This therapeutic model was born with cognitive therapy in the early 1960s, thanks to the intuitions of Aaron T. Beck at the University of Pennsylvania, to treat depression, in a structured, brief and present-oriented way, aimed at solving current problems, working on the client's beliefs and behavior. Since then, this model has been adapted and expanded for the treatment of a wide range of problems, keeping the theoretical assumptions constant and modifying the focus, technique and duration of the treatment.

Model assumptions

The cognitive model hypothesizes that the manifestations of psychological suffering are linked to substantially irrational - or, in any case, poorly functional - ways of thinking in achieving one's goals. In other words, our emotions and behaviors are influenced by "how" we evaluate events. It is not a situation itself that determines what we feel at that moment, but rather it is the way in which we interpret (think) that situation that makes us sad, angry, enthusiastic, jealous, scared, etc., and makes us act accordingly to such states of mind. Our thoughts mediate, as if through a lens, the reading of a situation and the consequences of one interpretation compared to another. This is particularly problematic when our thinking has become rigid and is characterized by the high presence of logical errors or cognitive biases, such as catastrophizing, shoulding, dichotomous reasoning, arbitrary inferences, personalization. These sort of "shortcuts" of thinking may help our mind to quickly label a certain situation, to deal with it in the short term, but they prevent us from processing the experience more completely and linking it to the real context in which it occurs, leaving us prey to prejudice and impulsive reactions following hasty conclusions.

Our way of thinking derives from very deep beliefs or convictions, which we have developed and strengthened during our growth; it therefore has a profound historical meaning and is not necessarily wrong, but, at a certain moment in life, it may prove less useful in dealing with new situations or it may have hardened excessively, becoming less fluid and elastic.

Working according to the theoretical model of cognitive behavioral therapy (CBT) implies trying to act on these beliefs by opening up to new alternatives, which may be viable and more effective for achieving one's goals and, in general, to be more adaptable facing life changes and news.

During the journey, therapist and client proceed like a pair of scientists: they build and experiment with hypotheses, testing the change first in the laboratory (session) and then outside (in the client's daily life). Everyone contributes with their own specific expertise: the therapist as an expert in the techniques used and the client as an expert on himself and his experiences.

The techniques of cognitive-behavioral psychotherapy

CBT originates from the combination of two forms of therapy, with their respective techniques:

• On the one hand we have cognitive therapy, which helps to identify recurrent thoughts, the usual logical errors in interpreting reality that cause negative emotions, and to replace them with more realistic thoughts that are functional to the person's well-being. Examples of cognitive techniques are psychoeducation, monitoring through diaries or cards, cognitive restructuring.
• On the other hand there is behavioral therapy, which aims at changing the way we react to those situations that challenge us, by learning new ways of reacting (emotions and behaviors). Examples of behavioral techniques are exposure with response prevention, systematic desensitization, breaking behavioral patterns and role-playing.

For each pathology, the techniques are used within specific and standardized protocols.

Finally, homework is a distinctive feature of CBT. In fact, between one session and another client and therapist agree on some "homework" useful to the client, to be carried out in client’s daily life, i.e. observations or actions that have been explored during therapy hour and which now can be consolidated and tested through real life practice, to be effectively learned. Examples of this include writing exercises, recommended readings, the gradual introduction of changes in the routine, behavioral experiments and the use of techniques (e.g. relaxation or breathing exercises).

Today the cognitive-behavioral model is among the most studied and validated in the world and is considered an elective treatment in international guidelines for various psychopathological problems, such as panic attacks, phobias, obsessive compulsive disorder, depression, sleep disorders , addictions, eating disorders (in particular for bulimia nervosa).

In summary, the cognitive-behavioral approach is therefore:

• present oriented
• practical and concrete
• short term focused
• purpose-oriented
• active and collaborative, because both the therapist and the client play an active role in the therapy
• scientifically founded and measurable, in fact it has been demonstrated by numerous studies that the cognitive-behavioral method is effective for the treatment of various disorders
• suitable for individuals, couples and group settings