To start the journey of the evolution of CBT, we start with the earliest piece of the history, namely the behavioral models of therapy.

Dr. David Barlow describes the evolution of behavior therapy and how we have the learnings about behavior that we have today, including the revolutionary idea of exposure and desensitization.

As explained, the idea of operant conditioning and classical conditioning were initially competing theories; however, over time they came together and became integrated. As you’ll see in the next clip, behavioral theories continued to integrate as cognitive theories emerged and developed.

Cognitive theories added to behavioral ideas by acknowledging the influence of cognition on behavior. Whereas psychodynamic approaches were aimed at understanding unconscious processes, Beck concluded that therapy needed to focus on the way a person perceived, interpreted, and attributed meaning in life (i.e. the scientific process of “cognition”)

The earliest form of cognitive psychotherapy was rational emotive behavior therapy (REBT), developed by Ellis in the 1950s. It was based on the idea that a person’s emotional distress arises from their thoughts about an event rather than the actual event itself. An important model as part of the development of cognitive therapies was the ABC model, used to describe the role of thoughts mediating between events and emotional responses.

The cognitive approach came into conflict with the behaviorism ascendant at the time, which denied the discussion of mental causes being scientific or meaningful.

Ellis and Beck, followed by other theorists, including Lazarus (1976), Mahoney (1974), Meichenbaum (1977), Goldfried and Davison (1976), and many others paved the way for CBT.

The development of treatment for panic disorder (by David Clark and David Barlow) was the major contribution to the success of combining these two frameworks. Despite the two theories having different foundations, a common ground between the two was found in their focus on the "here and now", and on dealing with symptom management

A key feature of the Cognitive- Behavioural framework is how the basic beliefs (core beliefs or schemas) influence how we perceive the world around us and adopt compensatory behaviors in light of these core beliefs

Although many techniques used in CBT are similar to those from the separate frameworks of Cognitive therapy and Behavioral therapy, in CBT there are various combinations of these techniques and new additions.

Don Meichenbaum, a CBT pioneer, talks about his research on CBT as it moved from a behaviorally oriented aspect of cognition to an information processing model. He discusses how CBT was not accepted at that time.

Since the development of CBT, it has gone through changes, and further developments, taken on new forms, and evolved to become what it is today. However, at its backbone, CBT has kept its key focus on the three systems that commonly impact us as humans – the cognitive, emotional, and behavioral models. There was a time where CBT lost its focus on working with emotions; however, CBT in its accurate form always takes note of emotion and cares about emotion.

The beauty of science is that it never stops evolving, which means neither will CBT. We can expect to continue to see changes in the development of CBT the more we learn about the science of psychology. We have already seen the implementation of technology in CBT, such as the use of apps and fitbits to monitor symptoms in real-time, practicing therapy via telehealth methods, and using virtual reality to provide life-like experiences for the client. We are also likely to see artificial intelligence make its way into the CBT approach, and it is our duty as CBT therapists to continue to learn and grow as the therapy does.