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What is CBT Really and How Can We Enhance The Impact of Effective Psychotherapies such as CBT?
Mansell W
In: Against and For CBT: Towards and Constructive Dialogue. 2008. p. 19-32.
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Abstract
[from the Introduction] At its core CBT focuses on how we attend, interpret, reason, reflect and make sense of inner and outer events. It is a journey into personal meaning making at the edge of mind and objective experience. It emerged from ego-analytic psychotherapy in the 1950 and 1960, routed itself in academic psychology and began the slow process of scientific investigation during the 1970s (Padesky 2004). [From the Conclusion]... an effective and acceptable psychotherapy: 1. needs to consider the person in their social context and their immediate interpersonal interactions because of the close relationship with inner mental processes, 2. must be based on more than the standardised evidence base because it needs to match the needs of the clients to whom it is targeted when put into practice in a particular context, 3. is likely to be at odds with a purely medical model of mental ‘illness’ and so needs to develop ways to accommodate to, or transform, its health service context, 4. needs to consistently monitor the process of control, sense of purpose and the balance of power during therapy so that clients can gain a perception of control in their lives, 5. needs a coherent theoretical model to guide its core principles that evolves in a dynamic way in response to new evidence or new ways of thinking about that evidence. Taking the family of CBT therapies as a whole, I see that they are tackling the above issues directly, in tandem with the popularisation and dissemination of the therapy. This process of evolution is likely to be a rocky one, as the desire for immediate accessibility is pitched against the need to adhere to these, and other, key principles. There is an emerging acceptance that CBT as it is currently practised will not exist in the future – it constantly changes depending on new research (Veale, 2008). There will need to be shifts in the nature of CBT and related psychotherapies during this process and that the evolving solution will lie in identifying commonalities rather than differences across approaches, and placing them within a coherent and clear scientific framework. In order to manage this, CBT clinicians and researchers will need to communicate and collaborate with a range of professions, including non-CBT psychotherapists, to form a coherent account of how to help manage psychological distress and facilitate people’s quality of life and well-being. This edited book can be one step on the way, if we agree to leave the straw (or metal?) man on the side lines, and take psychotherapy forward together.