How to Become a More Effective CBT Therapist: Mastering Metacompetence in Clinical Practice by

Language: eng
Format: azw3
ISBN: 9781118468371
Publisher: Wiley
Published: 2014-04-20T16:00:00+00:00

This procedural competence of being able to employ CBT theory to devise tentative hypotheses or formulations of what might be maintaining the resistance, I would argue, is an important aspect of developing appropriate flexibility and artistry as a CBT therapist. This can be contrasted with the possibility of responding to apparent client reluctance, ambivalence or non-cooperation with an increased “technical” focus and reiteration of the importance of complying or the value of the specific procedures. Or in other words therapist counter-resistance!

Castonguay, Goldfrield, Wiser, Raue, and Hayes (1996) report on an intriguing study that appeared to show that therapist persistence with standard CBT interventions (specifically persisting with a focus on the effects of distorted cognitions in the maintenance of depressed mood), in a situation of client resistance, was associated with poor outcome in CBT for depression. They also propose that this increase in apparent client resistance may not be due to the use of an inappropriate strategy or intervention, but rather that the appropriate strategy may have been used in an inflexible manner that was not responsive to the client’s feedback and concerns.

A significant step towards developing metacompetence as a CBT practitioner, is the ability to pause when apparent resistance is encountered, and, rather than persisting in an intervention that is not flowing, to attempt to think about what the roadblock might be indicating. In other words, in the face of apparent resistance, attempt to formulate rather than persist with the technical intervention.

As well as considering clients idiosyncratic beliefs about complying with treatment procedures, and the possibility that such beliefs are themselves implicated in the clinical problems the client is seeking help for, it may also be beneficial to widen your assessment of possible relevant factors to include influences from the client’s natural environment (such as the presence of a spouse hostile to or threatened by the client’s engagement in treatment, or struggling with their own substance misuse problem) as well as the possibility that the client’s reluctance in fact is expressive of a skill deficit rather than being primarily the expression of interfering beliefs or emotions.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.