document_title: Geologic time scale

question_text: which eon was the first in earth's history

question_tokens: which eon was the first in earth 's history

text: Geologic time scale

text: Terminology[edit]

text: The primary defined divisions of time are eons, in sequence the Hadean, the Archean, the Proterozoic and the Phanerozoic. The first three of these can be referred to collectively as the Precambrian supereon. Eons are divided into eras, which are in turn divided into periods, epochs and ages.

text: The following four timelines show the geologic time scale. The first shows the entire time from the formation of the Earth to the present, but this gives little space for the most recent eon. Therefore, the second timeline shows an expanded view of the most recent eon. In a similar way, the most recent era is expanded in the third timeline, and the most recent period is expanded in the fourth timeline.

text: Corresponding to eons, eras, periods, epochs and ages, the terms "eonothem", "erathem", "system", "series", "stage" are used to refer to the layers of rock that belong to these stretches of geologic time in Earth's history.

text: Geologists qualify these units as "early", "mid", and "late" when referring to time, and "lower", "middle", and "upper" when referring to the corresponding rocks. For example, the lower Jurassic Series in chronostratigraphy corresponds to the early Jurassic Epoch in geochronology.[2] The adjectives are capitalized when the subdivision is formally recognized, and lower case when not; thus "early Miocene" but "Early Jurassic."

text: Rationale[edit]

text: Evidence from radiometric dating indicates that Earth is about 4.54 billion years old.[3][4] The geology or deep time of Earth's past has been organized into various units according to events which took place. Different spans of time on the GTS are usually marked by corresponding changes in the composition of strata which indicate major geological or paleontological events, such as mass extinctions. For example, the boundary between the Cretaceous period and the Paleogene period is defined by the Cretaceous–Paleogene extinction event, which marked the demise of the non-avian dinosaurs and many other groups of life. Older time spans, which predate the reliable fossil record (before the Proterozoic eon), are defined by their absolute age.

text: Geologic units from the same time but different parts of the world often look different and contain different fossils, so the same time-span was historically given different names in different locales. For example, in North America, the Lower Cambrian is called the Waucoban series that is then subdivided into zones based on succession of trilobites. In East Asia and Siberia, the same unit is split into Alexian, Atdabanian, and Botomian stages. A key aspect of the work of the International Commission on Stratigraphy is to reconcile this conflicting terminology and define universal horizons that can be used around the world.[5]

text: Some other planets and moons in the Solar System have sufficiently rigid structures to have preserved records of their own histories, for example, Venus, Mars and the Earth's Moon. Dominantly fluid planets, such as the gas giants, do not preserve their history in a comparable manner. Apart from the Late Heavy Bombardment, events on other planets probably had little direct influence on the Earth, and events on Earth had correspondingly little effect on those planets. Construction of a time scale that links the planets is, therefore, of only limited relevance to the Earth's time scale, except in a Solar System context. The existence, timing, and terrestrial effects of the Late Heavy Bombardment is still debated.[a]

text: History and nomenclature of the time scale[edit]

text: Early history[edit]

text: In Ancient Greece, Aristotle (384-322 BCE) observed that fossils of seashells in rocks resembled those found on beaches – he inferred that the fossils in rocks were formed by living animals, and he reasoned that the positions of land and sea had changed over long periods of time. Leonardo da Vinci (1452–1519) concurred with Aristotle's interpretation that fossils represented the remains of ancient life.[6]

text: The 11th-century Persian geologist Avicenna (Ibn Sina, died 1037) and the 13th-century Dominican bishop Albertus Magnus (died 1280) extended Aristotle's explanation into a theory of a petrifying fluid.[7] Avicenna also first proposed one of the principles underlying geologic time scales, the law of superposition of strata, while discussing the origins of mountains in The Book of Healing (1027).[8][9] The Chinese naturalist Shen Kuo (1031–1095) also recognized the concept of "deep time".[10]

text: Establishment of primary principles[edit]

text: In the late 17th century Nicholas Steno (1638–1686) pronounced the principles underlying geologic (geological) time scales. Steno argued that rock layers (or strata) were laid down in succession, and that each represents a "slice" of time. He also formulated the law of superposition, which states that any given stratum is probably older than those above it and younger than those below it. While Steno's principles were simple, applying them proved challenging. Over the course of the 18th century geologists realized that:

text:
Sequences of strata often become eroded, distorted, tilted, or even inverted after deposition
Strata laid down at the same time in different areas could have entirely different appearances
The strata of any given area represented only part of Earth's long history

text: The Neptunist theories popular at this time (expounded by Abraham Werner (1749–1817) in the late 18th century) proposed that all rocks had precipitated out of a single enormous flood. A major shift in thinking came when James Hutton presented his Theory of the Earth; or, an Investigation of the Laws Observable in the Composition, Dissolution, and Restoration of Land Upon the Globe[11] before the Royal Society of Edinburgh in March and April 1785. It has been said[by whom?] that "as things appear from the perspective of the 20th century, James Hutton in those readings became the founder of modern geology".[12]:95-100 Hutton proposed that the interior of Earth was hot, and that this heat was the engine which drove the creation of new rock: land was eroded by air and water and deposited as layers in the sea; heat then consolidated the sediment into stone, and uplifted it into new lands. This theory, known as "Plutonism", stood in contrast to the "Neptunist" flood-oriented theory.

text: Formulation of geologic time scale[edit]

text: The first serious attempts to formulate a geologic time scale that could be applied anywhere on Earth were made in the late 18th century. The most influential of those early attempts (championed by Werner, among others) divided the rocks of Earth's crust into four types: Primary, Secondary, Tertiary, and Quaternary. Each type of rock, according to the theory, formed during a specific period in Earth history. It was thus possible to speak of a "Tertiary Period" as well as of "Tertiary Rocks." Indeed, "Tertiary" (now Paleogene and Neogene) remained in use as the name of a geological period well into the 20th century and "Quaternary" remains in formal use as the name of the current period.

text: The identification of strata by the fossils they contained, pioneered by William Smith, Georges Cuvier, Jean d'Omalius d'Halloy, and Alexandre Brongniart in the early 19th century, enabled geologists to divide Earth history more precisely. It also enabled them to correlate strata across national (or even continental) boundaries. If two strata (however distant in space or different in composition) contained the same fossils, chances were good that they had been laid down at the same time. Detailed studies between 1820 and 1850 of the strata and fossils of Europe produced the sequence of geologic periods still used today.

text: Naming of geologic periods, eras and epochs[edit]

text: Early work on developing the geologic time scale was dominated by British geologists, and the names of the geologic periods reflect that dominance. The "Cambrian", (the classical name for Wales) and the "Ordovician", and "Silurian", named after ancient Welsh tribes, were periods defined using stratigraphic sequences from Wales.[12]:113–114 The "Devonian" was named for the English county of Devon, and the name "Carboniferous" was an adaptation of "the Coal Measures", the old British geologists’ term for the same set of strata. The "Permian" was named after Perm, Russia, because it was defined using strata in that region by Scottish geologist Roderick Murchison. However, some periods were defined by geologists from other countries. The "Triassic" was named in 1834 by a German geologist Friedrich Von Alberti from the three distinct layers (Latin trias meaning triad)—red beds, capped by chalk, followed by black shales—that are found throughout Germany and Northwest Europe, called the ‘Trias’. The "Jurassic" was named by a French geologist Alexandre Brongniart for the extensive marine limestone exposures of the Jura Mountains. The "Cretaceous" (from Latin creta meaning ‘chalk’) as a separate period was first defined by Belgian geologist Jean d'Omalius d'Halloy in 1822, using strata in the Paris basin[13] and named for the extensive beds of chalk (calcium carbonate deposited by the shells of marine invertebrates) found in Western Europe.

text: British geologists were also responsible for the grouping of periods into eras and the subdivision of the Tertiary and Quaternary periods into epochs. In 1841 John Phillips published the first global geologic time scale based on the types of fossils found in each era. Phillips’ scale helped standardize the use of terms like Paleozoic ("old life") which he extended to cover a larger period than it had in previous usage, and Mesozoic ("middle life") which he invented.[14]

text: Dating of time scales[edit]

text: When William Smith and Sir Charles Lyell first recognized that rock strata represented successive time periods, time scales could be estimated only very imprecisely since estimates of rates of change were uncertain. While creationists had been proposing dates of around six or seven thousand years for the age of Earth based on the Bible, early geologists were suggesting millions of years for geologic periods, and some were even suggesting a virtually infinite age for Earth.[citation needed] Geologists and paleontologists constructed the geologic table based on the relative positions of different strata and fossils, and estimated the time scales based on studying rates of various kinds of weathering, erosion, sedimentation, and lithification. Until the discovery of radioactivity in 1896 and the development of its geological applications through radiometric dating during the first half of the 20th century, the ages of various rock strata and the age of Earth were the subject of considerable debate.

text: The first geologic time scale that included absolute dates was published in 1913 by the British geologist Arthur Holmes.[15] He greatly furthered the newly created discipline of geochronology and published the world-renowned book The Age of the Earth in which he estimated Earth's age to be at least 1.6 billion years.[16]

text: In 1977, the Global Commission on Stratigraphy (now the International Commission on Stratigraphy) began to define global references known as GSSP (Global Boundary Stratotype Sections and Points) for geologic periods and faunal stages. The commission's most recent work is described in the 2004 geologic time scale of Gradstein et al.[17] A UML model for how the timescale is structured, relating it to the GSSP, is also available.[18][19]

text: The Anthropocene[edit]

text: The term "Anthropocene" is used informally by popular culture and a growing number of scientists to describe the current epoch in which we are living. The term was coined by Paul Crutzen and Eugene Stoermer in 2000 to describe the current time, in which humans have had an enormous impact on the environment. It has evolved to describe an "epoch" starting some time in the past and on the whole defined by anthropogenic carbon emissions and production and consumption of plastic goods that are left in the ground.[20]

text: Critics of this term say that the term should not be used because it is difficult, if not nearly impossible, to define a specific time when humans started influencing the rock strata—defining the start of an epoch.[21] Others say that humans have not even started to leave their biggest impact on Earth, and therefore the Anthropocene has not even started yet.

text: as of September 2015[update], the ICS has not officially approved the term.[22] The Anthropocene Working Group met in Oslo in April 2016 to consolidate evidence supporting the argument for the Anthropocene as a true geologic epoch.[23] Evidence was evaluated and the group voted to recommend "Anthropocene" as the new geological age in August 2016.[24] Should the International Commission on Stratigraphy approve the recommendation, the proposal to adopt the term will have to be ratified by the International Union of Geological Sciences before its formal adoption as part of the geologic time scale.[25]

text: Table of geologic time[edit]

text: The following table summarizes the major events and characteristics of the periods of time making up the geologic time scale. This table is arranged with the most recent geologic periods at the top, and the most ancient at the bottom. The height of each table entry does not correspond to the duration of each subdivision of time.

