I didn't think my comments suggested that the CBT I use did not involve
guided discovery, collaborative empiricism and other standards of the Beck approach. What I suggested was that there are other methods that may accomplish the same end. A cost-benefit analysis
may not be helpful with a client who is resistant but using an experiential technique may trigger the schema and allow patient and therapist to work with it. I don't think it is a question of didactic vs experiential but what techniques allow us to facilitate a client's ability to be willing to experiment with new
thoughts, feelings and actions. For example, I recently began working with a woman with a bi-polar disorder who had previously been seen by another cognitive therapist. When I tried some of the traditional Beckian techniques she resisted saying, " that she did not wish me to put her on the spot." Apparently, she had interpeted the other therpist inquiries as confrontational. By
using a series of role plays she was guided into re-evaluating her assumptions and behavior. Cognitive insight was achieved and she was able to suggest her own extra session behavior experiment from the role play. She was more motivated and I believe had more insight into what had been a difficult interpersonal issue for her. I continue to use experiential techniques with this client modeling the cost-benefit analyis, having characters think aloud and so on in an effort to true to CT principles while being creatively engaging the client.
Jeff Young and Iris Fodor are other CT's who have incorporated experiential techniques in their therapuetic toolboxes.
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