Cognitive restructuring (CR) is a psychotherapeutic process of learning to identify and dispute irrational or maladaptive thoughts known as cognitive distortions,Gladding, Samuel. Counseling: A Comprehensive Review. 6th. Columbus: Pearson Education Inc., 2009. such as all-or-nothing thinking (splitting),

magical thinking Magical thinking, or superstitious thinking, is the belief that unrelated events are causally connected despite the absence of any plausible causal link between them, particularly as a result of supernatural effects. Examples include the idea tha ...

, overgeneralization,

magnification Magnification is the process of enlarging the apparent size, not physical size, of something. This enlargement is quantified by a size ratio called optical magnification. When this number is less than one, it refers to a reduction in size, so ...

, and

emotional reasoning Emotional reasoning is a cognitive process by which an individual concludes that their emotional reaction proves something is true, despite contrary empirical evidence. Emotional reasoning creates an 'emotional truth', which may be in direct con ...

, which are commonly associated with many

mental health disorders The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiatri ...

. CR employs many strategies, such as

Socratic questioning Socratic questioning (or Socratic maieutics) is an educational method named after Socrates that focuses on discovering answers by asking questions of students. According to Plato, Socrates believed that "the disciplined practice of thoughtful q ...

, thought recording, and guided imagery, and is used in many types of therapies, including

cognitive behavioral therapy Cognitive behavioral therapy (CBT) is a form of psychotherapy that aims to reduce symptoms of various mental health conditions, primarily depression, PTSD, and anxiety disorders. Cognitive behavioral therapy focuses on challenging and chang ...

(CBT) and rational emotive behaviour therapy (REBT). A number of studies demonstrate considerable efficacy in using CR-based therapies.

Overview

Cognitive restructuring involves four steps: # Identification of problematic

cognition Cognition is the "mental action or process of acquiring knowledge and understanding through thought, experience, and the senses". It encompasses all aspects of intellectual functions and processes such as: perception, attention, thought, ...

s known as "automatic thoughts" (ATs) which are dysfunctional or negative views of the self, world, or future based upon already existing beliefs about oneself, the world, or the future # Identification of the cognitive distortions in the ATs # Rational disputation of ATs with the Socratic method # Development of a rational rebuttal to the ATs There are six types of automatic thoughts: # Self-evaluated thoughts # Thoughts about the evaluations of others # Evaluative thoughts about the other person with whom they are interacting # Thoughts about

coping strategies Coping refers to conscious or unconscious strategies used to reduce and manage unpleasant emotions. Coping strategies can be cognitions or behaviors and can be individual or social. To cope is to deal with struggles and difficulties in life. It ...

and behavioral plans # Thoughts of avoidance # Any other thoughts that were not categorized

Clinical applications

Cognitive restructuring has been used to help individuals experiencing a variety of psychiatric conditions, including depression, substance abuse disorders,

anxiety disorder Anxiety disorders are a group of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal functions are significantly impaired. Anxiety may cause phys ...

s collectively,

bulimia Bulimia nervosa, also known simply as bulimia, is an eating disorder characterized by binge eating (eating large quantities of food in a short period of time, often feeling out of control) followed by compensatory behaviors, such as self-induc ...

social phobia Social anxiety disorder (SAD), also known as social phobia, is an anxiety disorder characterized by sentiments of fear and anxiety in social situations, causing considerable distress and impairing ability to function in at least some as ...

borderline personality disorder Borderline personality disorder (BPD) is a personality disorder characterized by a pervasive, long-term pattern of significant interpersonal relationship instability, an acute fear of Abandonment (emotional), abandonment, and intense emotiona ...

attention deficit hyperactivity disorder Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by symptoms of inattention, hyperactivity, impulsivity, and emotional dysregulation that are excessive and pervasive, impairing in multiple con ...

(ADHD), and

problem gambling Problem gambling, ludopathy, or ludomania is repetitive gambling behavior despite harm and negative consequences. Problem gambling may be diagnosed as a mental disorder according to DSM-5 if certain diagnostic criteria are met. Pathological ...

