From the author: the cognitive-behavioral method is by far the most effective and popular method of psychotherapy. According to modern research in the field of psychotherapy conducted by both the WHO (World Health Organization) and the US Department of Health, cognitive-behavioral therapy Behavioral therapy is the most effective treatment for most mental disorders. Among the problems that can be successfully treated with this method of psychotherapy are anxiety disorders, addictions, obsessions, post-traumatic stress disorder, phobias, sexual disorders, etc. It also gives excellent results in areas such as the treatment of neuroses, the treatment of depression and the treatment of panic attacks. Rarely a psychologist or psychiatrist denies the effectiveness of this method. In Western psychotherapy, cognitive behavioral therapy (CBT) is the most common treatment technique, showing good results in a relatively short time. More than 300 randomized controlled trials, involving about 20,000 people, confirm the effectiveness of CBT for the treatment of various disorders. Persons, Burns, and Perloff (1988) found that cognitive therapy is effective for patients regardless of their background, education level, or income. It has been adapted to work with patients of all age groups, from preschoolers (Knell, 1993) to the elderly (Casey & Grant, 1993; Thompson, Davies, Gallagher & Krantz, 1986). Although this book focuses exclusively on individual therapy, cognitive therapy has also been modified to work with groups of patients (Beutlerhzip., 1987; Freeman, Schrodt, Gilson, & Ludgate, 1993), problem solving with a partner (Baucom & Epstein, 1990; Dattilio & Padesky , 1990), as well as family therapy (Bedrosian & Bozicas, 1994; Epstein, Schlesinger, & Dryden, 1988). Controlled experiments have confirmed its effectiveness in the treatment of depression (see meta-analysis: Dobson, 1989), generalized anxiety disorder (Butler, Fennel, Robson, & Gelder, 1991), panic disorder (Barlow, Craske, Gerney, & Klosko, 1989; Beck, Sokol, Clark, Berchick, & Wright, 1992; Clark, Salkovskis, Hackmann, Middleton, & Gelder, 1992), social phobia (Gelernter et al., 1991; Heimberg et al., 1990), substance use disorder (Woody et al. ., 1983), eating disorders (Agras et al., 1992; Fairburn, Jones, Peveler, Hope, & Doll, 1991; Garner et al., 1993), relationship problems (Baucom, Sayers, & Scer, 1990) and hospital depression (Bowler, 1990; Miller, Norman, Keitner, Bishop, & Dow, 1989; Thase, Bowler, & Harden, 1991). Cognitive therapy is now used throughout the world as a sole or complementary treatment for many other disorders. These are obsessive-compulsive disorder (Salkovskis & Kirk, 1989), post-traumatic stress disorder (Dancu & Foa, 1992; Parrott & Howes, 1991), personality disorders (Beck et al., 1990; Layden, Newman, Freeman, & Morse, 1993; Young, 1990 ), recurrent depression (R. DeRubeis, personal communication October 1993), chronic pain syndrome (Miller, 1991; Turk, Meichenbaum, & Genest, 1983), hypochondriacal disorder (Warwick & Salkovskis, 1989), and schizophrenia (Chadwick & Lowe, 1990 ; Kingdon & Turkington, 1994; Perris, Ingelson, & Johnson, 1993). Cognitive behavioral therapy is successfully used not only in the treatment of psychiatric patients, but also in working with people serving sentences in prison, with schoolchildren, with patients suffering from various diseases, and many other categories of the population. "Beck et al compared the effectiveness of cognitive therapy for neurotic depression. Patients were randomly assigned to two groups - pharmacotherapy and cognitive therapy. Cognitive therapy lasted a maximum of 20 sessions (average 15 sessions over 11 weeks). Treatmentmedications lasted an average of 11 weeks, with one 20-minute appointment per week. Cognitive treatment was found to reduce symptoms of depression on the Beck Depression Inventory. The indicators improved significantly and remained so after completion of treatment for 3-6 months. In addition, 13 of 19 patients who received pharmacotherapy later required re-therapy, whereas only 3 of 19 patients who received cognitive therapy required re-therapy. B. F. Shaw compared the effectiveness of cognitive therapy with behavioral therapy for depression in college students. Patients were randomly divided into 4 groups of eight people each. Each group was subjected to a certain type of monotherapy: 1) cognitive; 2) behavioral (based on Levinson's model of depression (1974) and included methods such as activity lists, verbal contracts and behavioral rehearsal); 