Patients with depression and anxiety have many more negative or fearful automatic thoughts than control subjects, and these distorted cognitions stimulate painful emotional reactions. Automatic thoughts are frequently based on faulty logic or errors in reasoning. In cognitive therapy, patients are usually taught how to detect cognitive errors and to use this skill in developing a more rational style of thinking. Another focus of cognitive therapy is on underlying schemas. These cognitive structures are thought to be the templates, or basic rules, for interpreting information from the environment.
Cognitive therapists assist patients in modifying problematic schemas.
Generally, cognitive therapy for dysfunctional schemas is more complex and demanding than therapeutic work with automatic thoughts. Cognitive therapy also includes a number of behavioral interventions such as activity scheduling and graded task assignments. These procedures are used to reverse behavioral pathology and to influence cognitive functioning. If behavior improves, there is usually a salutatory effect on cognition. In a similar manner, cognitive changes can lead to behavioral gains.