Table Of ContentCOGNITIVE
BEHAVIOR
THERAPY
Research and Application
COGNITIVE
BEHAVIOR
THERAPY
Research and Application
Edited by
John P. Foreyt
Baylor College ofM edicine
Houston, Texas
and
Diana P. Rathjen
Rice University
Houston, Texas
PLENUM PRESS • NEW YORK AND LONDON
Library of Congress Cataloging in Publication Data
Main entry under title:
Cognitive behavior therapy.
Includes bibliographies and index.
1. Cognitive therapy. I. Foreyt, John Paul. II. Rathjen, Diana P.
RC489.C63C63 616.8'914 78-15948
ISBN-13: 978-1-4684-2498-0 e-ISBN-13: 978-1-4684-2496-6
DOl: 10.1007/978-1-4684-2496-6
© 1978 Plenum Press, New York
A Division of Plenum Publishing Corporation
227 West 17th Street, New York, N.Y. 10011
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted,
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
Contributors
Aaron T. Beck, M.D., Department of Psychiatry, University of
Pennsylvania, Philadelphia, Pennsylvania
John G. Bruhn, Ph.D., Community Affairs and Special Programs,
University of Texas, Medical Branch, Galveston, Texas
David D. Burns, M.D., Department of Psychiatry, University of
Pennsylvania, Philadelphia, Pennsylvania
Roy Cameron, Ph.D., Department of Psychology, University of
Saskatchewan, Saskatoon, Saskatchewan, Canada
Patrick H. Doyle, Ph.D., Department of Psychology, University of
Houston, Clear Lake City, Texas
John P. Foreyt, Ph.D., Departments of Medicine and Psychiatry,
Baylor College of Medicine, Houston, Texas
w. Doyle Gentry, Ph.D., Department of Psychiatry, Duke University
Medical Center, Durham, North Carolina
Alice Hiniker, Ph.D., Texas Research Institute of Mental Sciences,
Houston, Texas
Raymond W. Novaco, Ph.D., Program of Social Ecology, University
of California, Irvine, California
v
vi CONTRIBUTORS
Diana P. Rathjen, Ph.D., Department of Psychology, Rice Univer
sity, Houston, Texas
Eric D. Rathjen, Ph.D., Mental Health-Mental Retardation Author
ity, Harris County, Houston, Texas
Jeffrey C. Steger, Ph.D., Department of Rehabilitation Medicine,
University of Washington School of Medicine, Seattle,
Washington
Dennis C. Turk, Ph.D., Department of Psychology, Yale University,
New Haven, Connecticut
G. Terence Wilson, Ph.D., Graduate School of Applied and Profes
sional Psychology, Rutgers University, New Brunswick, New
Jersey
Foreword
The recent development of cognitive theories and therapies within
the ranks of behavior therapy has to be classified as one of the more
intriguing developments in contemporary clinical psychology. After
all, "behaviorists" have long been stereotyped as cold, hard-headed
environmentalists who have been anything but subtle in their at
tacks on mentalism. To those who have accepted such a stereotype,
a "cognitive behavior therapist" might sound like a self-contradic
tory creature, one steeped in two separate and incompatible psy
chological traditions. How can one be both "cognitive" and "be
havioral"? This is only one of the issues addressed in the present
volume, which represents a valuable contribution toward both the
oretical and empirical refinements in the area. Here one can read
how the behavioristic emphases on assessment and experi
mentation can be fruitfully integrated with therapeutic procedures
designed to alter patterns of human distress. Many of those
procedures involve specific focus on a client's thoughts and
fantasies.
This book represents a strong and timely overview of an excit
ing new area, and its contributors include some of the most ener
getic researchers in the field. A theme of cautious optimism is
blended with a commitment to empirical scrutiny, and there is an
admirable recognition of the important difference between inferred
therapeutic process and operationally specified therapeutic proce
dure. It is therefore a volume that should appeal to both researcher
vii
viii FOREWORD
and practitioner, and it is a valuable resource for exploring some of
the newer applications of cognitive behavioral techniques.
There are those within behavioral and nonbehavioral camps
who will be dismayed by the appearance of a volume such as the
present one. They are, however (1 think), in the minority relative to
the number of professionals who will be intrigued by these strange
bedfellows and eager to explore their theoretical and pragmatic via
bility. A recent survey of American clinical psychologists suggests
that cognitive behavioral approaches are now more popular than
client-centered therapy, and that the recent increase in ideological
eclecticism may partially reflect the increasing permeability be
tween former polarities. The behavior therapist is now relying on
assessment and treatment strategies that acknowledge the impor
tance of cognitive processes in human adaptation. Likewise, the
nonbehavioral counselor seems to be more frequently borrowing
from traditionally behavioral methods. In integrating their relative
skills and special interests, it is my hope that we may soon be able
to abandon the unfortunate polarities and isolationism that have
dominated clinical psychology and psychiatry.