3) client-centered; 4) not subjected to treatment (control group). The most effective (both according to the Beck Depression Inventory and clinical assessments) was cognitive therapy. Behavioral therapy and client-centered therapy did not differ significantly in effectiveness. L. Comas-Díaz tested the effectiveness of cognitive and behavioral therapy for depression in Puerto Rican women. Treatment included five 90-minute sessions over 4 weeks. The clients were 26 depressed women of low socioeconomic status, unemployed, unmarried, and receiving government assistance. The women were randomly divided into three groups: eight each were assigned to cognitive therapy and behavioral therapy, and ten were assigned to the control group. The results showed a significant reduction in depression, and there were no significant differences in the effectiveness of the two types of therapy. At 5 weeks after the end of treatment, the condition of patients undergoing cognitive therapy, according to clinical assessments, had slightly worsened, although no such deterioration was noted according to the Beck Depression Questionnaire. The condition of patients undergoing behavioral therapy remained without deterioration. R. Miller and J. Berman reviewed 48 studies of the effectiveness of cognitive behavioral therapy for depression. The authors indicated that the effectiveness of this therapy was superior to placebo treatment, but did not find convincing evidence that the effectiveness of cognitive therapy was greater than that of other types of therapy. C. S. Dobson also analyzed the effectiveness of cognitive therapy for depression. After analyzing 28 studies, this author concluded that the effectiveness of cognitive therapy is higher than pharmacotherapy, behavioral therapy and a number of other areas of psychotherapy. D. L. Chambless and M. M. Gillies demonstrated that cognitive therapy is effective in the treatment of anxiety disorders and social phobia, and results are maintained at least 6 months after completion of treatment. However, no advantages of cognitive therapy over behavioral therapy in the treatment of these disorders have been identified. A study by D. M. Clark and A. Ehlers showed the high effectiveness of cognitive therapy in the treatment of panic disorders, and it is higher than with maintenance therapy, relaxation therapy and psychotherapy using the “flood” technique. G. T. Wilson and K. G. Fairburn showed the effectiveness of cognitive therapy for eating disorders, especially bulimia. It turned out that the result of therapy was quite stable and higher than with other forms of psychotherapy. “A randomized trial of cognitive behavioral therapy in people with persistent symptoms of schizophrenia, conducted at three centers in East Anglia and London, showed a 25% reduction in psychopathological symptoms, mainly hallucinations and delusions (Kuipers et al., 1997). According to According to the data obtained, cognitive therapy was useful for almost half of patients with such symptoms, mainly for those patients with persistent delusions that initiallyadmitted (at least partially) that they might be mistaken in their beliefs (Garety et al., 1998). These patients showed sustained improvement over time, and this form of therapy ultimately resulted in cost savings due to reduced need for services in the following months (Kuipers et al., 1998). A study in London demonstrated that cognitive behavioral therapy, administered in a group setting to patients with persistent psychotic symptoms, was no less effective in teaching patients coping strategies and how to control their hallucinations than individual cognitive therapy, while being much more effective. less expensive. Participants in group therapy noted that they found it helpful to discuss “voices” together; After sharing their experiences, many felt relieved. The new coping strategies learned during the sessions were highly rated (Wykes et al., 1999). By accelerating the resolution of positive symptoms, cognitive therapy is also effective in treating patients with acute psychosis. In Birmingham, England, patients undergoing inpatient treatment for an acute psychotic illness (excluding bipolar affective disorder) were prescribed a course of individual and group cognitive therapy, consisting of four treatments, carried out in stages during their hospital stay. Individual treatment involved gentle dissection and testing of core delusional beliefs. Group therapy was conducted in the form of meetings of groups of inpatients (up to six people), in which participants offered