Psychology is a complex science, in which there are very diverse paradigms which study the psyche from diverse perspectives.

At present, one of the best valued and most empirical evidence is the cognitive-behavioral, which has been generating a large number of techniques in its therapeutic use.

The application of the therapies of this theoretical current has a series of great advantages, but also presents some limitations and disadvantages in comparison with those of other paradigms. Throughout this article we will comment on some of the main advantages and disadvantages of cognitive-behavioral therapy, in order to learn from them and assess how they can be improved and in what sense we can learn from other currents and developments.

Cognitive-behavioral therapy: a basic definition

The type of therapy and set of techniques that are based on the cognitive-behavioral model is known as cognitive-behavioral therapy. This type of therapy is based on the identification and subsequent work on the beliefs and dysfunctional thoughts that generate suffering or dysfunctionality in the patient, as well as the way of relating emotionally to them.

The starting point is the cognitive-behavioral model, which is heir to the behavioral perspective to which the advances of cognitivism are incorporated. This model starts from a strict methodology based on the scientific method, investigating on the basis of empirical observation and experimentation and starting from the verification and falsification of experimental hypotheses. The aim is to scientifically and objectively evaluate human behavior and the mental processes that govern it, making abstract constructs such as those of cognition and emotion operational and measurable.

The main work is done with the cognitions and behaviors that are carried out, with a focus on teaching the patient to modify their expectations, beliefs and fears as well as altering the dysfunctional behavior patterns that are carried out because of these. It works through the learning and modification of cognitions and behaviors, and the therapist can have different degrees of directivity in the therapy despite the fact that his role is to guide or support the process of change.

Main advantages

Cognitive-behavioral therapy is one of the most valued on a scientific level , and it is undoubtedly the theoretical current that is most widely taught at the university level.

A large majority of today’s psychologists follow or have initially departed from the cognitive-behavioral approach to develop professionally. This is due to the fact that this therapy offers a great number of advantages over other approaches, among which we can mention the following

1. Based on the scientific method

One of the most outstanding virtues of cognitive behavioural therapy is that the model employs an experimental methodology that allows the objective analysis of the results of the therapy , in such a way that it is closely associated with the scientific method.

It is possible to develop hypotheses based on previous information and then test them experimentally and even replicate their results. In other words, it establishes a methodology that allows psychology to advance as a science.

2. Empirical evidence of its great effectiveness

Cognitive-behavioral therapy is the type of therapy that presents the most empirical evidence regarding the effectiveness of the techniques and subtypes of therapy it uses, based on the reduction of the symptoms of the different disorders to be treated.

3. Flexibility

Cognitive-behavioral therapy has as another of its great advantages the fact that it is extremely versatile . We can often find how specialists in this type of therapy accept and integrate techniques from other approaches, such as psychodynamic, humanistic or gestalt therapy.

It also evolves by incorporating new ways of acting or relating to the patient (such as constructivism) as well as new theories and techniques (such as contextual ones).

4. Subject as active agent

In some paradigms of psychology the subject is seen as a passive agent, someone who reacts to the environment almost automatically.

The cognitive-behavioral approach was one of the first to show that it is the subject’s own action that can lead to the overcoming or reduction of symptoms: therapy aims to give the subject tools to cope with or modify that which generates discomfort.

5. Assesses the role of cognitive in behavior

Our thoughts, beliefs, perspectives and abilities, as well as the way we process information from the environment, are analyzable and workable from the cognitive-behavioral paradigm. It is important to work not only on the content but also on how it is reached and the structures and mental schemes that influence its appearance.

6. Highly systematized

In addition to being ascribed to the scientific method, another of the great advantages of this therapy is its high degree of systematization.

Although there may be a greater degree of freedom depending on the technique in question, the techniques used by cognitive behavioural therapy generally have a fairly clear basis, structure and procedure (although the therapist will have to adapt to the patient’s responses).

7. Allows the acquisition of competencies and skills

Cognitive-behavioral therapy relies heavily on learning as a means to generate, modify or eliminate maladaptive behaviors or mental products. Likewise, its action causes the subject to acquire abilities that previously he did not possess or that could benefit from a change or training, in a way that not only can help to solve a current problem but also to favor and optimize the adaptation and adjustment to the environment.

8. Effective in a wide range of conditions

Another great advantage of this type of therapy is its broad applicability to most existing mental disorders, and even to non-pathological situations. Thus, one can work on problems such as anxiety, depression, obsessive problems, eating disorders or sexual disorders, among many others.

Disadvantages and limitations of the cognitive-behavioral model

The cognitive-behavioral therapy model, as we have seen, is very useful and allows the treatment of many mental disorders. However, presents a series of limitations that should be taken into account. Among them, we can highlight the following .

Focus on the current symptom

Cognitive-behavioral therapy focuses largely on working through the difficulties and the set of symptoms that are currently present . That is, it works from the present and on what is happening to us now. Although the past is taken into account and explored in order to explain the current situation, at the level of therapy the causes that started the problem that afflicts the subject today are not usually treated directly.

And on many occasions it is necessary to work on the elements that originated the discomfort in the first place, otherwise the discomfort may come to appear in another form.

2. Excessively cognitive

Although one of the advantages of this therapy lies in the fact that it works in depth on such relevant aspects as beliefs, expectations and thought processes, factors of great relevance when it comes to explaining our behaviours, the truth is that on occasions cognitive-behavioral therapy may err on the side of reductionism and underestimate aspects such as emotion and motivation.

It is not that they do not work with emotional elements, but the work in this area is done from a rational perspective and not so emotional or experiential.

3. Effective, but why?

Cognitive-behavioral therapies are highly effective and the various studies conducted often attest to this.

However, provide little information as to why they are effective or why they can sometimes fail . It has been observed which techniques work best, but little attention has been paid to why.

4. Focus on the individual: little appreciation of context

Cognitive-behavioral therapy takes into account that the environment is a relevant factor in the origin, maintenance and even treatment of mental disorders, but tends to focus exclusively on the subject who has the problem or difficulty and leaves aside most of the contextual elements that affect the problems in question.

This limitation seems to be solved by the application of third generation therapies, which are gradually becoming more popular.

5. Aseptic and instrumental therapeutic relationship

In cognitive-behavioral therapy, the high value of the therapeutic relationship is taken into account, but historically it has tended to be seen as a way to apply the techniques . In recent years, however, and especially in contextual therapies, work is increasingly being done on the therapeutic relationship as an element per se of therapy, probably one of the most (if not the most) relevant in predicting the success of therapy.

Some patients also indicate that these types of techniques, although effective, are cold and do not value or fully understand the suffering they endure, something that makes it difficult for them to trust them and for them to succeed.

6. Possible stiffness as a consequence

Classic cognitive-behavioral therapy focuses on combating, changing or modifying the thoughts, beliefs and behaviors that generate suffering in the subject .

There is a strategy of opposing suffering, which in principle may seem positive but which may nevertheless push the patient into increasingly rigid behaviour aimed at avoiding pain and which involves a behavioural pattern that is not very adaptive, which in turn may be the source of new suffering.

Bibliographic references:

  • Caballo, V.E. (1998). Manual of therapy and behavior modification techniques. Siglo XXI.

  • Caro, I. (2009). Theoretical and practical manual of Cognitive Psychotherapies. Desclée de Brouwer Library of Psychology.

  • Vila, J. & Fernández, M.C. (2004). Psychological treatments. The experimental perspective. Madrid: Pirámide.