Case Conceptualization
The basic premises of all CBT models are • that cognition, emotion and behavior are reciprocally related; • that perceiving and experiencing are active processes that involve both experiencing the world as it is (sensory input, essentially) and interpreting the world (meaning-making); • that meaning-making is related to prior learning – often social learning; • that a person can learn to become aware of the interaction of cognition, emotion, and behavior; and that altering the ones that may be more directly under our control or influence – cognition and behavior – will impact the person’s responses on all levels. • Further, CBT models uniformly propose that basic or core beliefs acquired early in childhood evolve into a cognitive map of the world (schema or apperceptive mass or phenomenal field) that affects not only the information the person pays attention to (a cognitive filter, creating expectancies) but also how they explain what happens to them and others (their attributions).
Core beliefs or schema are usually unquestioned underlying assumptions about the world which the person takes as givens, and may be fairly accurate, flexibly responsive to incoming information, varying with time and situation, and thus adaptive. However, maladaptive schema tend to be irrational (unscientific, illogical), to be based on incomplete or incompletely understood information, to be rigidly adhered to across situations, and to be resistant to change despite conflicting information or experience.
Basic beliefs or schema are revealed by consistent patterns of cognition, behavior, and emotional response across situations. Long-standing maladaptive/irrational beliefs are evident in automatic thoughts/intermediary beliefs that form the stream of consciousness of the individual. When a person is seriously distressed, these automatic thoughts are likely to be characterized by