Are All Psychotherapies Cognitive?

Abstract

The well-known failure to find differential mechanisms and outcomes of psychotherapies has led to the suggestion that all therapies share a common mechanism—perhaps even a cognitive mechanism. I suggest that all therapies can be seen as cognitive—but all therapies can also be seen as behavioral, biological, emotional, and interpersonal. In fact, cognitive therapy itself has many noncognitive components, including behavioral, biological, emotional, and interpersonal elements. I argue that one of these vantage points is not more “correct” than the others, but that different approaches to the study of psychotherapeutic change may be useful to test different hypotheses. Rather than reflecting the action of a single common mechanism that cuts across therapies, the commonality of elements across therapies and the failure to find mode-specific actions of therapies may reflect the crudity of the measurement approaches currently available for detecting therapeutic change.