text: The content of the table is based on the current official geologic time scale of the International Commission on Stratigraphy,[1] with the epoch names altered to the early/late format from lower/upper as recommended by the ICS when dealing with chronostratigraphy.[2]

text: A service providing a Resource Description Framework/Web Ontology Language representation of the timescale is available through the Commission for the Management and Application of Geoscience Information GeoSciML project as a service[26] and at a SPARQL end-point.[27][28]

text:
[hide]Supereon
Eon
Era
Period[b]
Epoch
Age[c]
Major events
Start, million years ago[c]

n/a[d]
Phanerozoic
Cenozoic[e]
Quaternary
Holocene

chrons: Subatlantic · Subboreal · Atlantic · Boreal · Preboreal

Quaternary Ice Age recedes, and the current interglacial begins. Sahara forms from savannah. Rise of human civilization, beginning of agriculture. Stone Age cultures give way to Bronze Age (3300 BC) and Iron Age (1200 BC), giving rise to many pre-historic cultures throughout the world. Little Ice Age (stadial) causes brief cooling in Northern Hemisphere from 1400 to 1850. Following the Industrial Revolution, atmospheric CO2 levels rise from around 280 parts per million volume (ppmv) to the current level of 400[31] ppmv.[32][f]
0.0117[g]

Pleistocene
Late (locally Tarantian · Tyrrhenian · Eemian · Sangamonian)
Flourishing and then extinction of Pleistocene megafauna. Evolution of anatomically modern humans. Quaternary Ice Age continues with glaciations and interstadials (and the accompanying fluctuations from 100 to 300 ppmv in atmospheric CO2 levels[32][f]), further intensification of Icehouse Earth conditions, roughly 1.6 Ma. Last glacial maximum (30000 years ago), last glacial period (18000–15000 years ago). Dawn of human stone-age cultures, with increasing technical complexity relative to previous ice age cultures, such as engravings and clay statues (e.g. Venus of Lespugue), particularly in the Mediterranean and Europe. Lake Toba supervolcano erupts 75000 years before present, causing a volcanic winter that possibly pushes humanity to the brink of extinction. Pleistocene ends with Oldest Dryas, Older Dryas/Allerød and Younger Dryas climate events, with Younger Dryas forming the boundary with the Holocene.
0.126

Middle (formerly Ionian)
0.781

Calabrian
1.8*

Gelasian
2.58*

Neogene
Pliocene
Piacenzian
Intensification of present Icehouse conditions, present (Quaternary) ice age begins roughly 2.58 Ma; cool and dry climate. Australopithecines, many of the existing genera of mammals, and recent mollusks appear. Homo habilis appears.
3.6*

Zanclean
5.333*

Miocene
Messinian
Moderate Icehouse climate, punctuated by ice ages; Orogeny in Northern Hemisphere. Modern mammal and bird families become recognizable. Horses and mastodons diverse. Grasses become ubiquitous. First apes appear (for reference see the article: "Sahelanthropus tchadensis"). Kaikoura Orogeny forms Southern Alps in New Zealand, continues today. Orogeny of the Alps in Europe slows, but continues to this day. Carpathian orogeny forms Carpathian Mountains in Central and Eastern Europe. Hellenic orogeny in Greece and Aegean Sea slows, but continues to this day. Middle Miocene Disruption occurs. Widespread forests slowly draw in massive amounts of CO2, gradually lowering the level of atmospheric CO2 from 650 ppmv down to around 100 ppmv.[32][f]
7.246*

Tortonian
11.63*

Serravallian
13.82*

Langhian
15.97

Burdigalian
20.44

Aquitanian
23.03*

Paleogene
Oligocene
Chattian
Warm but cooling climate, moving towards Icehouse; Rapid evolution and diversification of fauna, especially mammals. Major evolution and dispersal of modern types of flowering plants
28.1

Rupelian
33.9*

Eocene
Priabonian
Moderate, cooling climate. Archaic mammals (e.g. Creodonts, Condylarths, Uintatheres, etc.) flourish and continue to develop during the epoch. Appearance of several "modern" mammal families. Primitive whales diversify. First grasses. Reglaciation of Antarctica and formation of its ice cap; Azolla event triggers ice age, and the Icehouse Earth climate that would follow it to this day, from the settlement and decay of seafloor algae drawing in massive amounts of atmospheric carbon dioxide,[32][f] lowering it from 3800 ppmv down to 650 ppmv. End of Laramide and Sevier Orogenies of the Rocky Mountains in North America. Orogeny of the Alps in Europe begins. Hellenic Orogeny begins in Greece and Aegean Sea.
37.8

Bartonian
41.2

Lutetian
47.8*

Ypresian
56*

Paleocene
Thanetian
Climate tropical. Modern plants appear; Mammals diversify into a number of primitive lineages following the extinction of the non-avian dinosaurs. First large mammals (up to bear or small hippo size). Alpine orogeny in Europe and Asia begins. Indian Subcontinent collides with Asia 55 Ma, Himalayan Orogeny starts between 52 and 48 Ma.
59.2*

Selandian
61.6*

Danian
66*

Mesozoic
Cretaceous
Late
Maastrichtian
Flowering plants proliferate, along with new types of insects. More modern teleost fish begin to appear. Ammonoidea, belemnites, rudist bivalves, echinoids and sponges all common. Many new types of dinosaurs (e.g. Tyrannosaurs, Titanosaurs, duck bills, and horned dinosaurs) evolve on land, as do Eusuchia (modern crocodilians); and mosasaurs and modern sharks appear in the sea. Primitive birds gradually replace pterosaurs. Monotremes, marsupials and placental mammals appear. Break up of Gondwana. Beginning of Laramide and Sevier Orogenies of the Rocky Mountains. atmospheric CO2 close to present-day levels.
72.1 ± 0.2*

Campanian
83.6 ± 0.2

Santonian
86.3 ± 0.5*

Coniacian
89.8 ± 0.3

Turonian
93.9*

Cenomanian
100.5*

Early
Albian
~113

Aptian
~125

Barremian
~129.4

Hauterivian
~132.9

Valanginian
~139.8

Berriasian
~145

Jurassic
Late
Tithonian
Gymnosperms (especially conifers, Bennettitales and cycads) and ferns common. Many types of dinosaurs, such as sauropods, carnosaurs, and stegosaurs. Mammals common but small. First birds and lizards. Ichthyosaurs and plesiosaurs diverse. Bivalves, Ammonites and belemnites abundant. Sea urchins very common, along with crinoids, starfish, sponges, and terebratulid and rhynchonellid brachiopods. Breakup of Pangaea into Gondwana and Laurasia. Nevadan orogeny in North America. Rangitata and Cimmerian orogenies taper off. Atmospheric CO2 levels 3–4 times the present day levels (1200–1500 ppmv, compared to today's 400 ppmv[32][f]).
152.1 ± 0.9

Kimmeridgian
157.3 ± 1.0

Oxfordian
163.5 ± 1.0

Middle
Callovian
166.1 ± 1.2

Bathonian
168.3 ± 1.3*

Bajocian
170.3 ± 1.4*

Aalenian
174.1 ± 1.0*

Early
Toarcian
182.7 ± 0.7*

Pliensbachian
190.8 ± 1.0*

Sinemurian
199.3 ± 0.3*

Hettangian
201.3 ± 0.2*

Triassic
Late
Rhaetian
Archosaurs dominant on land as dinosaurs, in the oceans as Ichthyosaurs and nothosaurs, and in the air as pterosaurs. Cynodonts become smaller and more mammal-like, while first mammals and crocodilia appear. Dicroidiumflora common on land. Many large aquatic temnospondyl amphibians. Ceratitic ammonoids extremely common. Modern corals and teleost fish appear, as do many modern insect clades. Andean Orogeny in South America. Cimmerian Orogeny in Asia. Rangitata Orogeny begins in New Zealand. Hunter-Bowen Orogeny in Northern Australia, Queensland and New South Wales ends, (c. 260–225 Ma)
~208.5

Norian
~227

Carnian
~237*

Middle
Ladinian
~242*

Anisian
247.2

Early
Olenekian
251.2

Induan
251.902 ± 0.06*

Paleozoic
Permian
Lopingian
Changhsingian
Landmasses unite into supercontinent Pangaea, creating the Appalachians. End of Permo-Carboniferous glaciation. Synapsid reptiles (pelycosaurs and therapsids) become plentiful, while parareptiles and temnospondyl amphibians remain common. In the mid-Permian, coal-age flora are replaced by cone-bearing gymnosperms (the first true seed plants) and by the first true mosses. Beetles and flies evolve. Marine life flourishes in warm shallow reefs; productid and spiriferid brachiopods, bivalves, forams, and ammonoids all abundant. Permian-Triassic extinction event occurs 251 Ma: 95% of life on Earth becomes extinct, including all trilobites, graptolites, and blastoids. Ouachita and Innuitian orogenies in North America. Uralian orogeny in Europe/Asia tapers off. Altaid orogeny in Asia. Hunter-Bowen Orogeny on Australian continent begins (c. 260–225 Ma), forming the MacDonnell Ranges.
254.14 ± 0.07*

Wuchiapingian
259.1 ± 0.4*

Guadalupian
Capitanian
265.1 ± 0.4*

Wordian
268.8 ± 0.5*

Roadian
272.95 ± 0.5*

Cisuralian
Kungurian
283.5 ± 0.6

Artinskian
290.1 ± 0.26

Sakmarian
295 ± 0.18

Asselian
298.9 ± 0.15*

Carbon-
iferous[h]
Pennsylvanian
Gzhelian
Winged insects radiate suddenly; some (esp. Protodonata and Palaeodictyoptera) are quite large. Amphibians common and diverse. First reptiles and coal forests (scale trees, ferns, club trees, giant horsetails, Cordaites, etc.). Highest-ever atmospheric oxygen levels. Goniatites, brachiopods, bryozoa, bivalves, and corals plentiful in the seas and oceans. Testate forams proliferate. Uralian orogeny in Europe and Asia. Variscan orogeny occurs towards middle and late Mississippian Periods.
303.7 ± 0.1

