Sample Dissertation Literature Review on Cognitive Therapy

Cognitive Therapy

Introduction

Cognitive therapy is a common type of therapeutic approach focusing on individuals’ current thinking, behaviors, and communication processes with the primary objective of developing viable solutions. In particular, cognitive therapy is a problem-focused approach to facilitating the identification of specific challenges and the elimination of such dysfunctional thought patterns, innate beliefs, and behaviors, causing them problems. Through this process, people can eliminate most of their unsuitable and repetitive desires capable of triggering specific problems (Clément, Lin, & Stangier, 2019). For example, a student struggling to execute complex math problems may develop repetitive thought patterns that include phrases such as “I am stupid” and “I cannot do it.” Cognitive therapy can help the student to eliminate and replace such negative thoughts with a more positive and realistic attitude and notions such as “I will seek help from the teacher,” among other related phrases. Besides, a person struggling to eliminate a smoking habit may undergo a cognitive therapy process that includes introducing him to alternative products. Subsequently, the paper provides a detailed discussion of the topic on cognitive therapy, the history, efficacy, clear illustration of the selected ideas, and comprehensive synthesis of relevant experimental research articles on cognitive therapy. The literature synthesis section also summarizes some of the critical evidence of the effectiveness of cognitive therapy arising from detailed empirical research.

Topic discussion

According to the selected articles, the concept of the cognitive therapy model assumes that individuals’ thoughts, feelings, and behaviors are all connected. Thus, most people may struggle to overcome their challenges without proper identification and elimination of distorted thoughts (Beck, 2016). Similarly, according to Milani, Nikmanesh, & Farnam, (2013), the underlying assumption under cognitive therapy is that people’s emotions can influence or shape their responses. According to the articles, cognitive therapy focuses on encouraging individuals to identify and change some of their crazy thoughts, assumptions, or maladaptive thinking processes. The authors further suggest that behavioral health specialists can depend on cognitive therapy to control the distorted viewpoints (cognitive restructuring) by exposing the individuals to rational and valid assumptions behind their situations. Overall, the outcomes of the experimental research affirm that cognitive restructuring seeks to understand people’s internal realities through effective interventions and identification of the distress areas. The primary objective of the concept was to develop a treatment guideline for clinical depression and other anxiety disorders (Beck, 2016). Thus, the articles support a practical understanding of individuals’ inner realities based on proper recognition of depression severity. In particular, by shaping people’s perceptions, interpretation, and attribution of specific meanings, cognitive therapists could influence their reactions to certain external and internal stimuli.

Article Synthesis

According to the concept of the cognitive therapy model, individuals’ thoughts, feelings, and behaviors are all connected. Thus, most people may struggle to overcome their challenges without proper identification and elimination of distorted thoughts. The cognitive therapist seeks to understand people’s internal realities through effective interventions and identification of the distress areas. Notably, Aaron T. Beck first coined the concept of cognitive therapy in the 1960s with the primary objective of developing a treatment to clinical depression and other anxiety disorders. According to Beck, understanding individuals’ inner realities required self-report measures of depression severity. In particular, people’s perceptions, interpretation, and attribution of certain meanings could influence their reactions to certain external and internal stimuli. Subsequently, the literature synthesis section summarizes some of the critical evidence of the effectiveness of cognitive therapy arising from detailed experimental research.

The research by Clément, Lin, &Stangier (2019) uses a randomized controlled trial to examine the efficacy of cognitive therapy. The primary outcome measure of this research was to help the selected patients to overcome their emotional conditions through cognitive restructuring. Specifically, the article questions whether cognitive restructuring can enhance a person’s emotional and psychological responses or distress. The research used about 60 patients with a primary diagnosis of SAD (social anxiety disorder). The results of this experimental research affirmed that cognitive therapy is an effective treatment model for such psychological distress. According to Clément, Lin, &Stangier (2019), the psychotherapy model can improve the anxiety disorder symptoms in most people with the condition. During therapy, the patients learned to recognize, eliminate, and change their negative thought patterns about themselves and their social environments. They also developed appropriate skills to gain and strengthen their confidence in dealing with various social situations. according to Clément, Lin, &Stangier (2019), exposure-based cognitive therapy improved the patients’ coping skills and effective mitigation of anxiety-inducing situations. However, such cognitive interventions should be prompt to facilitate the effective identification of the adverse impacts or side effects of the patients’ psychological conditions. Some of these impacts may include the development of suicidal thoughts and tendencies.

