Beck
Beck
Beck
Several lines of investigation have evolvedfrom the initial the much-publicized National Institute of Mental Health
cognitive model of depression and other disorders. A large collaborative study of the treatment of depression, has
number of studies have tested the cognitive model using shown superiority of cognitive therapy in follow-up, in
both clinical and laboratory-based strategies. In general, comparison with antidepressant drug and interpersonal
studies that most closely approximate the clinical con- therapy (Shea et al., 1990).
ditions from which the theory was derived are supportive Even more impressive has been the application of
of the cognitive model of depression. Studies of anxiety cognitive therapy to panic disorder. On the basis of the
and panic, although fewer, generally support the cognitive cognitive model of panic (Beck, 1976, 1987a; D. M. Clark,
model of anxiety and panic. The application to the treat- 1986), practically complete reduction of panic attacks
ment of clinical problems has been promising and supports after 12-16 weeks of treatment has been reported (Sokol,
the concept of cognitive specificity. The cognitive therapy Beck, & Clark, 1989; Sokol, Beck, Greenberg, Berchick,
of depression has led to the utilization of specific cognitive & Wright, 1989). Also impressive has been the successful
strategies based on the specific conceptualizations of a application of cognitive therapy to generalized anxiety
given disorder to a wide variety of disorders. Study of disorder (Butler, Fennell, Robson, & Gelder, 1991), eating
abnormal reactions has also provided clues to the cognitive disorders (Garner & Bemis, 1982), heroin addiction
structure of normal reactions. (Woody et al., 1984), and inpatient depression (Miller,
Norman, & Keitner, 1989). Further clinical work suggests
the utility of cognitive therapy in treating diverse disorders
such as couples' problems (Beck, 1988) and schizophrenia
Fifteen years have elapsed since I called for the admission
(Perils, 1988). A striking feature of the diverse application
of cognitive therapy into the therapeutic arena (Beck,
1976, p. 337), and 30 years have gone by since I first has been the importance of cognitive specificity. Each
disorder has its own specific cognitive conceptualization
formulated my cognitive model of depression based on
and relevant strategies that are embraced under the gen-
research on dreams and other ideational material (Beck,
eral principles of cognitive therapy (Beck, 1976; Beck &
1961). I suggested in 1976 that in order to qualify as a
Freeman, 1990; Beck, Rush, Shaw, & Emery, 1979).
system of psychotherapy a particular brand of psycho-
Because of the breadth of cognitive therapy and its
therapy had to provide (a) a comprehensive theory of
psychopathology that articulates with the structure of therapeutic eclecticism, and the ability of cognitive theory
to explain changes in psychopathology, the question has
psychotherapy, (b) a body of knowledge and empirical
been raised as to whether cognitive therapy might be
findings that support the theory, and (c) credible findings
based on outcome and other studies to demonstrate its viewed as the product of the integration of the effective
psychotherapies (Alford & Norcross, in press). The theo-
effectiveness.
retical framework of cognitive therapy appears to artic-
What is the status of cognitive therapy today? A
ulate well with contemporary developments in cognitive
steady flow of studies largely support the cognitive model
psychology and social psychology (Hollon & Garber,
of depression (Ernst, 1985). This model has facilitated
1990), as well as earlier concepts of developmental psy-
the development of strategies and techniques to provide
chology (Beck, 1967). In fact, there appears to be a kind
a psychotherapeutic structure. Numerous outcome stud-
ies have supported the effectiveness of the therapy in the
treatment of unipolar outpatient depression, anxiety dis- Editor'snote.Articlesbasedon APAawardaddressesthat appearin the
orders, and panic disorder. A meta-analysis of 27 studies AmericanPsychologistarescholarlyarticlesby distinguishedcontributors
to the field.As such,theyare givenspecialconsiderationin the American
(Dobson, 1989), for example, has demonstrated the ef- Psychologist'seditorial selectionprocess.
ficacy of cognitive therapy in unipolar depression and its This article was originally presented as a DistinguishedScientific
superiority to other treatments, including antidepressant Award for the Applicationsof Psychologyaddressat the 98th Annual
drugs. More striking has been the success of cognitive Conventionof the AmericanPsychologicalAssociationin Bostonin Au-
therapy in maintaining gains and p~reventing relapse. Five gust 1990.
published studies have indicated that cognitive therapy Author's note. Correspondenceconcerning this article should be
has a greater prophylact!c effect than do antidepressant addressed to Aaron T. Beck, Center for CognitiveTherapy, Suite 602,
drugs (Hollon & Najavits, 1988). A more recent study, 133 South 36th Street, Philadelphia, PA 19104.