Kasimovian
307 ± 0.1

Moscovian
315.2 ± 0.2

Bashkirian
323.2 ± 0.4*

Mississippian
Serpukhovian
Large primitive trees, first land vertebrates, and amphibious sea-scorpions live amid coal-forming coastal swamps. Lobe-finned rhizodonts are dominant big fresh-water predators. In the oceans, early sharks are common and quite diverse; echinoderms (especially crinoids and blastoids) abundant. Corals, bryozoa, goniatites and brachiopods (Productida, Spiriferida, etc.) very common, but trilobites and nautiloids decline. Glaciation in East Gondwana. Tuhua Orogeny in New Zealand tapers off.
330.9 ± 0.2

Viséan
346.7 ± 0.4*

Tournaisian
358.9 ± 0.4*

Devonian
Late
Famennian
First clubmosses, horsetails and ferns appear, as do the first seed-bearing plants (progymnosperms), first trees (the progymnosperm Archaeopteris), and first (wingless) insects. Strophomenid and atrypid brachiopods, rugose and tabulate corals, and crinoids are all abundant in the oceans. Goniatite ammonoids are plentiful, while squid-like coleoids arise. Trilobites and armoured agnaths decline, while jawed fishes (placoderms, lobe-finned and ray-finned fish, and early sharks) rule the seas. First amphibians still aquatic. "Old Red Continent" of Euramerica. Beginning of Acadian Orogeny for Anti-Atlas Mountains of North Africa, and Appalachian Mountains of North America, also the Antler, Variscan, and Tuhua Orogeny in New Zealand.
372.2 ± 1.6*

Frasnian
382.7 ± 1.6*

Middle
Givetian
387.7 ± 0.8*

Eifelian
393.3 ± 1.2*

Early
Emsian
407.6 ± 2.6*

Pragian
410.8 ± 2.8*

Lochkovian
419.2 ± 3.2*

Silurian
Pridoli
First vascular plants (the rhyniophytes and their relatives), first millipedes and arthropleurids on land. First jawed fishes, as well as many armoured jawless fish, populate the seas. Sea-scorpions reach large size. Tabulate and rugose corals, brachiopods (Pentamerida, Rhynchonellida, etc.), and crinoids all abundant. Trilobites and mollusks diverse; graptolites not as varied. Beginning of Caledonian Orogeny for hills in England, Ireland, Wales, Scotland, and the Scandinavian Mountains. Also continued into Devonian period as the Acadian Orogeny, above. Taconic Orogeny tapers off. Lachlan Orogeny on Australian continent tapers off.
423 ± 2.3*

Ludlow
Ludfordian
425.6 ± 0.9*

Gorstian
427.4 ± 0.5*

Wenlock
Homerian
430.5 ± 0.7*

Sheinwoodian
433.4 ± 0.8*

Llandovery
Telychian
438.5 ± 1.1*

Aeronian
440.8 ± 1.2*

Rhuddanian
443.8 ± 1.5*

Ordovician
Late
Hirnantian
Invertebrates diversify into many new types (e.g., long straight-shelled cephalopods). Early corals, articulate brachiopods (Orthida, Strophomenida, etc.), bivalves, nautiloids, trilobites, ostracods, bryozoa, many types of echinoderms (crinoids, cystoids, starfish, etc.), branched graptolites, and other taxa all common. Conodonts (early planktonic vertebrates) appear. First green plants and fungi on land. Ice age at end of period.
445.2 ± 1.4*

Katian
453 ± 0.7*

Sandbian
458.4 ± 0.9*

Middle
Darriwilian
467.3 ± 1.1*

Dapingian
470 ± 1.4*

Early
Floian
(formerly Arenig)
477.7 ± 1.4*

Tremadocian
485.4 ± 1.9*

Cambrian
Furongian
Stage 10
Major diversification of life in the Cambrian Explosion. Numerous fossils; most modern animal phyla appear. First chordates appear, along with a number of extinct, problematic phyla. Reef-building Archaeocyatha abundant; then vanish. Trilobites, priapulid worms, sponges, inarticulate brachiopods (unhinged lampshells), and numerous other animals. Anomalocarids are giant predators, while many Ediacaran fauna die out. Prokaryotes, protists (e.g., forams), fungi and algae continue to present day. Gondwana emerges. Petermann Orogeny on the Australian continent tapers off (550–535 Ma). Ross Orogeny in Antarctica. Adelaide Geosyncline (Delamerian Orogeny), majority of orogenic activity from 514–500 Ma. Lachlan Orogeny on Australian continent, c. 540–440 Ma. Atmospheric CO2 content roughly 15 times present-day (Holocene) levels (6000 ppmv compared to today's 400 ppmv)[32][f]
~489.5

Jiangshanian
~494*

Paibian
~497*

Series 3
Guzhangian
~500.5*

Drumian
~504.5*

Stage 5
~509

Series 2
Stage 4
~514

Stage 3
~521

Terreneuvian
Stage 2
~529

Fortunian
~541 ± 1.0*

Precambrian[i]
Proterozoic[j]
Neoproterozoic[j]
Ediacaran
Good fossils of the first multi-celled animals. Ediacaran biota flourish worldwide in seas. Simple trace fossils of possible worm-like Trichophycus, etc. First sponges and trilobitomorphs. Enigmatic forms include many soft-jellied creatures shaped like bags, disks, or quilts (like Dickinsonia). Taconic Orogeny in North America. Aravalli Range orogeny in Indian Subcontinent. Beginning of Petermann Orogeny on Australian continent. Beardmore Orogeny in Antarctica, 633–620 Ma.
~635*

Cryogenian
Possible "Snowball Earth" period. Fossils still rare. Rodinia landmass begins to break up. Late Ruker / Nimrod Orogeny in Antarctica tapers off.
~720[k]

Tonian
Rodinia supercontinent persists. Sveconorwegian orogeny ends. Trace fossils of simple multi-celled eukaryotes. First radiation of dinoflagellate-like acritarchs. Grenville Orogeny tapers off in North America. Pan-African orogeny in Africa. Lake Ruker / Nimrod Orogeny in Antarctica, 1,000 ± 150 Ma. Edmundian Orogeny (c. 920 – 850 Ma), Gascoyne Complex, Western Australia. Adelaide Geosyncline laid down on Australian continent, beginning of Adelaide Geosyncline (Delamerian Orogeny) in Australia.
1000[k]

Mesoproterozoic[j]
Stenian
Narrow highly metamorphic belts due to orogeny as Rodinia forms. Sveconorwegian orogeny starts. Late Ruker / Nimrod Orogeny in Antarctica possibly begins. Musgrave Orogeny (c. 1,080 Ma), Musgrave Block, Central Australia.
1200[k]

Ectasian
Platform covers continue to expand. Green algae colonies in the seas. Grenville Orogeny in North America.
1400[k]

Calymmian
Platform covers expand. Barramundi Orogeny, McArthur Basin, Northern Australia, and Isan Orogeny, c.1,600 Ma, Mount Isa Block, Queensland
1600[k]

Paleoproterozoic[j]
Statherian
First complex single-celled life: protists with nuclei. Columbia is the primordial supercontinent. Kimban Orogeny in Australian continent ends. Yapungku Orogeny on Yilgarn craton, in Western Australia. Mangaroon Orogeny, 1,680–1,620 Ma, on the Gascoyne Complex in Western Australia. Kararan Orogeny (1,650 Ma), Gawler Craton, South Australia.
1800[k]

Orosirian
The atmosphere becomes oxygenic. Vredefort and Sudbury Basin asteroid impacts. Much orogeny. Penokean and Trans-Hudsonian Orogenies in North America. Early Ruker Orogeny in Antarctica, 2,000–1,700 Ma. Glenburgh Orogeny, Glenburgh Terrane, Australian continent c. 2,005–1,920 Ma. Kimban Orogeny, Gawler craton in Australian continent begins.
2050[k]

Rhyacian
Bushveld Igneous Complex forms. Huronian glaciation.
2300[k]

Siderian
Oxygen catastrophe: banded iron formations forms. Sleaford Orogeny on Australian continent, Gawler Craton 2,440–2,420 Ma.
2500[k]

Archean[j]
Neoarchean[j]
Stabilization of most modern cratons; possible mantle overturn event. Insell Orogeny, 2,650 ± 150 Ma. Abitibi greenstone belt in present-day Ontario and Quebec begins to form, stabilizes by 2,600 Ma.
2800[k]

Mesoarchean[j]
First stromatolites (probably colonial cyanobacteria). Oldest macrofossils. Humboldt Orogeny in Antarctica. Blake River Megacaldera Complex begins to form in present-day Ontario and Quebec, ends by roughly 2,696 Ma.
3200[k]

Paleoarchean[j]
First known oxygen-producing bacteria. Oldest definitive microfossils. Oldest cratons on Earth (such as the Canadian Shield and the Pilbara Craton) may have formed during this period.[l] Rayner Orogeny in Antarctica.
3600[k]

Eoarchean[j]
Simple single-celled life (probably bacteria and archaea). Oldest probable microfossils. The first life forms and self-replicating RNA molecules evolve around 4,000 Ma, after the Late Heavy Bombardment ends on Earth. Napier Orogeny in Antarctica, 4,000 ± 200 Ma.
~4000

Hadean[j][m]
Early Imbrian (Neohadean) (unofficial)[j][n]
Indirect photosynthetic evidence (e.g., kerogen) of primordial life. This era overlaps the beginning of the Late Heavy Bombardment of the Inner Solar System, produced possibly by the planetary migration of Neptune into the Kuiper belt as a result of orbital resonances between Jupiter and Saturn. Oldest known rock (4,031 to 3,580 Ma).[34]
4130[35]

Nectarian (Mesohadean) (unofficial)[j][n]
Possible first appearance of plate tectonics. This unit gets its name from the lunar geologic timescale when the Nectaris Basin and other greater lunar basins form by big impact events. Earliest evidence for life based on unusually high amounts of light isotopes of carbon, a common sign of life.
4280[35]

Basin Groups (Paleohadean) (unofficial)[j][n]
End of the Early Bombardment Phase. Oldest known mineral (Zircon, 4,404 ± 8 Ma). Asteroids and comets bring water to Earth.[36]
4533[35]

Cryptic (Eohadean) (unofficial)[j][n]
Formation of Moon (4,533 to 4,527 Ma), probably from giant impact, since the end of this era. Formation of Earth (4,570 to 4,567.17 Ma), Early Bombardment Phase begins. Formation of Sun (4,680 to 4,630 Ma) .
4600

text: Proposed Precambrian timeline[edit]

text: The ICS's Geologic Time Scale 2012 book which includes the new approved time scale also displays a proposal to substantially revise the Precambrian time scale to reflect important events such as the formation of the Earth or the Great Oxidation Event, among others, while at the same time maintaining most of the previous chronostratigraphic nomenclature for the pertinent time span.[37] (See also Period (geology)#Structure.)