Similarly, Ginzburg et al. (2012) support the use of cognitive therapy in the treatment of social anxiety disorder. The study analyzes the relationship between competence and outcome in the application of cognitive therapy. It relies on Clark and Wells’ (1995) cognitive model to treat the selected patients. According to the model, self-monitoring and self-observation are critical components of the psychotherapy process. Ginzburg et al. (2012) argue that cognitive therapy can provide a platform for self-evaluation and elimination of negative social cognitions. Thus, the research on Outpatient Clinics focused on patients currently receiving 16 weekly therapy sessions, research conducted in 4 months.  The researchers recommend the application of the DSM-IV criteria for social anxiety disorder because of its effectiveness in the identification of psychological distress. The randomized research also relied on Cognitive Therapy Competence Scale for Social Phobia, comprising about 16 items to assess the specific components of the individuals’ reactions to various external and internal stimuli. Overall, according to the outcome of the randomized controlled trial, cognitive therapy is an effective intervention or treatment method for social anxiety disorders. Ginzburg et al. (2012) affirm that direct engagement in the therapy sessions can facilitate the identification and elimination of social phobias and enhance individuals’ self-esteem and confidence in their interactions. The researchers recommend the application of the DSM-IV criteria for social anxiety disorder because of its effectiveness in the identification of psychological distress.

Roe et al. (2014) reiterate that cognitive therapy is an effective treatment approach for various behavioral health problems. it goes further than the above-mentioned researches to explore the role of self-stigmatization in the wellness of people with mental illness. the authors conducted a quasi-experimental study of individuals with mental illnesses and struggling to overcome self-stigma. The primary objective of the study was to help the subjects identify the negative impacts of their self-stigma and help them eliminate roadblocks to their recovery processes. the study involved about 63 people with serious mental illnesses, subjected to cognitive therapy sessions and related treatment processes. Moreover, it relied on the Internalized Stigma of Mental Illness Scale to assess the participants’  personal experiences of stigma. The result of the experimental research suggests that cognitive therapy is an effective treatment model for the reduction of self-stigma among the selected patients. Specifically, cognitive therapy could facilitate the elimination of the individuals’ self-stigmatizing attitudes, improving their self-esteem and the general quality of life. The participants displayed significant reductions in self-stigma because of their exposure to the cognitive therapy sessions. Roe et al. (2014) attribute the positive impacts of cognitive therapy to the patients’ responses to psychological training and education, cognitive restructuring, and narrative enhancement. The synergistic impacts of these components of the psychotherapy model can help individuals to understand the nature of their stigma and the relationship of their thought patterns. In this case, the research by Roe et al. (2014) relied on the assumption that patients were capable of rejecting their stigmatized perception or views after identifying and eliminating their self-destructive behaviors and actions. As such, the study affirms that cognitive therapy is an effective intervention that can help eliminate the social stigma associated with mental health conditions.

Dimidjian et al. (2014) explore a different condition compared to the above-discussed literature, but the aim is to find out the effectiveness of cognitive therapy. The authors conducted an open trial and quasi-experimental research to ascertain the effectiveness of cognitive therapy in the identification and elimination of depressive symptoms. the study relied on about 107 recurrently depressed persons, screened and enrolled in an 8-session cognitive therapy process. The primary objective of the experiment was to demonstrate the perceived impacts of depressive symptoms severity. The outcome of the experiment by Dimidjian et al. (2014) confirmed that various cognitive interventions and models could improve individuals’ emotional reactions and reduce related psychological distress. One of these interventions is the Mindful Mood Balance (MMB) process that helped the patients to disengage from their negative habits or dysfunctional cognitive patterns. The successful identification and elimination of the depression-related ruminative thought processes reduced the patients’ susceptibility to possible relapse. The intervention involved a comprehensive body scan, a medication practice requiring the individuals to concentrate on specific thoughts and body regions. The guided instructions are part of the cognitive therapy processes that enable the patients to understand their experiences and behavioral components. Instructions may include sitting meditations, yoga stretching, and mindful eating. Overall, Dimidjian et al. (2014) affirmed that cognitive therapy interventions, such as the Mindful Mood Balance, could progressively reduce depressive symptoms with proper implementation. The research attributes the reduction in depressive severity to the increase in mindfulness.