alternative explanations for the irrational beliefs of other patients, questioned negative beliefs about psychotic illness, and supported each other in their attempts to integrate the concept of the illness into their lives and develop new coping strategies." "In 1994, the book by Grawe K. et al. was published, “Psychotherapy in the Process of Change: From Denomination to Profession,” which analyzed the results of studies of the effectiveness of psychotherapy given in the literature. Grawe and his collaborators collected all studies published up to the beginning of 1984 of acceptable scientific quality (i.e., serious psychotherapy and statistical comparisons of patient groups were conducted); there were 3500 of them. The scientific-empirical level of all works was not only acceptable: it was additionally assessed by the authors on almost a thousand criteria: the nature of the research and publication (place of psychotherapy; authors and their specialization); research plan (studied factors; control measures, use of overlapping methods: the first group is treated with the first method, then with the second; the second group is treated with the second method, then with the first; composition of groups, organization of psychotherapy - outpatient, group, etc.); patients (type and severity of disorder, motivation, social affiliation, etc.); psychotherapists (experience with the psychotherapeutic methods used; professional group affiliation - psychologist, doctor; attitude to the psychotherapy being studied, an accurate description of the methods used); the richness of information necessary to assess the validity of studies; the saturation of information necessary to assess the quality of measurement of parameters - time, methods and sources of their measurement and diversity. According to research results, cognitive-behavioral and supportive methods are much more effective than other types of psychotherapy. Methods of cognitive-behavioral psychotherapy have developed depending on the results of empirical studies of the operating factors, effects and effectiveness, so the number of such studies is very large - 452 sources. Systematic desensitization has been studied 56 times at a high scientific level. Specific fears, such as social and sexual phobias, are very treatable; The more the patients were afraid of the situation, the better the therapeutic results were, inparticularly in patients with exam anxiety. The range of effects is limited to fear symptoms; for this reason, desensitization is often combined with other behavioral methods. The most effective for a variety of fears, including panic, are methods of confrontation with situations that patients are afraid of; they have been studied 62 times to an excellent scientific level. Most of these works are clinically very significant and valid; the quality and variety of information, parameters, statistical processing and results are high; they included follow-up studies, and confrontational methods were compared with other behavioral techniques. In behavioral psychotherapy, there are 3 types of confrontation: gradual confrontation in real situations (in vivo), increased confrontation in real situations (flood), and increased confrontation in the imagination (implosion). Confrontational techniques in real situations (in vivo) are indicated for phobias, panic and obsessive states. The efficiency was very high; Patients were treated not only with general and individually formulated problems and symptoms, i.e. with phobic and obsessive states, but also with problems in the areas of work, leisure and well-being. The duration of psychotherapy is less than 20 sessions over 10 weeks, but individual sessions lasted until the patient became calm within 1.2-2 hours. The more pronounced the symptoms and the longer the session, the more noticeable the effects of confrontation. Confronting situations that patients fear is a dramatic experience that emotionally affects not only patients but also psychotherapists; patients who agree to undergo such therapy under the guidance of a psychotherapist rightly feel like heroes. Group psychotherapy (with 4 patients) is even more effective than individual therapy. Confrontation in the imagination (implosion) is less effective. Although symptoms decreased in patients of most groups, only in 60% of therapeutic groups the effectiveness was significantly higher than in control groups, and implosion had virtually no effect on individually formulated problems and symptoms. When compared with other methods, confrontation in reality (and