Cognitive Therapy: Basic Principles and Applications

Covering the Bases Cognitive Therapy: Basic Principles and Applications Robert L. Leahy. Northvale, NJ: Aronson (www.aronson). 1996, 250 pp., $50.00 (hardcover). There are many books that now purport to be surveys of cognitive-behavioral therapy (CBT). Many of them attempt to focus on specific diagnoses or methods to create a thematic thrust to the book. Some (e.g., J. Beck, 1995) do indeed attempt to provide broader coverage of both technique and theory. Leahy (1996) attempts the latter. Leahy (1996) is divided into three parts: (1) General Theory, (2) Assessment and Interventions, and (3) Specific Applications. In the introduction that precedes the first section, the author states that the general theoretical framework will be Beck's model. Excluded from the model, according to the author, are other models such as those of Meichenbaum or Ellis. However, in his treatment of the historical context of CBT, Leahy (1996) addresses the origins of some facets of Beckian principles. The audience for the book is defined as "the practitioner with little or no background in cognitive therapy" (p. 3); and the purpose to be "to provide the practitioner with a useful manual for evaluating and treating a variety of psychiatric disorders using cognitive therapy" (pp. 4-5). Given the book's brief 250 pages, such a goal, given the audience, is ambitious. In Part 1, the book covers the history of cognitive therapy, the cognitive model of psychopathology, and basic principles of CBT. Leahy (1996) traces some of the roots of Beck's model back to early philosophies including empiricism, phenomenology, and structuralism. He also notes the role of Kelly's personal construct theory and Ellis's rational approach. He then weaves together other major influences such as those of the developmental structuralists (e.g., Piaget), cognitive psychologists, and the attributional theory of social psychology. Leahy (1996) then turns his attention to the cognitive model of psychopathology. He covers several areas of Beck's theory, including cognitive distortions, schemas, maladaptive assumptions, and compensation reactions. The coverage is basic, and brief, detailing the view of psychopathology as an interaction of early developed maladaptive schemas, distorted thinking, and unhealthy behavior patterns that serve to reduce painful emotions. He uses terminology that suggests a levels approach to cognition, describing schemas as the deepest level of thinking and stating "schemas are the concepts the patient habitually uses in viewing reality" and which are defined by "specific bias of their content" (p. 25). He then describes how the various components of the CBT model would conceptualize depression, anxiety, and anger/marital conflict. Much of the discussion in this section is devoted to the role of maladaptive schemas, yet few references are made to Young's (1990/1994) theory of early maladaptive schemas. Further, when the discussion turns to the biases in cognitive processes found among those with depression, there is no mention of the learned affective reactions considered by schema theorists (see Young, Beck, & Weinberger, 1993) as part of the schema's core. Also, here and throughout the book, the notion of schemas is presented sometimes more in line with the theory of an underlying tacit rule system that guides information processing and perceptual processes, but at other times the term seems to be used interchangeably with the idea of core assumptions. The use of the term became slightly confusing. Leahy (1996) then reviews 20 principles of CBT. The list is expansive, and addresses a number of concepts and techniques that deserved inclusion. Many of the descriptions are brief, but informative if one had never studied CBT. Unfortunately, two concepts or techniques that are often considered core to CBT were not discussed: collaborative empiricism and agenda setting. While the latter is implied in some of the content covered in Leahy's fourth chapter, collaborative empiricism is not. …