Theoretical foundations of cognitive-behavior therapy for anxiety and depression

Cognitive-behavior therapy (CBT) involves a highly diverse set of terms and procedures. In this review, the origins of CBT are briefly considered, and an integrative theoretical framework is proposed that (a) distinguishes therapy interventions targeted at circumscribed disorders from those targeted at generalized disorders and (b) distinguishes interventions aimed at modifying conscious beliefs and representations from those aimed at modifying unconscious representations in memory. Interventions aimed at altering consciously accessible beliefs are related to their theoretical bases in appraisal theories of emotion and cognitive theories of emotion and motivation. Interventions aimed at modifying unconscious representations are related to their theoretical bases in learning theory and findings from experimental cognitive psychology. In the review, different formulations of CBT for anxiety disorders and depression are analyzed in terms of this framework, and theoretical issues relating to self-representations in memory and to emotional processing are considered.