not in imagination) has advantages; its effectiveness is higher than medications (6-blockers). Social competence training (behavioral therapy) improves the social capabilities of patients in difficult situations using various techniques: gradual improvement according to the model, role-playing game, differentiated reinforcement, behavioral exercises, etc. The effects and effectiveness of the training have been studied at a high scientific level in 74 works on material from 3400 patients. The treatment included patients with severe self-doubt and social phobias, as well as other diagnoses: depression, psychosis, alcoholism, breakdowns or painful reactions due to severe family, professional, social experiences, disasters, torture, disability, etc. The training was often combined with cognitive and other behavioral methods or medications. The duration of therapy is 6-15 sessions, and in 15 studies - 40. The effectiveness of the training is high: in all groups, patients not only significantly increased self-confidence and overcame social fears, but also improved relationships in the social and professional spheres, as well as general well-being ; In half of the groups, the training led to a significant reduction in depression, migraines and sexual disorders. Alcoholism was not treated by social competence training, but the technique had a beneficial effect on the interpersonal relationships of patients with alcoholism, and the effectiveness increased in combination with cognitive methods. The central theoretical and empirically proven rationale for the effectiveness of cognitive methods is the position that thoughts, beliefs, assumptions, expectations (i.e., fears, hopes) control behavior, feelings and emotional state. There may also be an inverse relationship. Suchinteractions stabilize mental systems. But if one side of the interaction can be changed, then in interconnected systems the other side must also change. This principle is reflected in many methods of behavioral psychotherapy: patients, under the guidance of a psychotherapist, successfully learn to behave more confidently or not to be afraid of difficult situations for them, and as a result, the feeling of confidence actually increases or fear decreases in such situations. Cognitive psychotherapy according to Beck (Beck A. T.) is a series of techniques for treating depression, fears and personality disorders. Its cognitive part is that pathogenic, i.e. inadequate, thoughts, beliefs, assumptions, expectations are detected, which precede pathological (inadequate) feelings (depression, fear) or behavior. Thoughts manifest themselves in different ways - in conversation, systematic recordings (special diaries) of thoughts, feelings, behavior, events, in confrontation, role-playing, etc. The psychotherapist changes pathogenic, inadequate thoughts with the help of Socratic dialogue and by comparison with reality presented and described by himself patient. The effectiveness of Beck's cognitive psychotherapy has been studied since 1977 in 16 studies at a high scientific level and with great success. Therapy lasted from 4 to 24 weeks; 7 studies provided fewer than 10 sessions. In all groups, all measured parameters (symptoms, personality, general well-being) improved significantly both in comparison with control groups and including follow-up. In 2 out of 3 studies, a comparison of cognitive psychotherapy with psychoanalytic therapy proved significant superiority of the former. "To assess the effectiveness of cognitive psychotherapy techniques in patients with arterial hypertension with initial manifestations of chronic cerebral ischemia, 40 patients were examined. Of these, 13 were men, 27 were women. The average age of the examined patients was 48.7 ± 12.2 years. After the initial examination, all Patients were randomly selected into 2 groups, comparable in age, duration of the disease, severity of clinical symptoms and basic therapy (BT) - 23 patients, in the complex treatment of which, along with BT, sessions of cognitive psychotherapy were carried out. - 17 patients who received only BT (antihypertensive drugs, antiplatelet agents, neurotrophic and vascular drugs, B vitamins). Cognitive psychotherapy sessions were conducted individually once a week, with a total of 8 sessions. Patients were given homework: keeping a self-observation diary, reading specialized literature. All patients underwent two examinations: a primary examination before the start of treatment, and a second examination after the course of therapy. The examination consisted of collecting