Skip to main content
Log in

Inception of a Discovery: Re-defining the Use of Socratic Dialogue in Cognitive Behavioral Therapy

  • Special Issue on Socratic Dialogue
  • Published:
International Journal of Cognitive Therapy Aims and scope Submit manuscript

Abstract

Cognitive behavioral therapy (CBT) was designed as a psychotherapy to support client ownership and self-confidence in the change process, not simply provide clients with the answers to their problems. In the first published guide for practice, Beck, Rush, Shaw, and Emery (Cognitive therapy of depression, New York: Guilford Press, 1974) described the therapeutic relationship as an environment where the therapist would exemplify the use of questioning to help evaluate the maladaptive beliefs and structures that lead to, or maintain, the client’s emotional distress. However, little research has been undertaken to examine the client’s adoption of self-questioning, or Socratic dialogue as relational process and intervention in CBT. This article presents an introduction to a special series in the International Journal of Cognitive Therapy, which aims to build upon previous efforts to unpack the complexities and nuances of Socratic dialogue in CBT by (a) compiling the most current expert opinion on the definition, role, and application of Socratic dialogue; (b) providing an account of key elements of the dialogue process; and (c) presenting the latest empirical examination of behavioral shaping as a potential mechanism underlying the change process during Socratic dialogue. In providing a greater conceptual understanding of contemporary issues and knowledge regarding core CBT processes, it is hoped that this special series will also encourage the practitioners to ask more questions of their own practice, as well as the gaps in the existing knowledge base, thereby widening the pathway for further scientific discoveries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  • Aviram, A., & Westra, H. A. (2011). The impact of motivational interviewing on resistance in cognitive behavioural therapy for generalized anxiety disorder. Psychotherapy Research, 21, 698–708. https://doi.org/10.1080/10503307.2011.610832.

    Article  PubMed  Google Scholar 

  • Barber, J. P., Liese, B. S., & Abrams, M. J. (2003). Development of the Cognitive Therapy Adherence and Competence Scale. Psychotherapy Research, 13, 205–221.

    Article  Google Scholar 

  • Barlow, D. H., Farchione, T. J., Bullis, J. R., Gallagher, M. W., Murray-Latin, H., Sauer-Zavala, S., Bentley, K. H., Thompson-Hollands, J., Conklin, L. R., Boswell, J. F., Ametaj, A., Carl, J. R., Boettcher, H. T., & Cassiello-Robbins, C. (2017). The unified protocol for transdiagnostic treatment of emotional disorders compared with diagnosis-specific protocols for anxiety disorders: a randomized clinical trial. JAMA Psychiatry, 74(9), 875–884. https://doi.org/10.1001/jamapsychiatry.2017.2164.

    Article  PubMed  Google Scholar 

  • Beck, A. T., & Bredemeier, K. (2016). A unified model of depression: integrating clinical, cognitive, biological, and evolutionary perspectives. Clinical Psychological Science, 4(4), 596–619. https://doi.org/10.1177/2167702616628523.

    Article  Google Scholar 

  • Beck, A. T., Rush, A. J., Shaw, B., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.

    Google Scholar 

  • Blackburn, I. M., James, I. A., Milne, D. L., Baker, C., Standart, S., Garland, A., & Reichelt, F. K. (2001). The revised Cognitive Therapy Scale (CTS-R): psychometric properties. Behavioural and Cognitive Psychotherapy, 29, 431–446.

    Article  Google Scholar 

  • Braun, J. D., Strunk, D. R., Sasso, K. E., & Cooper, A. A. (2015). Therapist use of Socratic questioning predicts session-to-session symptom change in cognitive therapy for depression. Behaviour Research and Therapy, 70, 32–37. https://doi.org/10.1016/j.brat.2015.05.004.

    Article  PubMed  PubMed Central  Google Scholar 

  • Carey, T. A., & Mullan, R. J. (2004). What is Socratic questioning? Psychotherapy: Theory, Research, Practice, Training, 41(3), 217–226.