text:
Hadean Eon – 4600–4031 MYA[contradictory]

Chaotian Era – 4600–4404 MYA – the name alluding both to the mythological Chaos and the chaotic phase of planet formation[37][38][39][contradictory]
Jack Hillsian or Zirconian Era – 4404–4031 MYA – both names allude to the Jack Hills Greenstone Belt which provided the oldest mineral grains on Earth, zircons[37][38]

Archean Eon – 4031–2420 MYA

Paleoarchean Era – 4031–3490 MYA

Acastan Period – 4031–3810 MYA – named after the Acasta Gneiss[37][38]
Isuan Period – 3810–3490 MYA – named after the Isua Greenstone Belt[37]

Mesoarchean Era – 3490–2780 MYA

Vaalbaran Period – 3490–3020 MYA – a portmanteau based on the names of the Kapvaal (Southern Africa) and Pilbara (Western Australia) cratons[37]
Pongolan Period – 3020–2780 MYA – named after the Pongola Supergroup[37]

Neoarchean Era – 2780–2420 MYA

Methanian Period – 2780–2630 MYA – named for the inferred predominance of methanotrophic prokaryotes[37]
Siderian Period – 2630–2420 MYA – named for the voluminous banded iron formations formed within its duration[37]

Proterozoic Eon – 2420–541 MYA

Paleoproterozoic Era – 2420–1780 MYA

Oxygenian Period – 2420–2250 MYA – named for displaying the first evidence for a global oxidizing atmosphere[37]
Jatulian or Eukaryian Period – 2250–2060 MYA – names are respectively for the Lomagundi–Jatuli δ13C isotopic excursion event spanning its duration, and for the (proposed)[40][41] first fossil appearance of eukaryotes[37]
Columbian Period – 2060–1780 MYA – named after the supercontinent Columbia[37]

Mesoproterozoic Era – 1780–850 MYA

Rodinian Period – 1780–850 MYA – named after the supercontinent Rodinia, stable environment[37]

Neoproterozoic Era – 850–541 MYA

Cryogenian Period – 850–630 MYA – named for the occurrence of several glaciations[37]
Ediacaran Period – 630–541 MYA

text: Shown to scale:

text: Compare with the current official timeline, not shown to scale:


document_title: Raising of school leaving age in England and Wales

question_text: when was school leaving age raised to 15

root

text: 19th century[edit]

text: Prior to the 19th century, there were very few schools. Most of those that existed were run by the church, for the church, stressing religious education. In the latter part of the 19th Century, compulsory attendance at school ceased to be a matter for local option, with the introduction of the Elementary Education Act 1870 a milestone in the British school education system.[4] Children had to attend between the ages of 5 and 10 though with some local discretion such as early leaving in agricultural areas.[5]

tag: p

text: The introduction of the Elementary Education Act 1870 (applying to England and Wales), commonly known as Forster's Education Act having been drawn up by William Edward Forster, created the concept of compulsory education for children under thirteen, although the decision to make education compulsory was at the discretion of school boards; education was compulsory in approximately 40% of schools by 1873.[6] In areas where education was considered a problem, elected school boards could be set up. These boards could, at their discretion, create local by-laws, confirmed by Parliament, to require attendance and fine the parents of children who did not attend.[4] There were exemptions for illness, living more than a certain distance (typically one mile) from a school, or certification of having reached the required standard (which varied by board) which were made mandatory across England and Wales by the 1880 Act.

text: The Elementary Education Act 1880 insisted on compulsory attendance from 5–10 years.[4] For poorer families, ensuring their children attended school proved difficult, as it was more tempting to send them working if the opportunity to earn an extra income was available. Attendance Officers often visited the homes of children who failed to attend school, which often proved to be ineffective. Children under the age of 13 who were employed were required to have a certificate to show they had reached the educational standard; employers of these children who weren't able to show this were penalised.[7] An act brought into force thirteen years later went under the name of the Elementary Education (School Attendance) Act 1893, which stated a raised minimum leaving age to 11. Later the same year, the act was also extended for blind and deaf children, who previously had no means of an official education. This act was later amended in 1899 to raise the school leaving age up to 12 years of age.[7][8]

text: 20th century[edit]

text: School boards were abolished in 1902 and replaced with local education authorities, which are still in use to the present day.[4]

text: The Fisher Act of 1918[edit]

text: The year 1918 saw the introduction of the Education Act 1918, commonly also known as the Fisher Act as it was devised by Herbert Fisher. The act enforced compulsory education from 5–14 years, but also included provision for compulsory part-time education for all 14-to-18-year-olds. There were also plans for expansion in tertiary education, by raising the participation age to 18 though cuts in public spending after World War I made this impractical. This is the first act which starting planning provisions for young people to remain in education until the age of 18.[9] The 1918 act was not implemented until a further act of 1921 was passed.[10]

text: Butler's post-war education changes[edit]

text: In 1944, Rab Butler introduced the Education Act 1944 which amongst other changes, including the introduction of the Tripartite System, included raising the school leaving age to 15. Although the act should have been brought into effect as from September 1939, it was not implemented because of the effects of World War II, but was eventually enforced from April 1947.[7][3] The comprehensive school system has since replaced the Tripartite System brought in by this act across most of England.[11] This act also recommended compulsory part-time education for all children until the age of 18, but was dropped, in  similar fashion to the 1918 Act, to cut spending after World War II.[9]

text: Reasons[edit]

text: Changes in government approaches towards education meant that it was no longer regarded adequate for a child to leave education aged 14, as that is the age when they were seen to really understand and appreciate the value of education, as well as being the period when adolescence was at its height. It was beginning to be seen as the worst age for a sudden switch from education to employment, with around 80% of children in 1938 leaving education at this age, many having only had primary-school level education.[12] Although there were concerns about the effects of having less labour from these children, it was hoped that the outcome of a larger quantity of more qualified, skilled workers would eliminate the deficit problem from the loss of unskilled labour.[13]

text: Effects[edit]

text: This act introduced the 11+ examination to determine if a child should be eligible for a grammar school, secondary modern or technical college, under the Tripartite System,[3] but has since been phased out across the majority of the United Kingdom, with just several boroughs in England[14] and Northern Ireland[15] still using it. League tables published in March 2007 showed grammar schools throughout the country were outperforming comprehensive schools;[16] data published ten years later in 2017 suggested a similar clear division between student attainment in grammar schools compared to comprehensive schools.[17]

text: Changes in society and approaches towards education, including equal opportunities, has meant that it is now recognised that all children deserve to have the same educational opportunities without singling out those who learn at a slower rate than others, thus every child has the opportunity to gain secondary school level qualifications or similar, regardless of background or intelligence.

text: Leaving age raised to 16[edit]

text: In 1964, preparations began to raise the school leaving age to 16.[18] These were delayed in 1968, and eventually the decision was taken in 1971 that the new upper age limit be enforced from 1 September 1972 onwards.[7] As well as raising the school leaving age in 1972, the year also saw the introduction of the Education (Work Experience) Act, allowing LEAs to organise work experience for the additional final year school students.[19] In some counties around the country, these changes also led to the introduction of middle schools in 1968,[19] where students were kept at primary or junior school for an additional year, meaning that the number of students in secondary schools within these areas remained virtually constant through the change.[3] In others, more radical changes led to middle schools for pupils aged up to 13 opening in smaller secondary school buildings, with other schools accommodating students over 13. As of 2010, there are fewer than 300 middle schools across England, situated in just 22 local education authorities; the number of remaining middle schools has gradually fallen since the mid-1980s.[20][3]

text: ROSLA Buildings[edit]

text: For many secondary schools around England and Wales in areas without a Middle School, accommodating for the new 5th year students would be a struggle. A popular solution was to provide those schools with a pre-fabricated building (often referred to as ROSLA Buildings or ROSLA Blocks) that were in need of additional capacity,[3] providing them with the resources to cope with the new generation of 5th year students. This solution proved popular with many schools across the country, not least due to the low cost involved for materials and construction, but also the speed which these buildings could be erected.  Many were supplied by F. Pratten and Co Ltd.[21][22][23][24]

text: The ROSLA Buildings were delivered to schools in self assembly packs, being assembled by a team often within days, regardless of weather conditions.  Consequently, they were not intended to stand long-term, though some have proven to have stood much longer than was initially planned.[3] Many ROSLA Buildings shared similar exterior attributes such as their design, with the only difference being the separation of rooms within the building. The room separation within the building was decided upon by senior school management, hence many walls are false from being added in after construction.

text: Although the majority of schools around England and Wales have since replaced the ROSLA Building at their site, there are still numerous schools around the country which are still actively using these buildings.[citation needed]

text: Education Act 1996[edit]

text: Between 1976 and 1997, the minimum school leaving arrangements were:

text:
A child whose sixteenth birthday falls in the period 1 September to 31 January inclusive, may leave compulsory schooling at the end of the Spring term (the following Easter).
A child whose sixteenth birthday falls in the period 1 February to 31 August, may leave on the Friday before the last Monday in May.

