As you probably know, Aaron T Beck died on Monday 1st November 2021 aged 100 years. There are several fine obituaries to him which you may have found, notably in The Guardian, The Times, The Telegraph and The New York Times. When people die it is often said that it is almost impossible to overstate their influence, and for AT Beck it is absolutely true. So many of the ideas he espoused in his books of the 1970s are now standard practice that it is easy to forget how they originally came about. 

In the 1970s he wrote two books introducing CBT to the world, the first (Cognitive Therapy and the Emotional Disorders) on his own, the second (Cognitive Therapy with Depression) with Rush, Shaw and Emery. The first in the mid-70s, the second near the end of the 70s, the exact year of publication varying slightly according to where you live. And they were truly ground-breaking and I want to mention some of the reasons why. 

Beck was writing at a time when most mental health professionals were swayed either by psychodynamic psychotherapy or by behaviour modification and behaviour therapy. In the former, ‘mental events’ and mental events below the level of conscious awareness were paramount, in the latter they were regarded by some as ‘white noise’. What CBT did was to ‘catalogue’ certain mental events – notably core beliefs and negative automatic thoughts - and to integrate them into working with people’s behaviour and produce a coherent package to apply to the client’s benefit. 

He did this by the simple (now) expedient of describing an interaction between emotions, behaviour and thoughts. Which meant that we were able to help patients with their emotions by addressing their behaviour and their thoughts. Which is accepted now – and at certain times prior to the 1970s - but much less so actually during the 1970s. Later of course two more factors would be added to the interaction, namely biology and the environment, including the social environment. 

He highlighted the concept of Guided Discovery, both by asking searching (‘Socratic’) questions and by diary-keeping. This enabled people to make sense of their fluctuations in mood simply by recording their mood variations and – alongside – recording what they were doing and thinking. Then analysing the results and finding what behaviour and thoughts worked well – and badly – for them. 

He described the approach of Collaborative Empiricism, ‘two inquisitive experimenters (the client and the therapist) working alongside each other and trying things out until they find things that work well for the client’. A wonderful phrase for a wonderful strategy, and one which underpins many of the other therapies available today. 

He emphasised the need for Evidence Based Practice and, in particular, Practice Based Evidence, where you monitor how well your interventions are proceeding and adapt what you do accordingly. Which meshes perfectly with collaborative empiricism and in embodied in most therapies now. 

He inspired countless other professionals, Judith Beck of course, but also for instance his then colleague at Pennsylvania David Burns (author of Feeling Good, the new mood therapy, a self-help book that has sold literally millions of copies), Christine Padeski (author of The Clinicians Guide to Mind over Mood, and co-author of Mind Over Mood) and many others. And part of his inspiration was not just the technical aspects of CBT but the fact of him so obviously being a very nice person; it is worth looking up some of the videos of him talking on YouTube just to see that. 

But of his achievements perhaps my favourite is that his books actually told you how to ‘do’ therapy, or as they say more acceptably, CBT was ‘protocol based’. I trained in the mid-1970s and I can still remember the lecturer’s look – and verbalisations – of horror when I suggested it would be great to have a protocol of just what we were meant to do in therapy. Just then therapy was mystical to many people, and to try and tie it down was tantamount to heresy, and anyway if you looked too closely at the process it would almost certainly disappear from view. So for Beck to do just that was wonderful. 

And possibly it was just that, and the realisation that a single individual could write a book that could influence so many therapists, that led to books introducing DBT, ACT, Motivational Interviewing, Compassion Focused Therapy, and many other approaches. Like CBT they are based also – to a greater or lesser degree - on the great underpinning work of the Behaviourists, but I believe that it was really Beck’s books and the ones he directly inspired that really guided these great later authors. 

And for the APT? Well for almost forty years we have been proud to teach CBT, never more so than now, and if you would like to view our 45-minute overview of CBT (free of charge) then click here. In the meantime, please rest in peace Aaron T Beck.

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