تکامل رفتاردرمانی و رفتاردرمانی شناختی

The historical background of the development of behaviour therapy is described. It was based on the prevailing behaviourist psychology and constituted a fundamentally different approach to the causes and treatment of psychological disorders. It had a cold reception and the idea of treating the behaviour of neurotic and other patients was regarded as absurd. The opposition of the medical profession and psychoanalysts is explained. Parallel but different forms of behaviour therapy developed in the US and UK. The infusion of cognitive concepts and procedures generated a merger of behaviour therapy and cognitive therapy, cognitive behaviour therapy (CBT). The strengths and limitations of the early and current approaches are evaluated.

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Summary and conclusions The development of psychological treatment for anxiety disorders and depression has improved health care for many thousands of people, and the massive expansion of psychotherapeutic services for people in the United Kingdom will doubtless inspire comparable improvements elsewhere. Clinical psychologists and clinical researchers provided the means for this unparallelled improvement in mental health care. In the post-war period the medical profession strongly opposed the provision of therapy by psychologists. The massive expansion of psychological services in the United Kingdom, hints at the outcome of that tendentious professional dispute. Developing the methods of treatment greatly enhanced our understanding of the nature of fear—the methods were, after all, methods for reducing fear. Lang (1968) introduced a fascinating conception of fear: fear is not a lump, but rather is a loosely connected set of three components. His work also led to a fresh conception of courage ( Rachman, 1978, 1990). A stimulating construal of prepared fears was introduced by Seligman (1971), and Clark (1986) introduced the first cognitive explanation of episodes of intense fear. Naturally many questions remain to be tackled, but insufficient progress has been made in answering one of Seligman's (1988) crucial questions: Why are unadaptive fearful misinterpretations so tenacious? Consideration of tenacious irrational beliefs are not confined to psychologists. In his book “The Heel of Achilles” the philosophically-minded novelist Arthur Koestler pondered whether “the prevalence of passionately held irrational beliefs” will ever become comprehensible ( Koestler, 1976, p.16).