tag: ul

text: Under the Education Act 1996, a new single school leaving date was set for 1998 and all subsequent years thereafter. This was set as the last Friday in June in the school year which the child reaches the age of 16.[25]

text: 21st century[edit]

text: Education and Skills Act 2008[edit]

text: Reports published in November 2006 suggested that Education Secretary Alan Johnson was exploring ways to raise the school leaving age in England to 18, just over 40 years later than the last rise in 1972, pointing to the decline in unskilled jobs and the need for young people to be equipped for modern day employment.[3]

text: Participation Age[edit]

text: A year later, on 6 November 2007, Prime Minister Gordon Brown unveiled the government's plans in his Queen's Speech. The plans included the duty for parents to assist their children in education or training participation until the date of their 18th birthday, as well as detailing proposed moves to reform the apprenticeship system and to improve achievement for children in care. The Education and Skills Act 2008, when it came into force in the 2013 academic year, initially required participation in some form of education or training until the school year in which the child turned 17, followed by the age being raised to the young person's 18th birthday in 2015.[27] This was referred to as raising the "participation age"[28] to distinguish it from the school leaving age which remains at 16.[29] To qualify as participation the young person must be in education or training for the equivalent of one day a week (at a minimum). The local council is responsible for ensuring that a suitable place is available.[28] The Act makes similar powers available to the National Assembly for Wales. A spokesperson for the Welsh Assembly indicated that it would want to encourage more young people to stay in education, but without compulsion,[30] so school leavers there are not required to continue with any education or training.[29]

text: Reasons[edit]

text:
Figures were published in June 2006 showing that 76.2% of all young people aged 16–18 are already in further education or training, meaning that the rise might only affect around 25% of young people who may have otherwise sought employment immediately upon finishing compulsory education. This did not specifically state that young people would remain in secondary school, but rather by law be required to continue their education full or part-time, whether that be in sixth form, college or work based training.[5][31]
Around 80% of 16-year-olds stay in full-time academic or vocational education, or go on a government-financed training course.[32] In a survey of 859 people, 9/10 supported the plans for the age increase.[33]

text: Reports published by the DfES showed that although there are around 70% of 16 year olds who remain in full-time education, this declines to less than 50% by the time they reach 18, with the majority finding unskilled employment and even fewer going into employment where their training has relevance. There is also a small increase in those who become unemployed by the time they reach 18, which the government hoped to reduce with the act.[26] It is these cases of unemployment which the government believes to be the toughest, whom it classifies as NEET (Not in Education, Employment or Training). In 2006 an additional 7% of 16 year olds fell into this category and the proportion rose to 13% among 18 year olds.[26]  In practice, only 1% of young people are classified as NEET during their time aged 16–18, due to churn between training, employment and NEET classification.[34] In 2015 the percentage of 16-18 classified as NEET fell to 7.5%, the lowest figure since 2000.[35]

text: The government believed that the changes were needed because of the collapse in unskilled jobs in the economy, which means that young school leavers at 16 years of age are finding it increasingly more difficult to find employment. The number of unskilled jobs available fell from 8 million in the 1960s to 3.5 by 2007, with predictions of further drops to just 600,000 by 2020 due to the increasing demand for skilled labour.

text: Opposition[edit]

text: Whilst the government is eager to implement the changes, many oppose the proposal,[36] some on civil liberties grounds.[37] Compulsory school attendance is usually justified by reference to the argument that minors are incapable of making sufficiently reasoned choices. However, the 16-18 age group falls into a grey area, being regarded as effectively adult in a number of contexts. Indeed, in some jurisdictions (e.g. Scotland), individuals are considered to reach full maturity at 16.

text: The proposal of using criminal sanctions to enforce attendance under this new system was opposed by MPs from both the Conservatives and the Liberal Democrats, who believed compulsion and threats were the wrong approach to increasing participation.[9] A spokesperson for the DfES said the proposals were not about "forcing young people to do something they don't want to", and that "we are letting young people down if we allow them to leave education and training without skills at the age of 16."[38] However, the Prime Minister's Queen's Speech in November 2007, which discussed the raise in school leaving age, suggested that pupils who failed to comply with new laws are to be expected to face fines or community service, rather than custodial sentencing which had previously been proposed. Local Authorities will also be expected to ensure pupils are participating up to 18 years of age.[30]

text: Effects[edit]

text: The downward trend in the number of unskilled jobs available throughout the country is continuing. The government believes that the extension of compulsory education until the age of 18 will mean many more young people will leave education in a much better position to find skilled employment. Speaking in March 2007, Chancellor Gordon Brown stated that around 50,000 teenagers would be paid a training allowance to sign up to college-based courses, with estimates on the available number of apprenticeships available to double to around 500,000 by 2020,[39] with 80% being available in England, which will be an increase from the current 250,000 apprenticeships available, offered by 130,000 employers.[30]

text: A skills commission report released in 2013, backed by Labour MP Barry Sheerman, suggests that young people were being let down by the education system, with particular criticism aimed towards the lack of information, advice and guidance available to 14-19 year olds.[40] The government were hopeful that the changes would have an effect on preventing the increase in crime levels, as figures reported a substantial percentage of young people leaving school were turning to a life of crime, with many being unable to find suitable work due to lack of skills and qualifications.[33]


document_title: Cognitive behavioral therapy

question_text: who has developed a cognitive theory of behavior change

question_tokens: who has developed a cognitive theory of behavior change

text: Cognitive behavioral therapy

text: Description[edit]

text: Mainstream cognitive behavioral therapy assumes that changing maladaptive thinking leads to change in behavior and affect,[12] but recent variants emphasize changes in one's relationship to maladaptive thinking rather than changes in thinking itself.[13] The goal of cognitive behavioral therapy is not to diagnose a person with a particular disease, but to look at the person as a whole and decide what needs to be fixed. The basic steps in a cognitive-behavioral assessment include:

text: These steps are based on a system created by Kanfer and Saslow.[15] After identifying the behaviors that need changing, whether they be in excess or deficit, and treatment has occurred, the psychologist must identify whether or not the intervention succeeded. For example, "If the goal was to decrease the behavior, then there should be a decrease relative to the baseline. If the critical behavior remains at or above the baseline, then the intervention has failed."[15]

text: Therapists or computer-based programs use CBT techniques to help individuals challenge their patterns and beliefs and replace "errors in thinking such as overgeneralizing, magnifying negatives, minimizing positives and catastrophizing" with "more realistic and effective thoughts, thus decreasing emotional distress and self-defeating behavior".[12] These errors in thinking are known as cognitive distortions. Cognitive distortions can be either a pseudo-discrimination belief or an over-generalization of something.[16] CBT techniques may also be used to help individuals take a more open, mindful, and aware posture toward cognitive distortions so as to diminish their impact.[13] Mainstream CBT helps individuals replace "maladaptive... coping skills, cognitions, emotions and behaviors with more adaptive ones",[17] by challenging an individual's way of thinking and the way that they react to certain habits or behaviors,[18] but there is still controversy about the degree to which these traditional cognitive elements account for the effects seen with CBT over and above the earlier behavioral elements such as exposure and skills training.[19]

text: Modern forms of CBT include a variety of diverse but related techniques such as exposure therapy, stress inoculation, cognitive processing therapy, cognitive therapy, relaxation training, dialectical behavior therapy, and acceptance and commitment therapy.[20] Some practitioners promote a form of mindful cognitive therapy which includes a greater emphasis on self-awareness as part of the therapeutic process.[21]

text: CBT has six phases:[17]

text:
Assessment or psychological assessment;
Reconceptualization;
Skills acquisition;
Skills consolidation and application training;
Generalization and maintenance;
Post-treatment assessment follow-up.

tag: ol

text: The reconceptualization phase makes up much of the "cognitive" portion of CBT.[17] A summary of modern CBT approaches is given by Hofmann.[22]

text: There are different protocols for delivering cognitive behavioral therapy, with important similarities among them.[23] Use of the term CBT may refer to different interventions, including "self-instructions (e.g. distraction, imagery, motivational self-talk), relaxation and/or biofeedback, development of adaptive coping strategies (e.g. minimizing negative or self-defeating thoughts), changing maladaptive beliefs about pain, and goal setting".[17] Treatment is sometimes manualized, with brief, direct, and time-limited treatments for individual psychological disorders that are specific technique-driven. CBT is used in both individual and group settings, and the techniques are often adapted for self-help applications. Some clinicians and researchers are cognitively oriented (e.g. cognitive restructuring), while others are more behaviorally oriented (e.g. in vivo exposure therapy). Interventions such as imaginal exposure therapy combine both approaches.[24][25]

text: Medical uses[edit]

text: In adults, CBT has been shown to have effectiveness and a role in the treatment plans for anxiety disorders,[26][27] body dysmorphic disorder,[28] depression,[29][30] eating disorders,[31] chronic low back pain,[17] personality disorders,[32] psychosis,[33] schizophrenia,[34] substance use disorders,[35] in the adjustment, depression, and anxiety associated with fibromyalgia,[12] and with post-spinal cord injuries.[36]

text: In children or adolescents, CBT is an effective part of treatment plans for anxiety disorders,[37] body dysmorphic disorder,[38] depression and suicidality,[39] eating disorders and obesity,[40] obsessive–compulsive disorder (OCD),[41] and posttraumatic stress disorder,[42] as well as tic disorders, trichotillomania, and other repetitive behavior disorders.[43] CBT-SP, an adaptation of CBT for suicide prevention (SP), was specifically designed for treating youths who are severely depressed and who have recently attempted suicide within the past 90 days, and was found to be effective, feasible, and acceptable.[44] Sparx is a video game to help young persons, using the CBT method to teach them how to resolve their own issues. CBT has also been shown to be effective for posttraumatic stress disorder in very young children (3 to 6 years of age).[45] CBT has also been applied to a variety of childhood disorders,[46] including depressive disorders and various anxiety disorders.

text: Cochrane reviews have found no evidence that CBT is effective for tinnitus, although there appears to be an effect on management of associated depression and quality of life in this condition.[47] Other recent Cochrane Reviews found no convincing evidence that CBT training helps foster care providers manage difficult behaviors in the youths under their care,[48] nor was it helpful in treating people who abuse their intimate partners.[49]

text: According to a 2004 review by INSERM of three methods, cognitive behavioral therapy was either "proven" or "presumed" to be an effective therapy on several specific mental disorders.[50] According to the study, CBT was effective at treating schizophrenia, depression, bipolar disorder, panic disorder, post-traumatic stress, anxiety disorders, bulimia, anorexia, personality disorders and alcohol dependency.[50]

text: Some meta-analyses find CBT more effective than psychodynamic therapy and equal to other therapies in treating anxiety and depression.[51][52]

text: Computerized CBT (CCBT) has been proven to be effective by randomized controlled and other trials in treating depression and anxiety disorders,[27][30][53][54][55][56][57] including children,[58] as well as insomnia.[59] Some research has found similar effectiveness to an intervention of informational websites and weekly telephone calls.[60][61] CCBT was found to be equally effective as face-to-face CBT in adolescent anxiety[62] and insomnia.[59]

text: Criticism of CBT sometimes focuses on implementations (such as the UK IAPT) which may result initially in low quality therapy being offered by poorly trained practitioners.[63][64] However, evidence supports the effectiveness of CBT for anxiety and depression.[55] Acceptance and commitment therapy (ACT) is a specialist branch of CBT (sometimes referred to as contextual CBT[citation needed]). ACT uses mindfulness and acceptance interventions and has been found to have a greater longevity in therapeutic outcomes. In a study with anxiety, CBT and ACT improved similarly across all outcomes from pre-to post-treatment. However, during a 12-month follow-up, ACT proved to be more effective, showing that it is a highly viable lasting treatment model for anxiety disorders. [65]

text: Evidence suggests that the addition of hypnotherapy as an adjunct to CBT improves treatment efficacy for a variety of clinical issues.[66][67][68]

