Historically, BT can be divided into three generations. The first generation is in part a rebellion against prevailing therapeutic concepts of the day (the Psychoanalytic and Humanistic approaches). Early interventions focused directly on reducing problematic signs of behaviour, using techniques based on well-defined and strictly confirmed scientific principles. An example can be made of an individual suffering from social anxiety who avoids situations in which he may be subject to judgment or criticism. The main goal of treatment would involve increasing exposure to such social situations or reducing anxiety from the stressful situations.
However BT was not insulated from events happening outside it. The “cognitive revolution” in psychology took place in the 1960s, and by the 1970s many behaviour therapists influenced by it began to call their therapy “Cognitive Behaviour Therapy” (CBT).
The advent of cognitivism in the 1960’s brought about a paradigm shift within the field of experimental psychology. While the behavioural model had regarded cognitive processes as an epiphenomenon, a new approach appeared that considered cognitive knowledge of central importance in psychological investigation, while still maintaining an empirical view.
Cognitive therapy is thus born (Beck, Shaw, Rush & Emery, 1979; Meichenbaum, 1977; Mahoney, 1974) and with it, the second generation of BT. The concept of associative learning was abandoned leaving room for more flexible principles which took into account the role of internal experiences (thoughts and feelings) in determining human behaviour; humans are, first and foremost, thinking beings, capable of organizing their behaviour and modifying it according to circumstances (Bandura, 1969).
The study of irrational thoughts (Ellis, 1977) and cognitive schemata of mental illness (Beck, 1993) has identified how certain errors of cognition can be pervasive in certain types of patients and, for each of these, a variety of techniques are aimed at changing negative automatic thoughts. Returning to the example of the individual with social anxiety, the objectives of graded exposure in social situations, or the reduction of anxiety in relation to those same situations, are extended to include questioning the validity of the automatic thoughts related to the social situation, as well as the judgment of others.
Therefore it is the integration between the first two generations of BT that gives rise to the concept of CBT, which is characterized by a form of psychotherapy aimed at modifying not only overt behaviours but also beliefs, attitudes, cognitive styles and expectations of the client (Galeazzi & Meazzini, 2004).