The research by Milani, Nikmanesh, &Farnam (2013) examines the efficacy of cognitive therapy interventions in reducing individuals’ aggressive behaviors in juvenile correction and rehabilitation centers. Notably, dealing with children and adolescents is a challenge for most parents in contemporary societies. As such, Milani, Nikmanesh, &Farnam (2013) explore the possibility of using mindfulness-based cognitive therapy in controlling such destructive tendencies. The experimental research used a Buss and Perry aggression questionnaire (1992) to collect related data and information on the progression of aggressive behaviors. In essence, uncontrolled aggression among children and adolescents can elicit various social, professional, educational, mental, and physical challenges. Some of the teenagers may struggle with alcohol and drug abuse, poor school performances, depressive symptoms, and delinquency, among other disorders. According to Milani, Nikmanesh, &Farnam (2013), cognitive therapy is an effective treatment method in such situations. The therapeutic model can train and strengthen the students’ cognitive skills, ensuring their effective management and elimination of the identified aggressive behaviors. Mindfulness meditation is an illustration of the role of cognitive therapy intervention in shaping the patients’ moods, thoughts, behaviors, and feelings. all the respondents in this study reported that the cognitive therapy model had a positive impact on the quality of their life and anger management. The result confirms that the therapeutic model can help in reducing depression and anxiety associated with negative thoughts and dysfunctional attitudes. The patients also recorded an increased desire to survive and cope with their varied challenges, improved their social functioning, and suppressed suicidal thoughts.

Panahi &Faramarzi (2016) also offers an interesting argument on the impacts of cognitive therapy on depression and anxiety. The targeted respondents in this study are women experiencing premenstrual syndrome. The randomized controlled trial included about 60 students at Mazandaran University experiencing mild to moderate premenstrual syndrome and other depressive and anxiety symptoms. According to Panahi &Faramarzi (2016), the syndrome can make women become hostile, lose concentration, experience social disturbance, and develop interpersonal conflicts. They may also experience physical distress, such as headache, pelvic pain, and other forms of discomfort, further enhancing their depressive symptoms. The distorted interpersonal relationships and cognitive may result in the women’s poor quality of life and domestic instability. Nevertheless, Panahi &Faramarzi (2016) demonstrate that mindful-based cognitive therapy can help individuals to regain their emotional stability. In particular, the therapeutic model can facilitate the identification, suppression, and acceptance of negative thought patterns. Similarly, the therapy process can strengthen the women’s intentional responses to tensions, stress, and pain associated with premenstrual syndrome. According to Panahi &Faramarzi (2016), the successful elimination of disturbing emotions such as fear, anger, and feelings of shamefulness can be complex. However, through cognitive therapy, people can learn various stress management techniques, such as yoga, increasing their attention and awareness. Overall, Panahi &Faramarzi (2016) hypothesized that the mindfulness-based cognitive therapy process can enhance women’s sensitivity to pain, mood irritability, and effective emotional regulation. the improvement of the premenstrual syndrome symptoms implies women’s ability to observe, understand, and accept their thoughts, feelings, and negative experiences. In particular, the improvement of the premenstrual syndrome symptoms implies women’s ability to observe, understand, and accept their thoughts, feelings, and negative experiences. The primary objective is to provide individuals with a heightened ability to develop and maintain balanced physical and social relationships while experiencing the negative impacts of premenstrual syndrome.