text: CBT has been applied in both clinical and non-clinical environments to treat disorders such as personality conditions and behavioral problems.[69] A systematic review of CBT in depression and anxiety disorders concluded that "CBT delivered in primary care, especially including computer- or Internet-based self-help programs, is potentially more effective than usual care and could be delivered effectively by primary care therapists."[53]

text: Emerging evidence suggests a possible role for CBT in the treatment of attention deficit hyperactivity disorder (ADHD);[70] hypochondriasis;[71] coping with the impact of multiple sclerosis;[72] sleep disturbances related to aging;[73] dysmenorrhea;[74] and bipolar disorder,[75] but more study is needed and results should be interpreted with caution. CBT can have a therapeutic effects on easing symptoms of anxiety and depression in people with Alzheimer's disease.[76] CBT has been studied as an aid in the treatment of anxiety associated with stuttering. Initial studies have shown CBT to be effective in reducing social anxiety in adults who stutter,[77] but not in reducing stuttering frequency.[78][79]

text: In the case of people with metastatic breast cancer, data is limited but CBT and other psychosocial interventions might help with psychological outcomes and pain management.[80]

text: There is some evidence that CBT is superior in the long-term to benzodiazepines and the nonbenzodiazepines in the treatment and management of insomnia.[81] CBT has been shown to be moderately effective for treating chronic fatigue syndrome.[82]

text: In the United Kingdom, the National Institute for Health and Care Excellence (NICE) recommends CBT in the treatment plans for a number of mental health difficulties, including posttraumatic stress disorder, obsessive–compulsive disorder (OCD), bulimia nervosa, and clinical depression.[83]

text: Anxiety disorders[edit]

text: CBT has been shown to be effective in the treatment of adults with anxiety disorders.[84]

text: A basic concept in some CBT treatments used in anxiety disorders is in vivo exposure. The term refers to the direct confrontation of feared objects, activities, or situations by a patient. For example, a woman with PTSD who fears the location where she was assaulted may be assisted by her therapist in going to that location and directly confronting those fears.[85] Likewise, a person with social anxiety disorder who fears public speaking may be instructed to directly confront those fears by giving a speech.[86] This "two-factor" model is often credited to O. Hobart Mowrer.[87] Through exposure to the stimulus, this harmful conditioning can be "unlearned" (referred to as extinction and habituation). Studies have provided evidence that when examining animals and humans that glucocorticoids may possibly lead to a more successful extinction learning during exposure therapy. For instance, glucocorticoids can prevent aversive learning episodes from being retrieved and heighten reinforcement of memory traces creating a non-fearful reaction in feared situations. A combination of glucocorticoids and exposure therapy may be a better improved treatment for treating patients with anxiety disorders.[88]

text: A 2015 Cochrane review also found that CBT might be helpful for patients with non-cardiac chest pain, and may reduce frequency of chest pain episodes.[89]

text: Schizophrenia, psychosis and mood disorders[edit]

text: Cognitive behavioral therapy has been shown as an effective treatment for clinical depression.[29] The American Psychiatric Association Practice Guidelines (April 2000) indicated that, among psychotherapeutic approaches, cognitive behavioral therapy and interpersonal psychotherapy had the best-documented efficacy for treatment of major depressive disorder.[90][page needed] One etiological theory of depression is Aaron T. Beck's cognitive theory of depression. His theory states that depressed people think the way they do because their thinking is biased towards negative interpretations. According to this theory, depressed people acquire a negative schema of the world in childhood and adolescence as an effect of stressful life events, and the negative schema is activated later in life when the person encounters similar situations.[91]

text: Beck also described a negative cognitive triad. The cognitive triad is made up of the depressed individual's negative evaluations of themselves, the world, and the future. Beck suggested that these negative evaluations derive from the negative schemata and cognitive biases of the person. According to this theory, depressed people have views such as "I never do a good job", "It is impossible to have a good day", and "things will never get better". A negative schema helps give rise to the cognitive bias, and the cognitive bias helps fuel the negative schema. Beck further proposed that depressed people often have the following cognitive biases: arbitrary inference, selective abstraction, over-generalization, magnification, and minimization. These cognitive biases are quick to make negative, generalized, and personal inferences of the self, thus fueling the negative schema.[91]

text: In long-term psychoses, CBT is used to complement medication and is adapted to meet individual needs. Interventions particularly related to these conditions include exploring reality testing, changing delusions and hallucinations, examining factors which precipitate relapse, and managing relapses.[33] Several meta-analyses suggested that CBT is effective in schizophrenia,[34][92] and the American Psychiatric Association includes CBT in its schizophrenia guideline as an evidence-based treatment. There is also limited evidence of effectiveness for CBT in bipolar disorder[75][93] and severe depression.[94]

text: A 2010 meta-analysis found that no trial employing both blinding and psychological placebos has shown CBT to be effective in either schizophrenia or bipolar disorder, and that the effect size of CBT was small in major depressive disorder. They also found a lack of evidence to conclude that CBT was effective in preventing relapses in bipolar disorder.[95] Evidence that severe depression is mitigated by CBT is also lacking, with anti-depressant medications still viewed as significantly more effective than CBT,[29] although success with CBT for depression was observed beginning in the 1990s.[96]

text: According to Cox, Lyn Yvonne Abramson, Patricia Devine, and Hollon (2012), cognitive behavioral therapy can also be used to reduce prejudice towards others. This other-directed prejudice can cause depression in the "others", or in the self when a person becomes part of a group he or she previously had prejudice towards (i.e. deprejudice).[97] "Devine and colleagues (2012) developed a successful Prejudice Perpetrator intervention with many conceptual parallels to CBT.[98] Like CBT, their intervention taught Sources to be aware of their automative thoughts and to intentionally deploy a variety of cognitive techniques against automatic stereotyping."[97] A 2012 systematic review investigated the effects of CBT compared with other psychosocial therapies for people with schizophrenia:

text:
Cognitive behavioral therapy compared with other psycho-social therapies for schizophrenia[99]

Summary

For people with schizophrenia trial-based evidence suggests no clear and convincing advantage for cognitive behavioral therapy over other – and sometime much less sophisticated – therapies.[99]

[show]Outcome
Findings in words
Findings in numbers
Quality of evidence

Adverse effect/event

Any adverse effect – medium-term only.
Follow-up: 26–52 weeks
Cognitive behavioural therapy may increase the chance of people with schizophrenia experiencing the ill-defined outcome of 'any adverse effects', but, at present it is not possible to be confident about the difference between the two treatments and data supporting this finding are very limited.
RR 2.0 (0.71 to 5.64)
Very low

Global state

Relapse – long-term.
Follow-up: 12 months
Cognitive behavioural therapy may very slightly reduce the chance of experiencing this global state outcome but there is no clear difference between people given cognitive behavioural therapy and those receiving other psychosocial therapies. These findings are based on data of low quality.
RR 0.91 (0.63 to 1.32)
Low

Rehospitalization – long-term.
Follow-up: 12 months
Cognitive behavioural therapy may very slightly reduce the chance of experiencing coming back into hospital but there is no clear difference between people given cognitive behavioural therapy and those receiving other psychosocial therapies. These findings are based on data of low quality.
RR 0.86 (0.62 to 1.21)
Low

Mental state

No important or reliable change – long-term.
Follow-up: 12 months
Cognitive behavioural therapy may reduce the chance of experiencing this broad mental state outcome, but, at present it is not possible to be confident about the difference between the two treatments and data supporting this finding are very limited.
RR 0.84 (0.64 to 1.09)
Very low

Social functioning

Average scores (social functioning scale, high = good)
Follow-up: median 26 weeks
On average, people receiving cognitive behavioural therapy scored 8.8 higher than people treated with other psychosocial therapies. There was no clear difference between the groups, and, at present the meaning of this in day-to-day care is unclear.
MD 8.8 higher (4.07 lower to 21.67 higher)
Very low

Quality of life

Average score (Euro. QOL, high = good) – long-term only.
Follow-up: 26 weeks
On average, people receiving cognitive behavioural therapy scored 1.86 lower than people treated with other psychosocial therapies on this measure. There was no clear difference between the groups. The meaning of this in day-to-day care is unclear.
MD 1.86 lower (19.2 lower to 15.48 higher)
Very low

tag: table

text: With older adults[edit]

text: CBT is used to help people of all ages, but the therapy should be adjusted based on the age of the patient with whom the therapist is dealing. Older individuals in particular have certain characteristics that need to be acknowledged and the therapy altered to account for these differences thanks to age.[100]

text: Prevention of mental illness[edit]

text: For anxiety disorders, use of CBT with people at risk has significantly reduced the number of episodes of generalized anxiety disorder and other anxiety symptoms, and also given significant improvements in explanatory style, hopelessness, and dysfunctional attitudes.[55][101][102] In another study, 3% of the group receiving the CBT intervention developed generalized anxiety disorder by 12 months postintervention compared with 14% in the control group.[103] Subthreshold panic disorder sufferers were found to significantly benefit from use of CBT.[104][105] Use of CBT was found to significantly reduce social anxiety prevalence.[106]

text: For depressive disorders, a stepped-care intervention (watchful waiting, CBT and medication if appropriate) achieved a 50% lower incidence rate in a patient group aged 75 or older.[107] Another depression study found a neutral effect compared to personal, social, and health education, and usual school provision, and included a comment on potential for increased depression scores from people who have received CBT due to greater self recognition and acknowledgement of existing symptoms of depression and negative thinking styles.[108] A further study also saw a neutral result.[109] A meta-study of the Coping with Depression course, a cognitive behavioral intervention delivered by a psychoeducational method, saw a 38% reduction in risk of major depression.[110]

text: For people at risk of psychosis, in 2014 the UK National Institute for Health and Care Excellence (NICE) recommended preventive CBT.[111][112]

text: Gambling addiction[edit]

text: CBT is also used for problem gambling addiction. The number of individuals who gamble is 1–3% around the world.[113] Cognitive behavioral therapy develop skills for relapse prevention and learn to control mind and manage high-risk cases.[114]

text: Smoking cessation[edit]

text: CBT looks at the habit of smoking cigarettes as a learned behavior, which later evolves into a coping strategy to handle daily stressors. Because smoking is often easily accessible, and quickly allows the user to feel good, it can take precedence over other coping strategies, and eventually work its way into everyday life during non-stressful events as well. CBT aims to target the function of the behavior, as it can vary between individuals, and works to inject other coping mechanisms in place of smoking. CBT also aims to support individuals suffering from strong cravings, which are a major reported reason for relapse during treatment.[115]