and quantitatively assessing complaints and examining the neurological status. We studied complaints of headache, dizziness, sleep and appetite disturbances, pain in the heart and palpitations, memory loss, sleep deterioration, decreased mood, anxiety, and general malaise. For each indicator of complaints, patients were asked to rate their severity using a 4-point system (0 - absent, 1 - mildly expressed, 2 - moderately expressed, 3 - severely expressed). In addition, an expert assessment of the severity of the complaints made by the doctor was also carried out using a 4-point system. At the end of the course of treatment, a statistically significant (according to the Wilcoxon test) decrease in group 1 (CP + BT) was achieved in the following indicators: the overall severity of complaints as assessed by the doctor, complaints of headache, dizziness, sleep and appetite disorders, general malaise, pain in the heart area, as well as a decrease in memory and mood (p Separately, it should be noted that the result of cognitive psychotherapy was not only a change in the emotional state of patients, but also, what is especially important, a decrease in ordinary “somatic” complaints, such as pain in the heart area, headache, dizziness, etc. The results obtained demonstrate the high therapeutic effectiveness of cognitivepsychotherapy in the complex treatment of patients with arterial hypertension with initial manifestations of chronic cerebral ischemia... Cognitive psychotherapy is successfully used in the treatment of chronic pain disorders. The therapy process is aimed at strengthening faith in recovery and improves the patient’s mood, and this is very important for mobilizing internal forces to fight the disease, changing attitudes towards one’s condition and the environment [Bergdahl J. Cognitive therapy in the treatment of patients with resistant burning mouth syndrome / J. Bergdahl, G. Anneroth, H. Perris //J. Oral Pathol. Med. – 1995. – Vol.24, No. 5. – P. 213–215. Johnson PR, Thorn BE Cognitive behavioral treatment of chronic headache: group versus individual treatment format. //Headache. 1989 Jun;29[6]:358 – 365.]. Cognitive-behavioral psychotherapy has shown greater effectiveness compared to other approaches in the treatment of somatoform disorders (somatoform pain disorder) in terms of reducing the intensity of pain and the number of complaints [Lipchik GL, Nash JM. Cognitive-behavioral issues in the treatment and management of chronic daily headache. //Curr Pain Headache Rep. 2002 Dec;6[6]:473 –479 ]. The effectiveness of cognitive psychotherapy for burning mouth syndrome has been established [Humphris GM, Longman LP, Field EA Cognitive-behavioural therapy for idiopathic burning mouth syndrome: a report of two cases. //Br Dent J. 1996 Sep. – 21;181[6]:204–8.]. In a controlled study [Lipchik GL, Nash JM. Cognitive-behavioral issues in the treatment and management of chronic daily headache. //Curr Pain Headache Rep. 2002 Dec;6[6]:473 –479] it is shown that cognitive psychotherapy, in addition to eliminating emotional disorders, reduces the intensity of pain and, as a result, improves the quality of life. Increased compliance and avoidance of excessive use of analgesics are considered as a separate advantage of psychotherapy. A ten-week course of cognitive behavioral psychotherapy reduced the catastrophic perception of chronic pain and reduced negative attitudes towards painful episodes [Bonfils P., Peignard P., Malinvaud D. Cognitive-behavioral therapy in the burning mouth syndrome a new approach.// Ann Otolaryngol Chir Cervicofac. 2005 Jun;122[3]:146 –149.]. It is noted that the duration of treatment is an important factor that must be taken into account when including cognitive psychotherapy in the treatment of chronic pain [Johnson PR, Thorn BE Cognitive behavioral treatment of chronic headache: group versus individual treatment format. //Headache. 1989 Jun;29[6]:358 – 365.]. Cognitive therapy strategies are successfully used in the treatment of comorbid pathology that combines pain and negative emotions [Bonfils P., Peignard P., Malinvaud D. Cognitive-behavioral therapy in the burning mouth syndrome a new approach. // Ann Otolaryngol Chir Cervicofac. 2005 Jun;122[3]:146 –149.]