Cognitive Theory Guides Phobia Treatment

Woman talking to counsellor
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Cognitive theory is an approach to psychology that attempts to explain human behavior by understanding your thought processes. For example, a therapist is using principles of cognitive theory when she teaches you to how to identify your maladaptive thought patterns and transform them into constructive ones. 

Cognitive Theory Basics

The assumption of cognitive theory is that thoughts are the primary determinants of emotions and behavior.

Information processing is a common description of this mental process and theorists compare the way the human mind functions to a computer.

Pure cognitive theory largely rejects behaviorism, another approach to psychology, on the basis that it reduces complex human behavior to simple cause and effect.

The trend of the last decades has been to merge cognitive theory and behaviorism into a comprehensive cognitive-behavioral theory. This allows therapists to use techniques from both schools of thought to help clients achieve their goals.

Social Cognitive Theory

Social cognitive theory is a subset of cognitive theory and therapists use it to treat phobias and other psychological disorders. Primarily focused on the ways in which we learn to model the behavior of others. Advertising campaigns and peer pressure situations are a good example. 

Cognitive Restructuring to Treat Phobia

All three types of phobia fall into a larger group of psychological issues called anxiety disorders, which are the most common type of psychiatric disorder.

Cognitive restructuring, based on cognitive theory, is part of an effective treatment plan for anxiety disorder

During a cognitive restructuring session, the therapist will ask questions, help you analyze your answers to increase your understanding of your anxiety and assist you in "rewriting" your maladaptive thoughts.

The basic approach to cognitive restructuring put forth by leading cognitive theorist Christine A. Padesky, Ph.D., recommends your therapist go through four basic steps with you. She will:

  1. Ask you questions to identify the "self-talk" going on in your head when you feel anxious, and then facilitate a discussion to test if what you're thinking is really true.
  2. Listen to what you have to say with an empathetic ear and unconditional acceptance.
  3. Ask you to summarize the main points of the session to reinforce what you've learned and to let her address any misunderstandings.
  4. Ask you questions that allow you to synthesize and analyze the new and more realistic view of your anxiety so you can restructure your thought patterns.

Cognitive Biases Treatment for Phobia

Your therapist is relying on cognitive theory if she highlights identifying the cognitive biases in your maladaptive thoughts a part of your treatment plan. Two types of cognitive biases addressed in anxiety treatment are attention bias and interpretation bias.

  • Attention bias means that when you are experiencing your anxiety trigger, you pay attention to the negative signals instead of positive ones. For example, if you have a fear of public speaking, you only look at audience members with facial expressions you see as threatening, rather than seeking out the smiling faces.
  • Interpretation bias, as the name implies, refers to misinterpreting information. At the podium might think an audience member with a negative facial expression is a reflection of how they feel about you when they're really just bored or tired.



Beard, Courtney. Expert Review of Neurotherapeutics: Cognitive bias modification for anxiety: current evidence and future directions (2011)

Seligman and Ollendick. Child and Adolescent Psychiatric Clinics of North America: Cognitive Behavioral Therapy for Anxiety Disorders in Youth (2011)

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