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CBT 50 years on: a celebration of empirically grounded and evidence-based psychological therapy

Published online by Cambridge University Press:  30 January 2024

Paul Salkovskis*
Affiliation:
Department of Experimental Psychology, University of Oxford, Oxford, UK Oxford Health NHS Foundation Trust, Oxford, UK
Richard Thwaites
Affiliation:
North Cumbria Talking Therapies, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, UK
*
Corresponding author: Paul Salkovskis; Email: paul.salkovskis@hmc.ox.ac.uk
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Abstract

Type
Editorial
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of British Association for Behavioural and Cognitive Psychotherapies

Fifty years ago, a group of behaviour therapists and applied behaviour analysts agreed to form a special interest group at a meeting in the Middlesex Hospital. The name agreed for this special interest group was the British Association for Behavioural Psychotherapy, the BABP. It cost £3 to join, equivalent of about £12 today. From small beginnings, this group became what is now known as the British Association for Behavioural and Cognitive Psychotherapies, and is the lead UK organisation for cognitive and behavioural psychotherapies, not only as a special interest group, but as a professional body. There are now over 20,000 members who actively engage in a wide range of activities.

At the time of its founding, a publication was also initiated. This was called Behavioural Psychotherapy, and became the official journal of the BABP. The first issues were simply photocopied sheets; subsequently a blue A5-size leaflet, then a burgundy journal with a publishing contract with Academic Press. The journal flourished under the editorial guidance of Bill Yule, who sadly passed away this year, and Ray Hodgson. There were further developments and expansion until the present incarnation as a hybrid online and print journal, with the name having changed to Behavioural and Cognitive Psychotherapy (BCP).

The journal has always been focused on providing value for members of the Association in terms of its work, and the increasing number of practice-oriented articles led to the development of a new journal, the Cognitive Behaviour Therapist (tCBT). This suite of journals continues to serve the needs of members in a range of complementary ways.

The journals wanted to mark the 50th anniversary by publishing a range of articles that celebrate the wide range of contributions to our field. We have fallen short because the range of work carried out by our membership far transcends the articles we have been able to include. This is a further cause for celebration; CBT as an evidence-based and empirically grounded approach has developed both depth and breadth. The challenge of this is also an opportunity; cognitive behavioural therapy is now a diverse family of approaches rather than being a single unified approach. This is as it should be; some of what we do is problem specific, some is transdiagnostic or pandiagnostic, and some is non-diagnostic.

Turning to the selection of articles: the current BCP Editor-in-Chief Paul Salkovskis and colleagues (Salkovskis et al., Reference Salkovskis, Sighvatsson and Sigurdsson2023) have briefly summarised the history of our field with a view to understanding what we can learn from this and how it can be taken forward. Cathy Creswell (Creswell et al., Reference Creswell, Chessell and Halliday2022) considers one of the key challenges we face, which is how to improve access to CBT in children. John Taylor (Taylor and Novaco, Reference Taylor and Novaco2023) considers the important issue of how to help adults with intellectual disabilities and the challenge of anger management, relating this to therapist experience. In CBT terms, depression initially forged ahead with the development of Beck’s cognitive therapy, but subsequently lagged behind possibly because of lags in theory development. Stephen Barton’s article (Barton et al., Reference Barton, Armstrong, Robinson and Bromley2023) considers CBT for difficult-to-treat depression and provides a theoretical context. Theory is also a major feature of the article from Mark Freeston (Freeston, Reference Freeston2023) considering how best to apply theory to generalised anxiety disorder. In a similar vein, Kate Rimes (Rimes et al., Reference Rimes, Smith and Bridge2023) provides a re-analysis of Melanie Fennell’s influential cognitive behavioural self-esteem model.

The journals have quite specifically welcomed and supported work with complex and neglected areas, and we are proud to have been the ‘go to’ journal for motivational interviewing, which characterises such a focus. Bill Miller (Miller, Reference Miller2023) has written a wonderful reflection on the evolution of motivational interviewing, which shows how this important approach has become so very well established. The journals have also been at the forefront of working with psychosis, and Tony Morrison’s article (Morrison et al., Reference Morrison, Gonçalves, Peel, Larkin and Bowe2023) advances the field by consideration of the priorities of service users in trials of CBT for psychosis. Bringing together complexity and compassion, Michael Duffy (Duffy and Wild, Reference Duffy and Wild2023) describes the cognitive approach to prolonged grief.

Similarly, tCBT also published special issue papers in areas such as adapting CBT for those with intellectual disabilities (Dagnan et al., Reference Dagnan, Taylor and Burke2023), working with PTSD following traumatic bereavement (Wild et al., Reference Wild, Duffy and Ehlers2023), involving loved ones in the treatment of OCD to maximise treatment benefit (Philpot et al., Reference Philpot, Thwaites and Freeston2022), the examination of common misconceptions around CT-PTSD (Murray et al., Reference Murray, Grey, Warnock-Parkes, Kerr, Wild, Clark and Ehlers2022), a new take on Beckian CBT for GAD (Gústavsson et al., Reference Gústavsson, Salkovskis and Sigurðsson2022), a single case design report looking at difficult-to-treat depression (Barton et al., Reference Barton, Armstrong, Holland and Tyson-Adams2022), a summary of tCBT papers on working with older adults (Charlesworth, Reference Charlesworth2022), an examination of the experience of CBTp trainees (Newman-Taylor et al., Reference Newman-Taylor, Wood, Ellis and Isham2022) plus a significant new paper clarifying the role of persistent negative self-evaluation in social anxiety from the Oxford group (Warnock-Parkes et al., Reference Warnock-Parkes, Wild, Thew, Kerr, Grey and Clark2022).

As is the case for BCP, tCBT is also pleased to publish papers in under-examined and under-published areas, in tCBT’s case particularly around how we ensure equitable access and outcomes for all groups including those from minoritised ethnicities (something that was even less focused on 50 years ago when CBT was first being developed). With this in mind, tCBT also published 50th Special Issue papers which aimed to capture the current state of the CBT field around equity in CBT. This included how to be an anti-racist clinician (Williams et al., Reference Williams, Faber and Duniya2022) and an examination of the various frameworks to date for the cultural adaption of CBT (Naeem et al., Reference Naeem, Sajid, Naz and Phiri2023). In line with the remit of tCBT in publishing all kinds of practice-based papers including those on training, supervision and practice-based research, it also published a summary paper on the key task of assessing CBT competence (Muse et al., Reference Muse, Kennerley and McManus2022) and an examination of the concept of reliable change, and reliable change index (Blampied, Reference Blampied2022).

The tasks required for the next 50 years of CBT, building on the development work of key pioneering figures (some of whom we are sadly losing much more regularly that we would wish) are likely to be very different from the tasks for the last 50 years. Whilst it is highly unlikely that either Editor-in-Chief will be here in 50 years’ time (never mind editing the journals), we as the BABCP look forward to the next 50 years of CBT development and the key challenges of improving the acceptability, delivery at scale and effectiveness of our treatment for all groups.

References

Barton, S. B., Armstrong, P. V., Holland, S., & Tyson-Adams, H. (2022). CBT for difficult-to-treat depression: single complex case. the Cognitive Behaviour Therapist, 15, e37. doi: 10.1017/S1754470X22000319 CrossRefGoogle Scholar
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