Cognitive–Behavior Therapy: Reflections on the Evolution of a Therapeutic Orientation

This article presents an account of the evolution of cognitive–behavior therapy over the past 35 years, which began with the introduction of cognition into behavior therapy in the mid-1960s. As cognitive–behavior therapists became more experienced clinically and recognized that clients did not always engage in clearly reportable internal dialogues, the schema construct was used to understand more about clients' implicit meaning structures. It is noted that self-schemas play a particularly important role in understanding how therapeutic change can be undermined, and clinical guidelines are offered to deal with this dilemma. The distinction between cognitive–behavior therapy and cognitive therapy is discussed, and the importance of activating emotional experiencing in the clinical change process is underscored.