Cognitive restructuring methods: what are they and how do they work?

We analyze what these methods consist of and what theories support them.

Cognitive-behavioral therapy has been shown to be effective in addressing multiple psychological disorders and disturbances.

One of the most widely used methods in this type of treatment is cognitive restructuring, which aims to modify the negative thoughts and dysfunctional beliefs that generate discomfort and emotional disturbances.

In this article we explain what the technique of cognitive restructuring consists of and what are the main methods used and their differences.

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Cognitive restructuring: definition and theoretical basis

Cognitive restructuring is a psychological technique used in cognitive-behavioral therapy to identify and correct dysfunctional or negative thoughts. or negative thoughts. This tool allows psychologist and patient to work together in the search for alternatives and in the restructuring of certain ideas and core beliefs that generate a subtle discomfort difficult to detect by oneself.

This cognitive technique manages thoughts as hypotheses to be tested or refuted through Socratic dialogue (a dialectical method that seeks to demonstrate hypotheses through inquiry and the search for new ideas and concepts), the formulation of questions and the performance of behavioral experiments (such as asking questions to other people, daring to act in a certain way, observing someone's behavior, etc.) to test dysfunctional beliefs.

Cognitive restructuring is based on the following theoretical foundations:

• How people structure their beliefs and ideas exerts an influence on how they perceive the world and themselves, how they feel (including physiological reactions) and how they act.

• People's cognitions can be detected through psychological methods and tools such as interviews, questionnaires, the Socratic method or self-records.

• Cognitions can be modified to achieve therapeutic change (modification of the patient's behavior).

Cognitive restructuring methods

Cognitive restructuring, as a cognitive technique, implicitly assumes the postulates of cognitive psychology that state that people react to events according to the meaning we assign to them; that is, what is important is not so much what happens, but what we tell ourselves is happening (or how we evaluate what happens to us).

The different methods of cognitive restructuring that have been implemented over the years assume that dysfunctional beliefs can cause affective and behavioral disturbances, hence the main objective of all of them is to modify such beliefs by more coherent and functional cognitions, either by addressing the and functional cognitions, either by addressing internal verbal behavior (what we believe about the world and ourselves) or the core beliefs that define our personality (such as believing that we deserve to be loved by everyone).

Next, we will look at two of the main cognitive restructuring methods most commonly used in cognitive-behavioral therapy.

1. Ellis' Rational Emotive Behavioral Therapy

Rational Emotive Behavioral Therapy, developed by the American psychologist Albert Ellis (1913-2007), is a brief psychotherapy method based on the premise that most affective problems and disorders (and associated behaviors) have their origin in erroneous and irrational interpretations that we make of what happens to us.

This therapy is based on the cognitive model ABCwhere A represents the event or occurrence that is causing us problems; B, the beliefs or interpretation we make of that event; and C, the affective and behavioral consequences (including physiological reactions) that all this causes us.

According to Ellis, we suffer from affective problems because we tend to generate irrational ideas about certain events. For example, believing that we need to depend on other people, that it is better to avoid certain responsibilities or that certain events are catastrophic, are just some of them.

Catastrophizing (believing that something bad that happens to us is horrible and we will never be able to bear it), thinking in absolute terms (with thoughts such as "I must pass all subjects") and overgeneralizing (if I ride a bicycle and fall, thinking that whenever I ride I will fall), are three of the main cognitive ills that Ellis highlights in his theory.

Ellis' approach is basically about confronting these irrational beliefs with more positive and realistic thoughts. First, by identifying the thoughts that generate discomfort and are based on dysfunctional beliefs; second, by employing an impetuous Socratic method that serves as a counterargument; and third, through modeling techniques (learning by imitation) and homework, patients learn to modify their beliefs based on what they have learned in therapy.

Beck's cognitive therapy

Another method of cognitive restructuring is that included in the cognitive therapy developed by the American psychiatrist Aaron Beck, which was originally intended to treat the patient's cognitive deficits.which was originally intended to treat depressive disorders, although it is now also used to treat a wide variety of psychological disorders, such as anxiety, obsessive disorders, phobias or psychosomatic disorders.

To apply Beck's cognitive restructuring technique it is necessary, firstly, to identify the dysfunctional thoughts that are generating emotional disturbances through mental exercises and questions from the Socratic method; secondly, after having identified the dysfunctional beliefs, to try to counteract them with methods such as testing the hypotheses (with real behavioral experiments) or role-playing (playing at being someone else).

Finally, in Beck's therapy, homework is a fundamental part for patients to practice what they have learned in therapy..

In relation to the theoretical bases on which this method of cognitive restructuring is based, Beck states the following: people who suffer affective and behavioral disturbances do so due to an excess of negative and dysfunctional thoughts and beliefs, something similar to what Ellis proposed.

These are some of the examples of dysfunctional beliefs that are usually addressed in Beck's cognitive therapy:

• Dichotomous thinking.: believing something in absolute, black-or-white terms, such as thinking that everything will go wrong when you have a failure.

• Arbitrary inferenceThis dysfunctional belief (or cognitive bias) consists of taking for granted or drawing general conclusions about something without sufficient evidence for it. For example, thinking that one is going to fail an entire academic year because one has a bad grade on an exam.

• OvergeneralizationDysfunctional idea: this dysfunctional idea, which we have already seen in Ellis' therapy, is a cognitive distortion that causes us to draw general conclusions from punctual and anecdotal events.

• Magnificationexaggerating or giving greater importance to some event than it has.

Differences between Ellis' approach and Beck's approach

It is clear that there are similarities between the two main methods of cognitive restructuring, Ellis' rational emotive behavioral therapy approach and Beck's cognitive therapy approach; however, it is no less true that there are also certain differences.

Both therapies assume and base their therapeutic procedures on the idea that people suffer emotional disturbances due to irrational or dysfunctional cognitive patterns, ideas and beliefs that provoke them. And both approaches try to modify these thoughts through cognitive and behavioral techniques.

All in all, in Ellis's therapy, however, rational debate is primarily used to test the validity of irrational beliefs, as opposed to Beck's therapy, which more often employs the hypothesis testing method to test the veracity of dysfunctional thoughts.This is in contrast to Beck's therapy, which more frequently employs the hypothesis-testing method to test the veracity of dysfunctional thoughts.

Something that also differentiates both therapies has to do with the ultimate foundation on which each therapy is based; Ellis places a greater philosophical and humanistic emphasis (he is in favor of a profound philosophical change in the person) and Beck a more scientific one, which does not prevent Ellis' postulates from also being scientifically validated.

Finally, it is worth noting another difference in the approach to working with patients. Ellis' approach seeks to modify irrational beliefs with a more aggressive and relentless questioning, while Beck's approach tries to help the patient to perform tasks that test those beliefs, with a gentler approach.

Bibliographical references:

• Bados, A., & García, E. (2010). The cognitive restructuring technique. Barcelona, Spain: Department of Personality, Psychological Assessment and Treatment. Faculty of Psychology, University of Barcelona.

• Martin, G., & Pear, J. (2008). Behavior modification: what it is and how to apply it. Publisher: Prentice Hall. Madrid.