The role of Behaviour and Cognition in Psychotherapy. Towards an Integration

Abstract

The present paper argues for an integration between the behavioural and the cognitive perspectives on psychotherapy. Both perspectives are necessary but neither is sufficient. The behavioural perspective is necessary, since no therapy is neutral to the client's behaviour; therapists of all schools are selective in what they attend and respond to, which leads to a selective reinforcement of certain kinds of behaviours. The cognitive perspective is also necessary, since all kinds of psychotherapy involve some kind of change of the client's beliefs and expectations. The behavioural perspective is insufficient, since empirical research indicates that even basic forms of conditioning depend on changes in beliefs and expectations, and since it is unable to handle the representational nature of beliefs and expectations. The cognitive perspective is insufficient since cognitive change is seldom therapeutically sufficient, and since there are some kinds of behaviour change (e.g., evaluative conditioning) which do not involve a change of beliefs or expectations. “Behaviourism” is the result of a reification of the behavioural perspective, whereas the reification of the cognitive perspective leads to “cognitivism”. It is argued that the behavioural and cognitive perspectives are complementary, and should be combined or integrated, and that all “isms” should be disposed of. In addition to behaviour and cognition, an integrative perspective may also contain a more explicit focus on affective processes. What is needed is not ideological commitments to some favourite “ism”, but a scientifically based psychotherapy, which is open to all kinds of therapeutically relevant psychological research.