The research by Ebrahiminejad et al. (2016) further illustrates the effectiveness of a cognitive therapy process in controlling social anxiety among adolescents. According to the authors, social anxiety is psychological distress is a mental health condition that can affect adolescents’ emotional states and social achievements. Most children and adolescents diagnosed with social anxiety are susceptible to educational problems and struggles, drug abuse, and reduced social relationships. They may also experience constant instances of depressive relapses, further enhancing their psychological distress. Notably, semi-experimental research integrated about 30 female students suffering from social anxiety (Ebrahiminejad et al., 2016). The selected respondents fulfilled the DSM-5 criteria based on the convenience sampling process. The result from the experimental group affirmed the effectiveness of cognitive therapy interventions in improving the patients’ self-esteem and decreasing their social anxiety. Overall, Ebrahiminejad et al. (2016) assert that cognitive therapy can improve female adolescents’ level of self-confidence and the reduction of stress. The students became more aware of their physical sensations and feelings through accurate identification of potentially harmful thought processes before they transformed into viable threats. The findings by Ebrahiminejad et al. (2016) are in line with the outcomes of other studies on the efficacy of a cognitive therapeutic approach in patients diagnosed with related psychological distress. For instance, the respondents in the experiment research reported a reduction in fear and avoidance after undergoing a cognitive therapy session. Therefore, based on the outcomes, behavioral health specialists should consider such alternative responses to mental health processes to ensure effective control of emotional reactions. Overall, the intervention is useful because it integrated the students’ attention, consciousness, curiosity, emotions.

Lastly, Alamout et al. (2020) reiterate the critical role of cognitive therapy in the improvement of individuals’ physical body conditions. In particular, the authors argue that the cognitive process can help individuals struggling with weight loss, hypertension, and attention bias to eating behaviors. The therapeutic intervention can help individuals to identify some of their social, biological, and cultural interactions and reactions, limiting their weight management desires. The experimental study incorporated about 45 participants categorized into various groups (Alamout et al., 2020). The respondents were mostly overweight women, subjected to psychological interventions. Besides, the authors subjected the experimental groups to both an energy-restricted diet and cognitive therapy to ascertain the effectiveness of each intervention. The result of this study by Alamout et al. (2020) revealed that the combination of diet and cognitive therapy could contribute to weight loss. The experimental results are consistent with the outcomes of the other research articles discussed in this paper. Individuals using the therapeutic model can control their stress levels, eating behaviors, and other related practices. Therefore, the synthesis of the experimental research articles is an affirmation that psychological interventions such as cognitive therapy are an effective treatment for behavioral and emotional distress. In particular, such interventions can have positive impacts on the patients’ self-esteem level, self-efficacy, and stress-management abilities. Alamout et al. (2020) further argue that most people are more likely to develop automatic responses to their distorted thoughts and perception of certain situations rather than understanding their realities.

Conclusions

The paper has provided detailed discussions on the topic of cognitive therapy, its history, and its effectiveness. The illustration and comprehensive synthesis of relevant experimental research articles reveal essential insights into cognitive therapy. First, according to the articles, individuals subjected to cognitive therapy become rational thinkers, capable of understanding and shaping their thought patterns. Such individuals can learn to shape their unwanted thought patterns and belief systems by developing self-confidence and esteem. Besides, the articles argue that cognitive therapy can help in controlling social anxiety and enhancing one’s ability to handle complex situations. More importantly, with cognitive therapy, Individuals can question their emotional reactions repeatedly. The focused targeting of thoughts (emotions and behaviors) can help in transforming feelings and minimize the negative impacts of related dysfunctional arguments. Therefore, according to the articles, individuals should rely on cognitive therapies and other psychological interventions to strengthen their mental health conditions. The experimental research affirms that behavioral health specialists can also use cognitive therapy to treat mental health conditions such as anxiety, personality disorders, and substance abuse, among others. Overall, the articles stipulate that the cognitive restructuring process should ensure proper identification of the challenging cognition or distortions before developing rational rebuttals.

References

Alamout, M. M., Rahmanian, M., Aghamohammadi, V., Mohammadi, E., & Nasiri, K. (2020). Effectiveness of mindfulness based cognitive therapy on weight loss, improvement of hypertension and attentional bias to eating cues in overweight people. International journal of nursing sciences, 7(1), 35-40. https://doi.org/10.1016/j.ijnss.2019.12.010

Beck, A. T. (2016). Cognitive therapy: nature and relation to behavior therapy–republished article. Behavior therapy, 47(6), 776-784. https://doi.org/10.1016/j.beth.2016.11.003

Clément, C., Lin, J., & Stangier, U. (2019). Efficacy of Behavioral Experiments in Cognitive Therapy for Social Anxiety Disorder: Study protocol for a randomized controlled trial. Trials, 20(1), 1-11. https://doi.org/10.1186/s13063-019-3905-3

