Preface
I am delighted to prepare this introduction to the Arabic
edition of Cognitive Therapy and the Emotional Disorders. Cognitive Therapy draws
on
a very strong empirical base for its theoretical formulation. The generic cognitive
model derived from the theory has been tailored to the specific characteristics of
a
wide range of Axis I and Axis II disorders. A large number of outcome studies have
supported its efficacy in the treatment of Axis I disorders.
The most recent controlled outcome studies have indicated
efficacy with or without medication in the more intractable and severe disorders,
such as Severe Chronic Depression, Bipolar Disorder, Anorexia Nervosa,
Schizophrenia, Chronic Fatigue Syndrome, and Substance Abuse. I would especially
highlight new cognitive approaches to schizophrenia.
It is now time to look ahead to the new millennium to see how
cognitive therapy may best serve the changing needs of the patients and the insurers
of health care. In the future, I expect the emergence of a broad psychotherapy that
can be refined for the broad range of psychological problems in psychiatric patients
and medical patients. With changes in the delivery of health system, I propose that
some kind of triage will assign psychotherapists according to their degree of
expertise and specialized skills. In all probability less experienced, less skillful
therapists will treat the simple garden-variety of disorders on a short-term basis
(from three to twelve visits). The more skillful therapists will work with the
intractable Axis I and Axis II disorders in longer-term therapy which will include
spacing out the visits over a longer period of time than is customary
presently.
Also, therapists will work as members of a team with primary
care physicians. Each therapist will be responsible for assessing and screening
medical patients for psychiatric problems. Since forty to fifty percent of family
practice patients have some degree of depression, these problems will be addressed
by the primary care therapist. Therapists will also be involved in the “disease
management” of disorders such as diabetes, hypertension, low back pain, and
asthma.
As we enter the Twenty-first Century, many broader
opportunities for well-trained, experienced therapists will open up. In the future
the accreditation of therapists will be based on the assessment of their competency
in dealing with patients, and they either will or will not be assigned to patients
depending upon their “non-specific” psychotherapy skills as well as their more
highly specialized skills.
Again, may I say how pleased I am to have an Arabic edition
of Cognitive Therapy and the Emotional Disorders available to professionals who are
interested in the cognitive approach. I realize that Cognitive Therapy fits in very
well with the concepts of mental illness in the Arabic countries, and this
translation should facilitate its use with people suffering from depression, anxiety
and other disorders.
Aaron T. Beck, M. D.
University Professor of
Psychiatry
University of Pennsylvania
Philadelphia, PA 19104, USA