text: In a 2008 controlled study out of Stanford University School of Medicine, CBT was proven as an effective tool for most participants. The results of 304 random adult participants were tracked over the course of one year. During this program, some participants were provided medication, CBT, 24 hour phone support, or some combination of the three methods. At 20 weeks, the participants who received CBT had a 45% abstinence rate, versus non-CBT participants, who had a 29% abstinence rate. Overall, the study concluded that emphasizing cognitive and behavioral strategies to support smoking cessation can help individuals build tools for long term smoking abstinence.[116]

text: Mental health history can affect the outcomes of treatment. It should be noted that individuals with a history of depressive disorders had a lower rate of success when using CBT alone to combat smoking addiction.[117]

text: Eating disorders[edit]

text: Though many forms of treatment can support individuals with eating disorders, CBT is proven to be a more effective treatment than medications and interpersonal psychotherapy alone.[118] CBT aims to combat major causes of distress such as negative cognitions surrounding body weight, shape and size. CBT therapists also work with individuals to regulate strong emotions and thoughts that lead to dangerous compensatory behaviors. CBT is the first line of treatment for Bulimia Nervosa, and Eating Disorder Non-Specific.[119]

text: History[edit]

text: Philosophical roots[edit]

text: Precursors of certain fundamental aspects of CBT have been identified in various ancient philosophical traditions, particularly Stoicism.[120] Stoic philosophers, particularly Epictetus, believed logic could be used to identify and discard false beliefs that lead to destructive emotions, which has influenced the way modern cognitive-behavioral therapists identify cognitive distortions that contribute to depression and anxiety.[121] For example, Aaron T. Beck's original treatment manual for depression states, "The philosophical origins of cognitive therapy can be traced back to the Stoic philosophers".[122] Another example of Stoic influence on cognitive theorists is Epictetus on Albert Ellis.[123] A key philosophical figure who also influenced the development of CBT was John Stuart Mill.[124]

text: Behavior therapy roots[edit]

text: The modern roots of CBT can be traced to the development of behavior therapy in the early 20th century, the development of cognitive therapy in the 1960s, and the subsequent merging of the two. Groundbreaking work of behaviorism began with John B. Watson and Rosalie Rayner's studies of conditioning in 1920.[125] Behaviorally-centered therapeutic approaches appeared as early as 1924[126] with Mary Cover Jones' work dedicated to the unlearning of fears in children.[127] These were the antecedents of the development of Joseph Wolpe's behavioral therapy in the 1950s.[125] It was the work of Wolpe and Watson, which was based on Ivan Pavlov's work on learning and conditioning, that influenced Hans Eysenck and Arnold Lazarus to develop new behavioral therapy techniques based on classical conditioning.[125][128] One of Eysenck's colleagues, Glenn Wilson showed that classical fear conditioning in humans could be controlled by verbally induced cognitive expectations,[129] thus opening a field of research that supports the rationale of cognitive behaviorial therapy.

text: During the 1950s and 1960s, behavioral therapy became widely utilized by researchers in the United States, the United Kingdom, and South Africa, who were inspired by the behaviorist learning theory of Ivan Pavlov, John B. Watson, and Clark L. Hull.[126] In Britain, Joseph Wolpe, who applied the findings of animal experiments to his method of systematic desensitization,[125] applied behavioral research to the treatment of neurotic disorders. Wolpe's therapeutic efforts were precursors to today's fear reduction techniques.[126] British psychologist Hans Eysenck presented behavior therapy as a constructive alternative.[126][130]

text: At the same time of Eysenck's work, B. F. Skinner and his associates were beginning to have an impact with their work on operant conditioning.[125][128] Skinner's work was referred to as radical behaviorism and avoided anything related to cognition.[125] However, Julian Rotter, in 1954, and Albert Bandura, in 1969, contributed behavior therapy with their respective work on social learning theory, by demonstrating the effects of cognition on learning and behavior modification.[125][128]

text: The emphasis on behavioral factors constituted the "first wave" of CBT.[131]

text: Cognitive therapy roots[edit]

text: One of the first therapists to address cognition in psychotherapy was Alfred Adler with his notion of basic mistakes and how they contributed to creation of unhealthy or useless behavioral and life goals.[132] Adler's work influenced the work of Albert Ellis,[132] who developed the earliest cognitive-based psychotherapy, known today as rational emotive behavior therapy, or REBT.[133]

text: Around the same time that rational emotive therapy, as it was known then, was being developed, Aaron T. Beck was conducting free association sessions in his psychoanalytic practice.[134] During these sessions, Beck noticed that thoughts were not as unconscious as Freud had previously theorized, and that certain types of thinking may be the culprits of emotional distress.[134] It was from this hypothesis that Beck developed cognitive therapy, and called these thoughts "automatic thoughts".[134]

text: It was these two therapies, rational emotive therapy and cognitive therapy, that started the "second wave" of CBT, which was the emphasis on cognitive factors.[131]

text: Behavior and cognitive therapies merge[edit]

text: Although the early behavioral approaches were successful in many of the neurotic disorders, they had little success in treating depression.[125][126][135] Behaviorism was also losing in popularity due to the so-called "cognitive revolution". The therapeutic approaches of Albert Ellis and Aaron T. Beck gained popularity among behavior therapists, despite the earlier behaviorist rejection of "mentalistic" concepts like thoughts and cognitions.[125] Both of these systems included behavioral elements and interventions and primarily concentrated on problems in the present.

text: In initial studies, cognitive therapy was often contrasted with behavioral treatments to see which was most effective. During the 1980s and 1990s, cognitive and behavioral techniques were merged into cognitive behavioral therapy. Pivotal to this merging was the successful development of treatments for panic disorder by David M. Clark in the UK and David H. Barlow in the US.[126]

text: Over time, cognitive behavior therapy became to be known not only as a therapy, but as an umbrella term for all cognitive-based psychotherapies.[125] These therapies include, but are not limited to, rational emotive therapy, cognitive therapy, acceptance and commitment therapy, dialectical behavior therapy, reality therapy/choice theory, cognitive processing therapy, EMDR, and multimodal therapy.[125] All of these therapies are a blending of cognitive- and behavior-based elements.

text: This blending of theoretical and technical foundations from both behavior and cognitive therapies constitute the "third wave" of CBT,[131] which is the current wave.[131] The most prominent therapies of this third wave are dialectical behavior therapy and acceptance and commitment therapy.[131]

text: Methods of access[edit]

text: Therapist[edit]

text: A typical CBT programme would consist of face-to-face sessions between patient and therapist, made up of 6-18 sessions of around an hour each with a gap of a 1–3 weeks between sessions. This initial programme might be followed by some booster sessions, for instance after one month and three months.[136] CBT has also been found to be effective if patient and therapist type in real time to each other over computer links.[137][138]

text: Cognitive behavioral therapy is most closely allied with the scientist–practitioner model in which clinical practice and research is informed by a scientific perspective, clear operationalization of the problem, and an emphasis on measurement, including measuring changes in cognition and behavior and in the attainment of goals. These are often met through "homework" assignments in which the patient and the therapist work together to craft an assignment to complete before the next session.[139] The completion of these assignments – which can be as simple as a person suffering from depression attending some kind of social event – indicates a dedication to treatment compliance and a desire to change.[139] The therapists can then logically gauge the next step of treatment based on how thoroughly the patient completes the assignment.[139] Effective cognitive behavioral therapy is dependent on a therapeutic alliance between the healthcare practitioner and the person seeking assistance.[2][140] Unlike many other forms of psychotherapy, the patient is very involved in CBT.[139] For example, an anxious patient may be asked to talk to a stranger as a homework assignment, but if that is too difficult, he or she can work out an easier assignment first.[139] The therapist needs to be flexible and willing to listen to the patient rather than acting as an authority figure.[139]

text: Computerized or internet-delivered[edit]

text: Computerized cognitive behavioral therapy (CCBT) has been described by NICE as a "generic term for delivering CBT via an interactive computer interface delivered by a personal computer, internet, or interactive voice response system",[141] instead of face-to-face with a human therapist. It is also known as internet-delivered cognitive behavioral therapy or ICBT.[142] CCBT has potential to improve access to evidence-based therapies, and to overcome the prohibitive costs and lack of availability sometimes associated with retaining a human therapist.[143] In this context, it is important not to confuse CBT with 'computer-based training', which nowadays is more commonly referred to as e-Learning.

text: CCBT has been found in meta-studies to be cost-effective and often cheaper than usual care,[144][145] including for anxiety.[146] Studies have shown that individuals with social anxiety and depression experienced improvement with online CBT-based methods.[147] A review of current CCBT research in the treatment of OCD in children found this interface to hold great potential for future treatment of OCD in youths and adolescent populations.[148] Additionally, most internet interventions for posttraumatic stress disorder use CCBT. CCBT is also predisposed to treating mood disorders amongst non-heterosexual populations, who may avoid face-to-face therapy from fear of stigma. However presently CCBT programs seldom cater to these populations.[149]

text: A key issue in CCBT use is low uptake and completion rates, even when it has been clearly made available and explained.[150][151] CCBT completion rates and treatment efficacy have been found in some studies to be higher when use of CCBT is supported personally, with supporters not limited only to therapists, than when use is in a self-help form alone.[144][152] Another approach to improving uptake and completion rate, as well as treatment outcome, is to design software that supports the formation of a strong therapeutic alliance between the user and the technology.[153]

text: In February 2006 NICE recommended that CCBT be made available for use within the NHS across England and Wales for patients presenting with mild-to-moderate depression, rather than immediately opting for antidepressant medication,[141] and CCBT is made available by some health systems.[154] The 2009 NICE guideline recognized that there are likely to be a number of computerized CBT products that are useful to patients, but removed endorsement of any specific product.[155]

text: A relatively new avenue of research is the combination of artificial intelligence and CCBT. It has been proposed to use modern technology to create CCBT that simulates face-to-face therapy. This might be achieved in cognitive behavior therapy for a specific disorder using the comprehensive domain knowledge of CBT.[156] One area where this has been attempted is the specific domain area of social anxiety in those who stutter.[157]

text: Reading self-help materials[edit]

text: Enabling patients to read self-help CBT guides has been shown to be effective by some studies.[158][159][160] However one study found a negative effect in patients who tended to ruminate,[161] and another meta-analysis found that the benefit was only significant when the self-help was guided (e.g. by a medical professional).[162]

text: Group educational course[edit]

text: Patient participation in group courses has been shown to be effective.[163] In a meta-analysis reviewing evidence-based treatment of OCD in children, individual CBT was found to be more efficacious than group CBT.[148]

text: Types[edit]

text: BCBT[edit]

text: Brief cognitive behavioral therapy (BCBT) is a form of CBT which has been developed for situations in which there are time constraints on the therapy sessions.[164] BCBT takes place over a couple of sessions that can last up to 12 accumulated hours by design. This technique was first implemented and developed on soldiers overseas in active duty by David M. Rudd to prevent suicide.[164]

text: Breakdown of treatment[164]

text:
Orientation

Commitment to treatment
Crisis response and safety planning
Means restriction
Survival kit
Reasons for living card
Model of suicidality
Treatment journal
Lessons learned

