In-Session Structure and Collaborative Empiricism
Highlights
► Examine interplay of cognitive therapy in-session structure and collaborative empiricism ► Describe structure and phases of “standard” CBT session ► Discuss factors that can influence the in-session structure ► Present case study to illustrate collaborative empiricism
Section snippets
Standard In-Session Structure
Orientation to the therapeutic model begins during the assessment or even earlier, at the initial contact with the client. Part of orientation to this model includes describing the in-session structure and its rationale. This rationale includes the need for the efficient use of session time, the importance of using homework as a part of the treatment plan, and, most significantly, the importance of client participation and collaboration with the therapeutic work. Orientation to the model is
Flexible Structure and the Therapeutic Alliance
A major difference between cognitive therapy and cognitive behavioral treatments and other types of psychotherapies is the use of structured sessions. In the following section we discuss how to use structure in flexible ways, and provide suggestions both about the use of structure and how it may be used to either advance or disadvantage the therapeutic alliance. These factors are examined from both the perspective of the client and therapist.
A Case Study in Session Structure
Janet N.1 was a 48-year-old woman who was referred for therapy following an inpatient admission. The admission was precipitated by a suicide attempt, which involved an overdose of prescription medications. During the intake interview, Janet reported that she was divorced, but had two young adult children, a son and a daughter, both of whom lived at home. Shortly after her overdose, she called her daughter, who
Summary and Conclusions
This article has addressed the issues that are implicated in cognitive therapy, related to both in-session structure and the use of collaborative empiricism in the therapeutic relationship. Although very little evidence exists to support the ideas and suggestions expressed in this article, we have highlighted what has become more or less accepted wisdom, or canon, in the field. It is perhaps axiomatic that further research related to session structure, collaborative empiricism, and the process
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