Cognitive Behavioural Therapy with Older People by James Ian Andrew;

Author:James, Ian Andrew; [Ian Andrew James]
Language: eng
Format: epub
ISBN: 9780857002839
Publisher: Jessica Kingsley Publishers
Published: 2014-05-07T00:00:00+00:00

9.2.ii: Item 2 – Feedback

The therapist should both provide and elicit feedback throughout each session. The key features of ‘feedback’ are outlined in the CTS-R as shown in the box.

This item stresses the importance of two-way feedback. By ‘summarising’ and ‘chunking’ information at regular intervals, the therapist can emphasise the major features, synthesise new material and highlight issues that require further clarification. By eliciting the patient’s feedback (thoughts and feelings) regarding the therapy, the therapist can check the patient’s attitude, knowledge base and understanding.

Chunking information and eliciting feedback should occur frequently. On occasions, when either particularly important or confusing material is being discussed, the feedback should occur after each major point; this can also help ‘contain’ distressing issues. During normal short-term CBT, the two-way feedback should occur at least every ten minutes. Major summaries should occur at the beginning and end of each session, to help reinforce and consolidate therapeutic material. In Mohlman and Gorman’s (2005) study, using enhanced CBT for older people, during the last five minutes of each session, the therapist led an ‘expanding review’ of all concepts and techniques learned to date.

Key features: The patient’s and therapist’s understanding of key issues should be helped through the use of two-way feedback. The two major forms of feeding back information are through general summary and chunking of important units of information. The use of appropriate feedback helps both the therapist to understand the patient’s situation, and the patient to synthesise material enabling her to gain major insight and make therapeutic shifts. It also helps to keep the patient focused.

Three features need to be considered when scoring this item:

(i)presence and frequency, or absence, of feedback; feedback should be given/elicited throughout the therapy – with major summaries both at the beginning (review of week) and end (session summary), while topic reviews (i.e. chunking) should occur throughout the session

(ii)appropriateness of the contents of the feedback

(iii)manner of its delivery and elicitation (NB: can be written).

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