Skill focus

Skill development worksheets
Coping cards
Demonstration
Practice
Skill refinement

Relapse prevention

Skill generalization
Skill refinement

text: Cognitive emotional behavioral therapy[edit]

text: Cognitive emotional behavioral therapy (CEBT) is a form of CBT developed initially for individuals with eating disorders but now used with a range of problems including anxiety, depression, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and anger problems. It combines aspects of CBT and dialectical behavioral therapy and aims to improve understanding and tolerance of emotions in order to facilitate the therapeutic process. It is frequently used as a "pretreatment" to prepare and better equip individuals for longer-term therapy.[165]

text: Structured cognitive behavioral training[edit]

text: Structured cognitive behavioral training (SCBT) is a cognitive-based process with core philosophies that draw heavily from CBT. Like CBT, SCBT asserts that behavior is inextricably related to beliefs, thoughts and emotions. SCBT also builds on core CBT philosophy by incorporating other well-known modalities in the fields of behavioral health and psychology: most notably, Albert Ellis's rational emotive behavior therapy. SCBT differs from CBT in two distinct ways. First, SCBT is delivered in a highly regimented format. Second, SCBT is a predetermined and finite training process that becomes personalized by the input of the participant. SCBT is designed with the intention to bring a participant to a specific result in a specific period of time. SCBT has been used to challenge addictive behavior, particularly with substances such as tobacco, alcohol and food, and to manage diabetes and subdue stress and anxiety. SCBT has also been used in the field of criminal psychology in the effort to reduce recidivism.

text: Moral reconation therapy[edit]

text: Moral reconation therapy, a type of CBT used to help felons overcome antisocial personality disorder (ASPD), slightly decreases the risk of further offending.[166] It is generally implemented in a group format because of the risk of offenders with ASPD being given one-on-one therapy reinforces narcissistic behavioral characteristics, and can be used in correctional or outpatient settings. Groups usually meet weekly for two to six months.[167]

text: Stress inoculation training[edit]

text: This type of therapy uses a blend of cognitive, behavioral and some humanistic training techniques to target the stressors of the client. This usually is used to help clients better cope with their stress or anxiety after stressful events.[168] This is a three-phase process that trains the client to use skills that they already have to better adapt to their current stressors. The first phase is an interview phase that includes psychological testing, client self-monitoring, and a variety of reading materials. This allows the therapist to individually tailor the training process to the client.[168] Clients learn how to categorize problems into emotion-focused or problem-focused, so that they can better treat their negative situations. This phase ultimately prepares the client to eventually confront and reflect upon their current reactions to stressors, before looking at ways to change their reactions and emotions in relation to their stressors. The focus is conceptualization.[168]

text: The second phase emphasizes the aspect of skills acquisition and rehearsal that continues from the earlier phase of conceptualization. The client is taught skills that help them cope with their stressors. These skills are then practised in the space of therapy. These skills involve self-regulation, problem-solving, interpersonal communication skills, etc.[168]

text: The third and final phase is the application and following through of the skills learned in the training process. This gives the client opportunities to apply their learned skills to a wide range of stressors. Activities include role-playing, imagery, modeling, etc. In the end, the client will have been trained on a preventative basis to inoculate personal, chronic, and future stressors by breaking down their stressors into problems they will address in long-term, short-term, and intermediate coping goals..[168]

text: Mindfulness-based cognitive behavioral hypnotherapy[edit]

text: Mindfulness-based cognitive behavioral hypnotherapy (MCBH) is a form of CBT focusing on awareness in reflective approach with addressing of subconscious tendencies. It is more the process that contains basically three phases that are used for achieving wanted goals.[169]

text: Criticisms[edit]

text: Relative effectiveness[edit]

text: The research conducted for CBT has been a topic of sustained controversy. While some researchers write that CBT is more effective than other treatments,[170] many other researchers[171][172][9][173][174] and practitioners[175][176] have questioned the validity of such claims. For example, one study[170] determined CBT to be superior to other treatments in treating anxiety and depression. However, researchers[9] responding directly to that study conducted a re-analysis and found no evidence of CBT being superior to other bona fide treatments, and conducted an analysis of thirteen other CBT clinical trials and determined that they failed to provide evidence of CBT superiority.

text: A major criticism has been that clinical studies of CBT efficacy (or any psychotherapy) are not double-blind (i.e., either the subjects or the therapists in psychotherapy studies are not blind to the type of treatment). They may be single-blinded, i.e. the rater may not know the treatment the patient received, but neither the patients nor the therapists are blinded to the type of therapy given (two out of three of the persons involved in the trial, i.e., all of the persons involved in the treatment, are unblinded). The patient is an active participant in correcting negative distorted thoughts, thus quite aware of the treatment group they are in.[177]

text: The importance of double-blinding was shown in a meta-analysis that examined the effectiveness of CBT when placebo control and blindedness were factored in.[178] Pooled data from published trials of CBT in schizophrenia, major depressive disorder (MDD), and bipolar disorder that used controls for non-specific effects of intervention were analyzed. This study concluded that CBT is no better than non-specific control interventions in the treatment of schizophrenia and does not reduce relapse rates; treatment effects are small in treatment studies of MDD, and it is not an effective treatment strategy for prevention of relapse in bipolar disorder. For MDD, the authors note that the pooled effect size was very low. Nevertheless, the methodological processes used to select the studies in the previously mentioned meta-analysis and the worth of its findings have been called into question.[179][180][181]

text: Declining effectiveness[edit]

text: Additionally, a 2015 meta-analysis revealed that the positive effects of CBT on depression have been declining since 1977. The overall results showed two different declines in effect sizes: 1) an overall decline between 1977 and 2014, and 2) a steeper decline between 1995 and 2014. Additional sub-analysis revealed that CBT studies where therapists in the test group were instructed to adhere to the Beck CBT manual had a steeper decline in effect sizes since 1977 than studies where therapists in the test group were instructed to use CBT without a manual. The authors reported that they were unsure why the effects were declining but did list inadequate therapist training, failure to adhere to a manual, lack of therapist experience, and patients' hope and faith in its efficacy waning as potential reasons. The authors did mention that the current study was limited to depressive disorders only.[182]

text: High drop-out rates[edit]

text: Furthermore, other researchers[173] write that CBT studies have high drop-out rates compared to other treatments. At times, the CBT drop-out rates can be more than five times higher than other treatments groups. For example, the researchers provided statistics of 28 participants in a group receiving CBT therapy dropping out, compared to 5 participants in a group receiving problem-solving therapy dropping out, or 11 participants in a group receiving psychodynamic therapy dropping out.[173] This high drop-out rate is also evident in the treatment of several disorders, particularly the eating disorder anorexia nervosa, which is commonly treated with CBT. Those treated with CBT have a high chance of dropping out of therapy before completion and reverting to their anorexia behaviors.[183]

text: Other researchers[174] conducting an analysis of treatments for youths who self-injure found similar drop-out rates in CBT and DBT groups. In this study, the researchers analyzed several clinical trials that measured the efficacy of CBT administered to youths who self-injure. The researchers concluded that none of them were found to be efficacious. These conclusions[174] were made using the APA Division 12 Task Force on the Promotion and Dissemination of Psychological Procedures to determine intervention potency.[184]

text: Philosophical concerns with CBT methods[edit]

text: The methods employed in CBT research have not been the only criticisms; some individuals have called its theory and therapy into question. For example, Fancher[176] argues that CBT has failed to provide a framework for clear and correct thinking. He states that it is strange for CBT theorists to develop a framework for determining distorted thinking without ever developing a framework for "cognitive clarity" or what would count as "healthy, normal thinking." Additionally, he writes that irrational thinking cannot be a source of mental and emotional distress when there is no evidence of rational thinking causing psychological well-being. Or, that social psychology has proven the normal cognitive processes of the average person to be irrational, even those who are psychologically well. Fancher also says that the theory of CBT is inconsistent with basic principles and research of rationality, and even ignores many rules of logic. He argues that CBT makes something of thinking that is far less exciting and true than thinking probably is. Among his other arguments are the maintaining of the status quo promoted in CBT, the self-deception encouraged within clients and patients engaged in CBT, how poorly the research is conducted, and some of its basic tenets and norms: "The basic norm of cognitive therapy is this: except for how the patient thinks, everything is ok".[185]

text: Meanwhile, Slife and Williams[175] write that one of the hidden assumptions in CBT is that of determinism, or the absence of free will. They argue that CBT invokes a type of cause-and-effect relationship with cognition. They state that CBT holds that external stimuli from the environment enter the mind, causing different thoughts that cause emotional states. Nowhere in CBT theory is agency, or free will, accounted for. At its most basic foundational assumptions, CBT holds that human beings have no free will and are just determined by the cognitive processes invoked by external stimuli.

text: Another criticism of CBT theory, especially as applied to major depressive disorder (MDD), is that it confounds the symptoms of the disorder with its causes.[177]

text: Side effects[edit]

text: CBT is generally seen as having very low if any side effects.[186][187][188] Calls have been made for more appraisal of CBT side effects.[189][190]

text: Society and culture[edit]

text: The UK's National Health Service announced in 2008 that more therapists would be trained to provide CBT at government expense[191] as part of an initiative called Improving Access to Psychological Therapies (IAPT).[192] the NICE said that CBT would become the mainstay of treatment for non-severe depression, with medication used only in cases where CBT had failed.[191] Therapists complained that the data does not fully support the attention and funding CBT receives. Psychotherapist and professor Andrew Samuels stated that this constitutes "a coup, a power play by a community that has suddenly found itself on the brink of corralling an enormous amount of money ... Everyone has been seduced by CBT's apparent cheapness."[191][193] The UK Council for Psychotherapy issued a press release in 2012 saying that the IAPT's policies were undermining traditional psychotherapy and criticized proposals that would limit some approved therapies to CBT,[194] claiming that they restricted patients to "a watered down version of cognitive behavioural therapy (CBT), often delivered by very lightly trained staff".[194]

text: The NICE also recommends offering CBT to people suffering from schizophrenia, as well as those at risk of suffering from a psychotic episode.[195]