Cognitive therapy (CT) is now widely recommended as an effective form of psychological treatment for a variety of psychiatric disorders, particularly depressive and anxiety states. The therapy itself consists of a specific treatment ‘package’ derived from the cognitive theory of psychopathology and seems to have developed because of a growing dissatisfaction with dynamic psychotherapy on the one hand, and a strictly behavioural approach to the patient's difficulties on the other. A further factor has been the unwillingness of some patients to continue for long periods on psychotropic medication and the unwillingness of medical practitioners to prescribe it in patients who have expressed suicidal ideas, or have not previously responded well to medication. The main thrust of the CT is problem orientated, and treatment itself is an active, moderately directive, time-limited, structured approach set in the present in which the patient and therapist work in collaboration to relieve the patient's symptoms.
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