. When utilizing cognitive restructuring in rational emotive therapy (RET), the emphasis is on two central notions: (1) thoughts affect human emotion as well as behavior and (2) irrational beliefs are mainly responsible for a wide range of disorders. RET also classifies four types of irrational beliefs: dire necessity, feeling awful, cannot stand something, and self-condemnation. It is described as cognitive-emotional retraining. The rationale used in cognitive restructuring attempts to strengthen the client's belief that (1) " self-talk" can influence performance, and (2) in particular self-defeating thoughts or negative self-statements can cause emotional distress and interfere with performance, a process that then repeats again in a cycle. Mood repair strategies are implemented in cognitive restructuring in hopes of contributing to a cessation of the negative cycle.Werner-Seidler, A., Moulds, M. L. "Mood repair and processing mode in depression". Oct 24, 2011. US: American Psychological Association. When utilizing cognitive restructuring in cognitive behavioral therapy (CBT), it is combined with psychoeducation, monitoring, ''in vivo'' experience, imaginal exposure, behavioral activation, and homework assignments to achieve remission. The cognitive behavioral approach is said to consist of three core techniques: cognitive restructuring, training in coping skills, and problem solving.

Applications within therapy

There are many methods used in cognitive restructuring, which usually involve identifying and labelling distorted thoughts, such as "all or none thinking, disqualifying the positive, mental filtering,

jumping to conclusions Jumping to conclusions (officially the jumping conclusion bias, often abbreviated as JTC, and also referred to as the inference-observation confusion) is a psychological term referring to a communication obstacle where one "judge or decide somethin ...

, catastrophizing, emotional reasoning, should statements, and personalization." The following lists methods commonly used in cognitive restructuring: *

*Thought recording *Identifying cognitive errors *Examining the evidence (pro-con analysis or cost-benefits analysis) *Understanding idiosyncratic meaning/semantic techniques *Labeling distortions * Decatastrophizing *Reattribution *Cognitive rehearsal *Guided imagery *Listing rational alternatives *

Rational emotive behavior therapy Rational emotive behavior therapy (REBT), previously called rational therapy and rational emotive therapy, is an active-directive, philosophically and empirically based psychotherapy, the aim of which is to resolve emotional and behavioral pr ...

(REBT) includes awfulizing, when a person causes themselves disturbance by labelling an upcoming situation as 'awful', rather than envisaging how the situation may actually unfold, and Must-ing, when a person places a false demand on themselves that something 'must' happen (e.g. 'I must get an A in this exam'.)

Criticism

Critics of cognitive restructuring claim that the process of challenging dysfunctional thoughts will "teach clients to become better suppressors and avoiders of their unwanted thoughts" and that cognitive restructuring shows less immediate improvement because real-world practice is often required. Other criticisms include that the approach is mechanistic and impersonal and that the relationship between therapist and client is irrelevant. Neil Jacobson's component analysis of cognitive behavioural therapy (CBT), claims that the cognitive restructuring component is unnecessary, at least with depression. He argues that it is the behavioural activation components of CBT that are effective in giving therapy, not cognitive restructuring, as delivered by cognitive behavioural therapy. Others also argue that it's not necessary to challenge thoughts with cognitive restructuring.

References

External links

A free Thinking Matters Facilitator Manual

National Institute of Corrections

An Overview of Cognitive-behavioral Group Therapy for Social Phobia

Cognitive Restructuring
- ACCI's list of erroneous beliefs of the criminal mind.

- as pioneered by

Albert Ellis Albert Ellis (September 27, 1913 – July 24, 2007) was an American psychologist and psychotherapist who founded rational emotive behavior therapy (REBT). He held MA and PhD degrees in clinical psychology from Columbia University, and was cer ...

, Aaron Beck, and others.
Cognitive restructuring worksheets
- Tools that therapists use to help guide cognitive restructuring {{Cognitive behavioral therapy Cognitive therapy