The present volume is, I think, a valuable step toward demon
strating the compatability and rich therapeutic promise of combin
ing intrapersonal, environmental, and scientific concerns. It does
not promise miracles and is, in fact, commendable in its critical
self-scrutiny. With modeling such as that offered in this book, we
may hope to see continuing refinements of our understanding as
well as revisions of our treatment strategies. Cognitive Behavior
Therapy: Research and Application represents a welcome addition to
the literature.
J.
MICHAEL MAHONEY
Pennsylvania State University
Preface
Commenting on the first 50 years of behaviorism, Skinner (1964L in
the early 1960s, noted:
No entity or process which has any useful explanatory force is to be
rejected on the ground that it is subjective or mental. The data which
have made it important must, however, be studied and formulated in
effective ways. The assignment is well within the scope of an experi
mental analysis of behavior, which thus offers a promising alternative
to a commitment to pure description on the one hand and an appeal to
mentalistic theories on the other. (Skinner, B. F. Behaviorism at fifty. In
T.W. Wann (Ed.), Behaviorism and phenomenology: Contrasting bases for
modern psychology. Chicago: The University of Chicago Press, 1964, p.
96.)
In the intervening years, psychologists applying behavioral
principles to clinical problems have attempted to provide the data
Skinner suggests. In particular, the work of Albert Ellis, Aaron
Beck, and Albert Bandura has steadily kept alive a cognitive frame
work introduced by the early social psychologists such as Julian
Rotter and George Kelly.
The renewed interest in a merger or at least dialogue between
the proponents of a cognitive and a behavioral perspective in un
derstanding human behavior is an exciting recent development in
the field of psychology. In addition to the intellectual stimulation
provided by such a rapprochement, practical implications for clini
cal treatment may also be forthcoming.
This book is an effort to explore current answers to the ques
ix
x PREFACE
tion, What is the role of cognitive factors in clinical treatment? Each
of the authors presents a unique perspective revealing no overall
consensus but rather a diverse collection of thought-provoking pos
sibilities.
The idea for this volume originated at the Sixth Annual Sym
posium of the Houston Behavior Therapy Association (HBTA),
Houston, Texas. We are deeply indebted to each of the authors for
their outstanding contributions. We are also grateful to the co-spon
sors of the symposium: University of Houston, Rice University,
Baylor College of Medicine, and Spring Branch Academy, Houston,
Texas. Each year HBT A presents a topic of significance to behavior
therapists and others concerned with behavioral issues. Our sym
posium is successful only because of the hard work of many people,
including HBTA members Drs. Pat Doyle, Richard Jones, Ed Keuer,
Paul Mader, Sander Martin, Ben Williams, and in particular, Martha
Frede and Larry Brandt who co-chaired the conference. Thanks also
to Mr. Bill Kortas for his hard work and Ms. Susi LeBaron for her
never-ending task of typing the manuscript. To all of them, our
deepest gratitude.
JOHN P. FOREYT
DIANA P. RATHJEN
Houston Texas
Contents
INTRODUCTION .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1. COGNITIVE BEHAVIOR THERAPY: PARADIGM SHIFT OR PASSING
PHASE? ................................................ 7
G. Terence Wilson
Behavior Therapy in the 1970s: Current Conceptual Models 8
The Cognitive Therapies: A Paradigm Shift? . . . . . . . . . . . . . . 16
Cognitive (Behavior) Therapy: A Passing Phase? . . . . . . . . .. 21
The Clinical Efficacy of the Cognitive Therapies. . . . . . . . . .. 26
A Terminological Note. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 27
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
2. A COGNITIVE ANALYSIS OF SOCIAL PERFORMANCE: IMPLICA
TIONS FOR ASSESSMENT AND TREATMENT. . .. .. .. . . .. .. .. .. . 33
Diana P. Rathjen, Eric D. Rathjen, and Alice Hiniker
A Cognitive and Behavioral Definition of Social Competence 33
Cognitive Techniques for Cognitive-Affective Change ..... 57
Cognitive Techniques for Behavior Change . . . . . . . . . . . . . . . 67
Summary and Conclusions .... . . . . . . . . . . . . . . . . . . . . . . . . .. 73
References ........ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
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