Hostname: page-component-7479d7b7d-t6hkb Total loading time: 0 Render date: 2024-07-11T01:29:28.918Z Has data issue: false hasContentIssue false
  • English
  • Français

Three ways to change your mind: an epistemic framework for cognitive interventions

Published online by Cambridge University Press:  06 February 2023

Stirling Moorey
Stirling Moorey*
Affiliation:
Honorary Cognitive Behaviour Therapist, South London and Maudsley NHS Trust, London, UK
*
Email: s.moorey@btopenworld.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Belief change is an important element of much CBT, yet very little consideration has been given to the theories of knowledge, the epistemology, which underlie this process. This article argues that understanding the epistemic basis of the techniques therapists use can help guide their choice of interventions. The empirical evidence for cognitive restructuring is considered, the importance of distancing and decentring noted, and three epistemic styles are identified: the rational-empiricist, pragmatist and ‘constructivist’ approaches. Different schools of CBT emphasise one or more of these. The article describes how these epistemes can be used to make decisions about which cognitive interventions to use, particularly when clients may be sceptical about reality testing because of entrenched beliefs or real-life adversity.

Keywords

cognitive behaviour therapycognitive restructuringconstructivist therapyepistemologyempiricism
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 51 , Issue 3 , May 2023 , pp. 187 - 199
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of British Association for Behavioural and Cognitive Psychotherapies

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arthur, A. R. (2000). The personality and cognitive-epistemological traits of cognitive-behavioural and psychoanalytic psychotherapists. British Journal of Medical Psychology, 73, 243–257. https://doi.org/10.1348/000711200160453 CrossRefGoogle ScholarPubMed
Bacon, F. (1908). I. Of Truth. In Scott, M. A. (ed), The Essays of Francis Bacon. Charles Scribner’s Sons; Wikisource.Google Scholar
Barnard, P. J., & Teasdale, J. D. (1991). Interacting cognitive subsystems: a systemic approach to cognitive-affective interaction and change. Cognition and Emotion, 5, 1–39. https://doi.org/10.1080/02699939108411021 CrossRefGoogle Scholar
Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. International Universities Press, Inc.Google Scholar
Beck, A. T. (1985). Anxiety Disorders and Phobias: A Cognitive Perspective. Basic Books.Google Scholar
Beck, A. T., Rush, A. J., Shaw, B., & Emery, G. (1979). Cognitive Therapy of Depression. Guilford Press.Google Scholar
Beck, A. T. (1996). Beyond belief: a theory of modes, personality and psychpathology. In Salkovskis, P. M. (ed), Frontiers of Cognitive Therapy (pp. 1–25). Guilford Press.Google Scholar
Beck, J. S. (1995). Cognitive Therapy: Basics and Beyond. Guilford Press.Google Scholar
Bennett-Levy, J. (2003). Mechanisms of change in cognitive therapy: the case of automatic thought records and behavioural experiments. Behavioural and Cognitive Psychotherapy, 31, 261–277. https://doi.org/10.1017/S1352465803003035 CrossRefGoogle Scholar
Bennett-Levy, J., Butler, G., Fennell, M., Hackmann, A., Mueller, M., Westbrook, D., & Rouf, K. (2004). Oxford Guide to Behavioural Experiments in Cognitive Therapy. Oxford University Press. https://doi.org/10.1093/med:psych/9780198529163.001.0001 CrossRefGoogle Scholar
Blackburn, I. M., James, I. A., Milne, D. L., Baker, C., Standart, S., Garland, A., & Reichelt, F. K. (2001). The revised cognitive therapy scale (CTS-R): psychometric properties. Behavioural and Cognitive Psychotherapy, 29, 431–446. https://doi.org/10.1017/s1352465801004040 CrossRefGoogle Scholar
Blease, C. R. (2015). Talking more about talking cures: cognitive behavioural therapy and informed consent. Journal of Medical Ethics, 41, 750–755. https://doi.org/10.1136/medethics-2014-102641 CrossRefGoogle ScholarPubMed
Bream, V., Challacombe, F., Palmer, A., & Salkovskis, P. M. (2017). Cognitive Behaviour Therapy for Obesessive-Compulsive Disorder (1st edn). Oxford University Press.CrossRefGoogle Scholar
Bryant, R. A., Moulds, M. L., Guthrie, R. M., Dang, S. T., Mastrodomenico, J., Nixon, R. D. V., Felmingham, K. L., Hopwood, S., & Creamer, M. (2008). A randomized controlled trial of exposure therapy and cognitive restructuring for posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 76, 695–703. https://doi.org/10.1037/a0012616 CrossRefGoogle ScholarPubMed
Bryant, R. A., Moulds, M. L., Guthrie, R. M., Dang, S. T., & Nixon, R. D. V. (2003). Imaginal exposure alone and imaginal exposure with cognitive restructuring in treatment of posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 71, 706–712. https://doi.org/10.1037/0022-006X.71.4.706 CrossRefGoogle ScholarPubMed
Burns, D. D. (2020). Feeling Great: The Revolutionary New Treatment for Depression and Anxiety. PESI Publishing & Media.Google Scholar
Carona, C. (2022). The philosophical assumptions across the ‘three waves’ of cognitive–behavioural therapy: how compatible are they? British Journal of Psychiatry Advances, 1–5. https://doi.org/10.1192/bja.2022.12 CrossRefGoogle Scholar
Ciharova, M., Furukawa, T. A., Efthimiou, O., Karyotaki, E., Miguel, C., Noma, H., Cipriani, A., Riper, H., & Cuijpers, P. (2021). Cognitive restructuring, behavioral activation and cognitive-behavioral therapy in the treatment of adult depression: a network meta-analysis. Journal of Consulting and Clinical Psychology, 89, 563–574. https://doi.org/10.1037/ccp0000654 CrossRefGoogle ScholarPubMed
Clark, D. A. (2013). Cognitive restructuring. In The Wiley Handbook of Cognitive Behavioral Therapy (pp. 1–22). John Wiley & Sons, Ltd. https://doi.org/10.1002/9781118528563.wbcbt02 Google Scholar
Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In Social Phobia: Diagnosis, Assessment, and Treatment (pp. 69–93). Guilford Press.Google Scholar
Clark, G. I., & Egan, S. J. (2015). The Socratic Method in cognitive behavioural therapy: a narrative review. Cognitive Therapy and Research, 39, 863–879. https://doi.org/10.1007/S10608-015-9707-3 CrossRefGoogle Scholar
Cohen, J. S., Edmunds, J. M., Brodman, D. M., Benjamin, C. L., & Kendall, P. C. (2013). Using self-monitoring: implementation of collaborative empiricism in cognitive-behavioral therapy. Cognitive and Behavioral Practice, 20, 419–428. https://doi.org/10.1016/j.cbpra.2012.06.002 CrossRefGoogle Scholar
De Shazer, S. (1985). Keys to Solution in Brief Therapy. W.W. