The clinical cognitive model has significant problems. It employs lay conceptions of cognition and emotion. Moreover, its core assumptions have significant flaws. CBT, more generally, has failed to bridge the gap between research and practice operating in isolation from theoretical and empirical developments in the cognition and emotion literature. This research represents a contribution towards the integration of current emotion and cognition theory into cognitive-behavioural theory. Importantly, the theories of cognition and emotion outlined offer more than refined cognitive theory and respite from theoretical criticism (which they do), providing a holistic framework that explains the efficacy of a range of treatments. There is overarching agreement amongst all the theories presented that the qualitative nature of the cognition involved in emotion production is automatic, tacit, higher-order, and schema based. This contrasts with the cognitive model that assumes the causal antecedents of emotion to be explicit/conscious cognition. These implicit cognitive structures are characterised by networks of associated, emotionally relevant information (much of which can be non-verbal). There are several implications of viewing emotion in this way. From this perspective emotional disorders are thought to originate from the development and maintenance of maladaptive emotion schemata. Emotion schema theory helps explain the enduring, recurring attributes of emotional disorders. For emotion schema theory the success of therapeutic intervention is dependent upon accessing and altering maladaptive emotion schemata.

There are three main ways that this could happen. Altering the primary maladaptive emotion schema, reducing or extinguishing the maintaining conditions of the primary maladaptive emotion schema, and activating alternative emotion schemata. Viewing clinical intervention from this perspective provides a holistic rationale that accounts for the effectiveness of cognitive, behavioural, and several other noncognitive, nonbehavioural, non-evidential techniques. This contrasts with cognitive theory, which offers no insight into the effectiveness of noncognitive approaches and does not even provide an adequate explanation of cognitive treatments.