SPECIAL SERIES
Introduction: Using Techniques via the Therapeutic Relationship☆

https://doi.org/10.1016/j.cbpra.2013.03.001Get rights and content

Highlights

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    Conceptualizations of “collaboration” and “empiricism” were heralded as defining features of cognitive behavior therapy

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    These relational attributes also serve as a process for cognitive change

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    There remains little guidance for practitioners on how to develop relationships that are strong in “empiricism”

Abstract

In this work, we have the opportunity to hear people’s most private concerns, worries, distress, and share in their hopes, aspirations, and dreams for the future. The work involved in the practice of cognitive behavior therapy; our knowledge, theories, techniques, and strategies are practically useless if we are unable to relate to our clients. Relational attributes were incorporated as part of the defining features essential to therapeutic change in the seminal guide for cognitive therapy (A. T. Beck, Rush, Shaw, & Emery, 1979). Conceptualizations of “collaboration” and “empiricism” have since been misconstrued with the construct of the working alliance in the past, although both have unique distinctions and implications for practice. This article presents an introduction to a special series in Cognitive and Behavioral Practice, which illustrates the vital role of collaborative empiricism within culturally responsive CBT, through the structure of the therapy session, cognitive case conceptualization, self-monitoring, interventions focused on cognitive change, and exposure to emotions and situations. We invite you to join with us in considering the extent to which the ideas shared herein are relevant for your work with clients. It is also our hope that you will consider evaluating and incorporating the utility of these ideas in your therapy.

Section snippets

A Clarification for Empiricism in CBT

The field of psychotherapy research has helped us to utilize the scientific method as a context for defining and evaluating our practices. To operate as a competent, ethical, and professional practitioner is to evaluate the effectiveness of clinical work, and adjust it based on those data (Levant and Hasan, 2008, Sackett et al., 1996). Thus, the first “level” of empiricism concerns the evidence for our therapeutic work and the data we gather to support those therapies in the settings in which

Implications for the Evidence for CBT

Our discussion here carries two important implications for the interpretation of the existing data on CBT’s processes and efficacy. First, those studies attempting to assess the working alliance as the central relational construct in CBT are likely to have underestimated the contribution of relational attributes to therapeutic outcomes (e.g., DeRubeis and Feeley, 1990, Feeley et al., 1999, Safran and Wallner, 1991). It is possible that a more comprehensive assessment of the therapeutic

The Cognitive and Behavioral Practice Special Series

Limited guidance exists for the mental health professional to develop therapeutic relationships that are strong in collaboration (Kazantzis, 2012) and empiricism. Given that these relational attributes are expected to be present in every therapy session (Beck, 1995, Young and Beck, 1980), it is important to have clear, succinct, and useful tips for practice. Together with leading experts in the field, it has been our privilege to contribute discussions on the topic of defining collaborative

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    ☆

    First and foremost our heartfelt appreciation to our clients for their resilience, wisdom, and teaching. We also extend thanks to our teachers Aaron T. Beck (FD, NK, and KS), Christine Padesky and Kathleen Mooney (NK), Judith S. Beck (NK and KS), and Cory Newman (NK). The intellect, enthusiasm, and diligence of the trainees at La Trobe University’s Cognitive Behavior Therapy Research Unit have also been important motivating factors through this project. Our colleagues and friends David A. Clark, Arthur Freeman, Stefan G. Hofmann, Gregoris Simos, Mehmet Sungur, and Wing Wong are also acknowledged for their scholarly discussions and encouragement for this work. Finally, the valued support of Bonnie Brown, as Editorial Assistant, is gratefully acknowledged.

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