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Cognitive therapy as brain training

Therapy Session

Cog­ni­tive ther­a­py (CT) was found­ed by Dr. Aaron Beck. It is based on the idea that the way peo­ple per­ceive their expe­ri­ence influ­ences their behav­iors and emo­tions. The ther­a­pist teach­es the patient cog­ni­tive and behav­ioral skills to mod­i­fy his or her dys­func­tion­al think­ing and actions.

CT aims at improv­ing spe­cif­ic traits, behav­iors, or cog­ni­tive skills, such as plan­ning and flex­i­bil­i­ty, which are exec­u­tive func­tions, depres­sion, obses­sive-com­pul­sive dis­or­ders, and pho­bias. It has been shown effec­tive in many stud­ies and con­texts such as depres­sion, high lev­els of anx­i­ety, insom­nia. The inter­view with Lee Woodruff (Chap­ter 1) describes the spec­tac­u­lar recov­ery of her hus­band who suf­fered a severe trau­mat­ic brain injury in Iraq. CT was part of this recov­ery and was used to improve speech and lan­guage skills.

Recent­ly, Dr. Aaron Beck’s daugh­ter, Dr. Judy Beck, has suc­cess­ful­ly used CT to help dieters acquire new skills in order to achieve their goals (see Dr. Beck’s inter­view at the end of this Chap­ter). Accord­ing to Dr. Beck, the main mes­sage of CT and its appli­ca­tion in the diet world is that prob­lems los­ing weight are not the dieter’s fault. These prob­lems reflect the lack of skills that can be acquired through train­ing. What skills is Dr. Beck talk­ing about? Most­ly exec­u­tive func­tions: the skills to plan in advance, to moti­vate one­self, to mon­i­tor one’s behav­ior, etc.

Recent evi­dence sup­ports the effi­cien­cy of CT. For instance, Stahre and Hal­strom (2005) con­duct­ed a ran­dom­ized con­trolled study test­ing the effect of CT on weight loss. Near­ly all 65 patients com­plet­ed the pro­gram and the short-term inter­ven­tion (10-week, 30-hours) showed a sig­nif­i­cant long-term weight reduc­tion, even larg­er (when com­pared to the 40 indi­vid­u­als in the con­trol group) after 18 months than right after the 10-week pro­gram.

Neu­roimag­ing has also been used to show the results of CT on the brain. Let’s take the exam­ple of spi­der pho­bia. In 2003, Paque­tte and col­leagues showed that before the cog­ni­tive ther­a­py, the fear induced by view­ing film clips depict­ing spi­ders was cor­re­lat­ed with sig­nif­i­cant acti­va­tion of spe­cif­ic brain areas, like the amyg­dala. After the inter­ven­tion was com­plet­ed (one three-hour group ses­sion per week, for four weeks), view­ing the same spi­der films did not pro­voke acti­va­tion of those areas. Dr. Judith Beck, explains that the adults in this study were able to “train their brains” which result­ed in reduc­ing the stress response trig­gered by spi­ders.

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