Cognitive-Behavioural Therapy (CBT) is a system of psychotherapy that attempts to reduce excessive emotional reactions and self-defeating behaviour by modifying the faulty or erroneous thinking and maladaptive beliefs that underlie these reactions (Beck, Rush, Shaw & Emery, 1979). Based on the premise that maladaptive behaviour and emotion is “cognitively mediated” (Butler, Chapman, Forman & Beck, 2006), CBT has elicited much interest in the treatment of psychological problems both in and outside the realm of sport.
Evolving from a combination of behavioural-based (Wolpe, 1958; Skinner 1957) and cognitive-based approaches (Beck, 1970; Ellis, 1962), CBT emerged as a major form of psychology in the “cognitive revolution” of the 1970s (Dember, 1974). Assembled into a single coherent framework, the concepts of CBT offered a new and improved approach to understanding the complex reciprocal interactions between cognition, emotion, physical reactions and behaviour. Specifically, the framework proposes that psychological disorders stem from the interaction of these four systems (McArdle & Moore, 2012), with environmental factors (e.g. social and cultural contexts) playing an influential role within these interactions.
While a substantial repertoire of techniques and methods are employed in CBT, all the therapies revolve around the notion that affective disorders are not due to undesirable events per se, but rather from the meanings clients give to events; therefore cognitive modification is vital to achieving positive therapeutic outcome (Clark & Steer, 1996). Central to this assumption, CBT interventions aim to alter dysfunctional thoughts either directly via cognitive techniques or indirectly through behavioural techniques.
The process of “strengthening positive behaviour and weakening negative behaviour towards a goal” (Behncke, 2004, p.8-9) has meant that CBT is inherently appealing to sport psychologists focusing on performance enhancement in athletes. Historically, the framework has had a strong impact on sport psychology’s development (Smith, 2006), and still, to this day, remains a dominant approach to cognitive and behavioural interventions in sport.
A popular CBT intervention aimed to improve athlete performance involves ‘positive self-talk’. Following the CBT principles, self-talk involves activating mental processes to change existing thought patterns in an attempt to influence the occurrence of desired action or behaviour (Johnson, Hrycaiko, Johnson & Halas, 2004). Strong support for the effectiveness of self-talk has been generated research: For example, Landin and Hebert (1999) participants’ positive self-talk not only improved volleying performance in tennis, but also enhanced their attention and self-confidence. In a similar vein, findings from Theodorakis, Hatzigeorgiadis, and Chroni (2008) suggests that positive self-talk increases self-confidence, regulates effort, controls cognitive and emotional reactions and triggers automatic executions. It must be noted however, that the external validity of these findings are questionable as stronger support for the effectiveness of self-talk has been generated from laboratory-based studies, as opposed to field-based studies (Hardy, 2006).
In addition to positive self-talk, Luiselli and Reed (2011) suggest the goal setting and imagery are key cognitive-behavioural methods used to enhance athlete performance. With regard to the latter, imagery is based on the notion that ‘the body achieves what the mind believes’ and as such, practitioners from a cognitive-behavioural perspective view images as functional equivalents of thoughts (Beck et al, 1979). Therefore, cognitively rehearsing the desired performance outcome enables athletes to regulate negative cognitive thoughts, ruminations and emotions. This self-controlling element is thought to improve the irrational thought and anxiety associated with athletes with a perfectionist mind-set (Achtiziger & Bayer, 2012).
Goal setting is another example of a cognitive-behavioural approach that can be used to help athletes with perfectionism. Research has shown that ego-orientation is positively associated with a maladaptive profile of perfectionism (Dunn, Dunn & Syrotuik, 2002). Thus, within the context of CBT, practitioners can use goal setting to set task-orientated goals (i.e. goals that focus on self-improvement) in an attempt to modify these maladaptive thoughts on achievement and subsequently, reduce perfectionist behaviour. It should be noted however, that the majority of literature encourages setting difficult goals for athletes (Locke, 1991), but this approach is somewhat unwarranted with perfectionistic athletes, as attempts should be made to avoid situations where athletes can engage in self-criticism when unrealistic standards are not met (Smith, 2006). This highlights that when choosing interventions for athletes with specific problems, CBT practitioners should always consider the following: what treatment is most effective for this individual with that specific problem, and under which set of circumstances? (Paul, 1967, p. 111).