Using Self-Monitoring: Implementation of Collaborative Empiricism in Cognitive-Behavioral Therapy

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Abstract

Self-monitoring is an important clinical technique used in cognitive-behavioral therapy. It is frequently used for homework assignments in the context of comprehensive treatments. A description of self-monitoring and practical considerations is presented, followed by an examination of self-monitoring as a means to facilitate collaborative empiricism in therapy. It may foster collaboration between therapist and client in collecting and reviewing essential data, inform treatment planning, and enhance the client's sense of agency. A clinical case example is included to provide an emphasis on clinical application. We conclude by noting potential mechanisms for facilitating change through the use of self-monitoring. Continued examination of applied clinical practice, including strategies such as self-monitoring, is needed to further our understanding of the mechanisms of therapeutic change.

Highlights

► We describe the use of self-monitoring in cognitive-behavioral therapy. ► We discuss how collaborative empiricism is relevant for self-monitoring. ► We present a case study to illustrate the practice of self-monitoring. ► We conclude with a focus on the facilitation of mechanisms of change.

Section snippets

Self-Monitoring and Collaborative Empiricism

Given the role that collaboration (Creed & Kendall, 2005) and empiricism play in therapeutic change, their operationalization and application in CBT is essential. Tee and Kazantzis (2011) put forth a definition of collaborative empiricism that clarifies the interaction between these core components. Turning to self-determination theory (Deci and Ryan, 1980, Deci and Ryan, 1985, Ryan and Deci, 2000, Ryan and Deci, 2002), they suggest that the “generation and evaluation of the client's intrinsic

Case Illustration of Self-Monitoring With an Anxious Youth

Jason was an 11-year-old boy who presented for treatment to an anxiety disorders clinic with a previous diagnosis of specific phobia of vomiting. This diagnosis was confirmed via separate semistructured interviews with Jason and with his parents. Jason reported an intense fear of witnessing others vomiting and of vomiting himself. Jason and his parents reported significant impairment since the onset of this phobia 1 year prior. Although Jason used to be an avid ice hockey player, at the time of

Conclusion

As the case example illustrates, self-monitoring is a facet of collaborative empiricism in therapy and it can be implemented in various ways throughout treatment. Collaboration was evident in the selection of self-monitoring tools (e.g., use of a personal notebook), review of collected data, and choice of targeted behaviors and exposure tasks—the therapist did not simply offer an explanation of the client's anxiety or dictate all aspects of treatment. Empiricism was evident in the client's

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    Preparation of this manuscript was facilitated by research grants awarded to Courtney L. Benjamin MH086954 and Philip C. Kendall (MH063747; MH086438; MH080788)

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