    Article  Google Scholar 

  • Carter, J. D., McIntosh, V. V., Jordan, J., Porter, R. J., Frampton, C. M., & Joyce, P. R. (2013). Psychotherapy for depression: a randomized clinical trial comparing schema therapy and cognitive behavior therapy. Journal of Affective Disorders, 151, 500–505. https://doi.org/10.1016/j.jad.2013.06.034.

    Article  PubMed  Google Scholar 

  • Clark, G., & Egan, S. (2015). The Socratic method in cognitive behavioural therapy: a narrative review. Cognitive Therapy and Research, 39(6), 863–879. https://doi.org/10.1007/s10608-015-9707-3.

    Article  Google Scholar 

  • Clark & Egan (2018) Clarifying the role of the Socratic Method in CBT: a survey of expert opinion.

  • Discover [Def 1]. (n.d.). In Merriam-Webster online. Retrieved February 1, 2018, from https://www.merriam-webster.com/dictionary/discover

  • Ellis, A. (1971). Growth through reason. Palo Alto: Science and Behavior Books.

    Google Scholar 

  • Fluckiger, C., Del Re, A. C., Wampold, B. E., Symonds, D., & Horvath, A. O. (2012). How central is the alliance in psychotherapy? A multilevel longitudinal meta-analysis. Journal of Counseling Psychology, 59(1), 10–17. https://doi.org/10.1037/a0025749.

    Article  PubMed  Google Scholar 

  • Froján-Parga, M. X., Calero-Elvira, A., & Montaño-Fidalgo, M. (2011). Study of the Socratic method during cognitive restructuring. Clinical Psychology & Psychotherapy, 18, 110–123.

    Article  Google Scholar 

  • Froján Parga et al. (2018). Verbal change and cognitive change: conceptual and methodological analysis for the study of cognitive restructuring using the Socratic dialogue.

  • Glasser, W. (1999). Choice theory: a new psychology of personal freedom. New York: HarperPerennial.

    Google Scholar 

  • Hayes, S. C., & Hofmann, S. G. (2017). The third wave of CBT and the rise of process-based care. World Psychiatry, 16, 245–246. https://doi.org/10.1002/wps.20442.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hayes, S. C., & Hofmann, S. G. (2018). Process-based CBT: the science and core clinical competencies of cognitive behavioral therapy. Oakland: New Harbinger.

    Google Scholar 

  • Heiniger, L. E., Clark, G. I., & Egan, S. J. (2018). Perceptions of Socratic and non-Socratic presentation of information in cognitive behaviour therapy. Journal of Behavior Therapy and Experimental Psychiatry, 58, 106–113. https://doi.org/10.1016/j.jbtep.2017.09.004.

    Article  PubMed  Google Scholar 

  • Inception. (n.d.). In Merriam-Webster online. Retrieved February 1, 2018, from https://www.merriam-webster.com/dictionary/discover

  • Kazantzis, N. (2003). Therapist competence in cognitive and behaviour therapies: review of the contemporary empirical evidence. Behaviour Change, 20, 1–12. https://doi.org/10.1375/bech.20.1.1.24845.

  • Kazantzis, N. (2018). Introduction to the special issue on processes of cognitive behavioral therapy: does “necessary, but not sufficient” still capture it? Cognitive Therapy and Research, 42(2), 115–120. https://doi.org/10.1007/s10608-018-9891-z.

    Article  Google Scholar 

  • Kazantzis, N., Fairburn, C. G., Padesky, C. A., Reinecke, M., & Teeson, M. (2014). Unresolved issues regarding the research and practice of cognitive behavior therapy: the case of guided discovery using Socratic questioning. Behav Chang, 31, 1–17.

