Taking the ‘C’ out of CBT: A review of the role of cognition in clinical change

Although the evidential support of CBT as an integrated treatment package is overwhelming there have been a number of objections against the centrality of cognition in clinical change. This paper will focus on three such challenges:•Component-based studies of CBT•Multi-level theories of cognition•Third wave CBT approachesThe paper accepts that although these three challenges pose questions, they are themselves not without criticism and their evidence is somewhat limited, inconsistent and open to interpretation. Yet it also observes an anomaly: despite repeated reference to evidential data within the cognitive therapy movement, there is limited research into the efficacy of specific cognitive techniques. It concludes however that while Beck’s notion of cognition as the centre-piece of psychotherapeutic process is evidentially assumptive, such is the role of the current cognitive paradigm that any radical alteration is deemed unlikely.