Thread: Gerry
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Unread September 24th, 2004, 10:14 PM
Sharkey Sharkey is offline
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Join Date: Aug 2004
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Default Re: Third Wave Behavior Therapies and CT

Jim,
I think that your reply underlines some of the problems that I, as an experienced cognitive therapist, am currently grappling with. I would like to make the following points:

1. Firstly, Cognitive Therapy (CT) is defined as a psychotherapy by its emphasis on changing cognitive content...read all the seminal publications and subsequent ones and prove me wrong on this. The fact that cognitive therapists have , from very early on, routinely integrated techniques from other approaches should not detract from this point. When this type of integration has been applied in a theoretically consistent way it has been used in the service of belief change. However ( and this criticism has been made by John Teasdale and others) very often cognitive therapists have been using interventions that simply do not make sense in terms of the cognitive model...two-chair dialogues, mindfulness meditation, and other mainly experiential interventions. When CT has not used CT techniques to target problems, like simple phobias for example, this seems to me because the theory is simply limited (not, as it appears from your argument, that CT continues to be CT even if it is BT)

2. You say that the targeting of cognitive content continues to be warranted in the treatment of depression "because it works and works well". The best of the research trials show that at least 40 per cent of recipients fail to respond to CT. Thus, our search for better treatments should not stop. To continue to emphasise the targeting of cognitive content in the treatment of depression when we now have 10-15 years of research findings suggesting that it is the cognitive process of rumination that is the main feature of depressive cognition seems to me to be irresponsible. Furthermore it raises the question as to why a therapy that seems to have been so clinically liberal in the past (even if this was theoretically incoherent in many ways) seems now to have have lost clinical flexibility when it comes to an apparently indisputable empirical finding.

Can Cognitive Therapy become a dinosaur?

Last edited by Sharkey; September 25th, 2004 at 03:02 AM.
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