Dimidjian, S., Beck, A., Felder, J. N., Boggs, J. M., Gallop, R., & Segal, Z. V. (2014). Web-based mindfulness-based cognitive therapy for reducing residual depressive symptoms: an open trial and quasi-experimental comparison to propensity score matched controls. Behaviour Research and Therapy, 63, 83-89. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5714615/

Ebrahiminejad, S., Poursharifi, H., Roodsari, A. B., Zeinodini, Z., & Noorbakhsh, S. (2016). The effectiveness of mindfulness-based cognitive therapy on Iranian female adolescents suffering from social anxiety. Iranian Red Crescent Medical Journal, 18(11). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292141/

Ginzburg, D. M., Bohn, C., Höfling, V., Weck, F., Clark, D. M., & Stangier, U. (2012). Treatment specific competence predicts outcome in cognitive therapy for social anxiety disorder. Behaviour Research and Therapy, 50(12), 747-752. https://doi.org/10.1016/j.brat.2012.09.001

Milani, A., Nikmanesh, Z., & Farnam, A. (2013). Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in reducing aggression of individuals at the juvenile correction and rehabilitation center. International journal of high risk behaviors & addiction, 2(3), 126. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4070155/

Panahi, F., & Faramarzi, M. (2016). The effects of mindfulness-based cognitive therapy on depression and anxiety in women with premenstrual syndrome. Depression research and treatment, 2016. https://www.hindawi.com/journals/drt/2016/9816481/

Roe, D., Hasson‐Ohayon, I., Mashiach‐Eizenberg, M., Derhy, O., Lysaker, P. H., & Yanos, P. T. (2014). Narrative enhancement and cognitive therapy (NECT) effectiveness: A quasi‐experimental study. Journal of clinical psychology, 70(4), 303-312. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3954406

References

Alamout, M. M., Rahmanian, M., Aghamohammadi, V., Mohammadi, E., &Nasiri, K. (2020). Effectiveness of mindfulness based cognitive therapy on weight loss, improvement of hypertension and attentional bias to eating cues in overweight people. International journal of nursing sciences, 7(1), 35-40. https://doi.org/10.1016/j.ijnss.2019.12.010

Clément, C., Lin, J., &Stangier, U. (2019). Efficacy of Behavioral Experiments in Cognitive Therapy for Social Anxiety Disorder: Study protocol for a randomized controlled trial. Trials, 20(1), 1-11. https://doi.org/10.1186/s13063-019-3905-3

Dimidjian, S., Beck, A., Felder, J. N., Boggs, J. M., Gallop, R., & Segal, Z. V. (2014). Web-based mindfulness-based cognitive therapy for reducing residual depressive symptoms: an open trial and quasi-experimental comparison to propensity score matched controls. Behaviour Research and Therapy, 63, 83-89. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5714615/

Ebrahiminejad, S., Poursharifi, H., Roodsari, A. B., Zeinodini, Z., &Noorbakhsh, S. (2016). The effectiveness of mindfulness-based cognitive therapy on Iranian female adolescents suffering from social anxiety. Iranian Red Crescent Medical Journal, 18(11). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292141/

Ginzburg, D. M., Bohn, C., Höfling, V., Weck, F., Clark, D. M., &Stangier, U. (2012). Treatment specific competence predicts outcome in cognitive therapy for social anxiety disorder. Behaviour Research and Therapy, 50(12), 747-752. https://doi.org/10.1016/j.brat.2012.09.001

Milani, A., Nikmanesh, Z., &Farnam, A. (2013). Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in reducing aggression of individuals at the juvenile correction and rehabilitation center. International journal of high risk behaviors & addiction, 2(3), 126. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4070155/

Panahi, F., &Faramarzi, M. (2016). The effects of mindfulness-based cognitive therapy on depression and anxiety in women with premenstrual syndrome. Depression research and treatment, 2016. https://www.hindawi.com/journals/drt/2016/9816481/

Roe, D., Hasson‐Ohayon, I., Mashiach‐Eizenberg, M., Derhy, O., Lysaker, P. H., &Yanos, P. T. (2014). Narrative enhancement and cognitive therapy (NECT) effectiveness: A quasi‐experimental study. Journal of clinical psychology, 70(4), 303-312. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3954406/