. Cognitive models of both emotional disorders and chronic pain disorder are being developed. The researchers' work is aimed at developing the basic cognitive-behavioral principles for the treatment of chronic pain based on cognitive psychotherapy and drawing up clinical recommendations for the integration of cognitive psychotherapy into the complex treatment of burning mouth syndrome [Bergdahl J. Cognitive therapy in the treatment of patients with resistant burning mouth syndrome / J . Bergdahl, G. Anneroth, H. Perris //J. Oral Pathol. Med. – 1995. – Vol.24, No. 5. – P. 213–215]. Confirming the negative mutual influence of burning mouth syndrome and negative emotions, taking into account the negative impact of depression on the treatment of chronic pain, they consider the prescription of cognitive psychotherapy to be quite justified [Bonfils P., Peignard P., Malinvaud D. Cognitive-behavioral therapy in the burning mouth syndrome a new approach.// Ann Otolaryngol Chir Cervicofac. 2005 Jun;122[3]:146 –149.]. Meta-analysis comparing the results of cognitive-behavioral andpharmacological treatments for burning mouth syndrome have found similar levels of effectiveness [Van Houdenhove B, Joostens P. Burning mouth syndrome. Successful treatment with combined psychotherapy and psychopharmacotherapy. //Gen Hosp Psychiatry. 1995 Sep;17[5]:385 – 388.]. The effectiveness of cognitive therapy for back pain So, researchers from the UK studied the medical records of 700 people who were treated for chronic back pain for 6 months. After receiving preliminary information about the patients’ condition, they were divided into two groups: 2/3 of the experiment participants underwent CBT, and the rest received traditional treatment. In the first group, patients were prescribed group CBT once a week for 90 minutes. The course was 6 weeks. The classes were conducted by qualified psychologists and medical staff; there were 8 patients in one group. Compared to the control group, people who received CBT reported less back pain during treatment and at 3 and 6 months after treatment. A year later, all participants in the experiment were re-examined. Improvements as a result of therapy were found in 59% of patients who completed a course of CBT, and only in 31% of patients in the control group. Dr. Hansen was surprised by these results because such a long-lasting therapeutic effect from CBT is quite unusual for the treatment of chronic pain. American medical experts also find that CBT can significantly help people suffering from back pain and even prevent disability. However, the American health care system is not currently equipped to support the widespread introduction of CBT into clinical practice. However, in the short term, primary care physicians may be able to implement some CBT techniques in the treatment of patients with chronic back pain. The effectiveness of behavioral therapy for tension headaches GSBarolin [Barolin GS Psychotherapy and mental health in chronic headache Wien Med Wochenschr - 1995 - N145(10) - p. 246-52] believes that when treating headaches, the most important are especially behavioral methods, including biofeedback. G.Bussone, L.Grazzi, D.D'Amico, M.Leone, F.Andrasik [Bussone G., Grazzi L., D'Amico D., Leone M., Andrasik F. Biofeedback-assisted relaxation training for young Adolescents with tension-type headache: a controlled study. Cephalalgia - 1998 - N18(7) - p. 463-7] showed in their study that behavioral methods can provide an effective alternative to medications. In a study conducted by these authors, individuals suffering from juvenile tension headaches were treated with a relaxation method combined with biofeedback training and showed better results than the control group after 6 and 12 months (86% and 50%). P.Aull, S.Maly, J.Mraz, M.Schnider, P.Travniczek, A.Zeiler, K.Wessely [Aull P., Maly S., Mraz J., Schnider M., Travniczek P., Zeiler A ., Wessely K., Polypragmasy in chronic tension headache? 1994 - vol. 106 - N 6 - pp. 153-8.], who studied the effectiveness of various forms of therapy for tension headaches (both medicinal and non-medicinal), showed the need to include relaxation psychotherapeutic approaches, as well as biofeedback training. N.J.King and B.J.Tonge [King NJ; Tonge BJ Behavioral assessment and treatment of chronic headaches in children J Paediatr. Child Health - 1996 - N32(5) - p.359-61] reviewed the achievements of behavioral medicine in the treatment of headaches in children and came to the conclusion that behavioral treatment strategies in the treatment of headaches are a very promising direction. One explanation for the effectiveness of electromyographic biofeedback training for tension headaches is the cognitive model of biofeedback. This model is based on the idea that headache reduction may be due to feedback-induced cognitive changes rather than a reduction in electromyographic activity. In 1984.