    Article  Google Scholar 

  • Kazantzis, N., Cronin, T. J., Norton, P. J., Lai, J., & Hofmann, S. G. (2015). Reservations about the conclusions of the Interdivisional (APA Divisions 12 & 29) Task Force on Evidence-Based Therapy Relationships: what do we know, what don’t we know? J Clin Psychol, 71, 423–427. https://doi.org/10.1002/jclp.22178.

    Article  PubMed  Google Scholar 

  • Kazantzis, N., Dattilio, F. M., & Dobson, K. S. (2017). The therapeutic relationship in cognitive behavior therapy: a clinician’s guide. New York: Guilford.

    Google Scholar 

  • Kazantzis, N., Beck, J. S., Clark, D. A., Dobson, K. S., Hofmann, S. G., Leahy, R. L., & Wong, W. C. (2018a). Socratic dialogue and guided discovery in cognitive behavioral therapy: a modified Delphi panel. International Journal of Cognitive Therapy.

  • Kazantzis, N., Luong, H. K., Usatoff, A. S., Impala, T., Yew, R. Y., & Hofmann, S. G. (2018b). The processes of cognitive behavioral therapy: A review of meta-analyses. Manuscript submitted for publication.

  • Kazantzis, N., Dattilio, F. M., McGinn, L., Newman, C., Persons, J. B., & Radomsky, A. (2018c). Defining the role and function of the therapeutic relationship in cognitive behavioral therapy: a modified Delphi panel (in press).

  • Lorenzo-Luaces, L., & DeRubeis, R. J. (2018). Miles to go before we sleep: advancing the understanding of psychotherapy by modeling complex processes. Cognitive Therapy and Research, 42(2), 212–217.

    Article  Google Scholar 

  • Lorenzo-Luaces, L., German, R. E., & DeRubeis, R. J. (2015). It’s complicated: the relation between cognitive change procedures, cognitive change, and symptom change in cognitive therapy for depression. Clin Psychol Rev, 41, 3–15. https://doi.org/10.1016/j.cpr.2014.12.003.

    Article  PubMed  Google Scholar 

  • Muse, K., & McManus, F. (2013). A systematic review of methods for assessing competence in cognitive-behavioural therapy. Clin Psychol Rev, 33, 484–499. https://doi.org/10.1016/j.cpr.2013.01.010.

    Article  PubMed  Google Scholar 

  • Overholser (2018) Guided discovery: a clinical strategy derived from the Socratic method.

  • Padesky, C. A. (1993). Socratic questioning: Changing minds or guiding discovery? London: Keynote address to European Congress of Behavioural and Cognitive Therapies.

  • Petrik, A. M., Kazantzis, N., & Hofmann, S. G. (2013). Distinguishing integrative from eclectic practice in cognitive behavioral therapies. Psychotherapy, 50(3), 392–397. https://doi.org/10.1037/a0032412.

    Article  PubMed  Google Scholar 

  • Safran, J. D., Muran, J. C., & Eubanks-Carter, C. (2011). Psychotherapy, 48(1), 80–87. https://doi.org/10.1037/a0022140.

    Article  PubMed  Google Scholar 

  • Schoenwald, S. K., & Garland, A. F. (2013). A review of treatment adherence measurement methods. Psychological Assessment, 25, 146–156. https://doi.org/10.1037/a0029715.

    Article  PubMed  Google Scholar 

  • Tryon, G. S., & Winograd, G. (2011). Goal consensus and collaboration. Psychotherapy, 48(1), 50–57. https://doi.org/10.1037/a0022061.

    Article  PubMed  Google Scholar 

  • Young, J. E., & Beck, A. T. (1980). Cognitive Therapy Scale: Rating manual. Unpublished manuscript. Philadelphia: University of Pennsylvania.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nikolaos Kazantzis.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kazantzis, N., Stuckey, M.E. Inception of a Discovery: Re-defining the Use of Socratic Dialogue in Cognitive Behavioral Therapy. J Cogn Ther 11, 117–123 (2018). https://doi.org/10.1007/s41811-018-0015-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s41811-018-0015-z

Keywords

Navigation