Aaron Beck developed a form of psychotherapy in the 1960s and 1970s that he originally named “cognitive therapy,” a term that is often used synonymously with “cognitive behavior therapy” (CBT) by much of our field. Beck devised a structured, short-term, present-oriented psychotherapy for depression (Beck, 1964). Since that time, he and others around the world have successfully adapted this therapy to a surprisingly diverse set of populations with a wide range of disorders and problems, in many settings and formats. These adaptations have changed the focus, techniques, and length of treatment, but the theoretical assumptions themselves have remained constant.

In all forms of CBT that are derived from Beck’s model, clinicians base treatment on a cognitive formulation: the maladaptive beliefs, behavioral strategies, and maintaining factors that characterize a specific disorder (Alford & Beck, 1997). You will also base treatment on your conceptualization, or understanding, of individual clients and their specific underlying beliefs and patterns of behavior. One of Abe’s underlying negative beliefs was “I’m a failure,” and he engaged in extensive behavioral avoidance so his (perceived) incompetence, or failure, wouldn’t be apparent. But his avoidance ironically strengthened his belief of failure.