current unhelpful thinking patterns, including their core beliefs, cognitive distortions and lines of negative thinking.

A conceptualization of the patient is formulated based on the information gathered to provide an accurate picture of the patient’s whole situation. These findings can be refined with each therapy  session as more information is revealed.

4. CBT Requires A Sound Therapeutic Alliance

This principle clarifies that cognitive therapy is far more likely to be effective when the patient and therapist have a strong trusting relationship. 

5. CBT Emphasizes Collaboration And Active Participation

The patient should be active in their CBT sessions, not passive. This active participation is key to cognitive therapy having a lasting impact on their mental health conditions.

6. CBT Is Goal-Oriented And Problem-Focused

CBT initially emphasizes goal-setting within a patient’s initial sessions. These are required to help the patient identify and interrupt dysfunctional thoughts that interfere with their goals. 

7. CBT Initially Emphasizes The Present

CBT aims to fix the problems that are occurring in the patient’s mind right now. It’s always problem-focused and present-focused.

The past should only be considered if the patient expresses a strong desire to explore the patient’s life experiences, as a way to understand and change their core beliefs.  

8. CBT Is Educative, Aims To Teach The Patient To Be Their Own Therapist, And Emphasizes Relapse Prevention

Teaching CBT isn’t about the therapist ‘fixing’ the patient and sending them on their way. It’s about showing the patient how to be their own therapist. The goal is that patients can identify key cognitions and interrupt their own dysfunctional thinking without assistance. This is why CBT emphasizes collaboration and active participation teamwork so heavily.   

9. CBT Aims To Be Time-Limited

The goal of CBT sessions is to improve the patient’s mental health and teach them to be their own therapist, so they no longer need CBT sessions!

That’s why relapse prevention is a key part of the therapy. 

The structured treatment should be time limited. Straightforward anxiety disorders might be treated within 6 to 14 sessions. Those with more severe mental illnesses might need longer. 

10. CBT Sessions Are Structured

The structured treatment will include: 

  • Introduction: A mood check, a brief review of the week, setting goals for the session together.
  • Middle: Reviewing homework, discussing the patient’s current thinking patterns and the patient’s problems, setting new homework.
  • Conclusion: eliciting feedback from the patient and finalizing their goals.

Related: Average Number Of Therapy Sessions – A Complete Guide

11. CBT Teaches Patients To Identify, Evaluate, And Respond To Their Dysfunctional Thoughts And Beliefs

Therapists help patients identify key cognitions and adopt more realistic rational perspectives. This is what we call becoming your own therapist.  

12. CBT Uses A Variety Of Techniques To Change Thinking, Mood, And Behavior

The chosen techniques will depend on the individual conceptualization of the patient, the patients’ problems and the problematic behaviors being discussed. 

Related: How Long Does Psychoanalysis Typically Take?

What Are The Main Techniques Of Cognitive Therapy?

Cognitive restructuring is the process of leading a patient towards more positive thinking patterns instead of their current patterns of negative thinking. 

As with all types of talk therapy, the patient’s active participation is important. It’s crucial that patients identify key cognitions and more rational perspectives themselves. The therapist’s role is simply to lead them to the realisations of their cognitive errors.

Behavioral experiments are a common part of CBT treatment. This is essentially where the therapist asks the patient to do something to test the accuracy of their dysfunctional thinking. A therapist creates behavioral experiments to help the patient easily identify evidence that their negative belief system is inaccurate.

It requires a strong trusting relationship with the therapist for a depressed patient to follow through on the recommended behavioral experiments, but this form of ‘exposure therapy’ can often decrease problematic behaviors and lead to positive behavioral changes.

Acceptance and commitment therapy (ACT) can also prove useful. This therapy aims to help patients accept that distress is sometimes part of life. When you accept instead of resist this fact, it becomes easier to stop distress ruining your mental health for weeks or months at a time. ACT often includes meditation and mindfulness exercises. 

Journaling is highly encouraged in cognitive therapy, because it becomes easier to challenge thoughts when they are written down. CBT requires the therapist to be aware of your ever-evolving formulation of thought patterns and journaling helps them to gain this awareness. 

Activity scheduling can be a useful exercise to help patients improve their mental health. There are four categories of activities when it comes to CBT-related activity scheduling; pleasure, mastery, self-care, managing home. 

The therapist will recommend different categories depending on the patient’s mental health problems and the potential cause of it. For example, a workaholic may be prescribed more pleasure activities, while someone with core beliefs surrounding the meaningless of life might be encouraged to engage in more mastery and self-care activities. 

Related: Therapeutic Process & Therapeutic Steps – Easy Explained

Benefits Of Group Therapy

CBT treatment can be performed via one-or-one sessions or in groups. The most widely-accepted benefits of group therapy include: camaraderie, different rational perspectives of a patient’s life experiences, increased accountability and increased self-discovery.

The behavioral experiments can be more enjoyable in group sessions as well.   

Any More Questions About What CBT Teaches Patients?

Thanks for reading my guide. 

I hope you now have a better understanding of which principle underlies cognitive behavioral therapy, what to expect from CBT sessions and how it can aid with various mental health problems. 

If you have any questions about cognitive therapy, feel free to leave a comment below. 

It would be great to hear from you. 

About The Author

Bijan Kholghi is a certified life coach with the Milton Erickson Institute Heidelberg (Germany). He helps clients and couples reach breakthroughs in their lives by changing subconscious patterns. His solution-oriented approach is based on Systemic- and Hypnotherapy.