Charles, this is an excellent observation. I was aware that the effectiveness of CT in the collaborative study had varied a lot from site to site. I didn't know it varied so much between therapists.
Occasionally, CT is criticized as being difficult to master. It doesn't seem that difficult to me, but then I've been doing it for a long time and I had some very good supervisors. I train quite a few therapists in CT. Many of them initially focus on technique and neglect the therapeutic relationship, others (usually ones from a psychodynamic background) continue to focus on the therapeutic relationship and are slow to use specific techniques when appropriate. Both approaches are less effective that an approach which is based on a strong, collaborative therapy relationship and in which the specific techniques are used strategically (rather than being used in an unthinking -cookbook- fashion). Many experienced therapists find that it isn't easy to find a good balance between relationship-focused interventions and specific cognitive-behavioral techniques.
I hope you find time to write that letter to the Behavior Therapist. I also hope that you, or someone else reading this thread, will pursue the idea of interviewing the other therapists from the collaborative study.
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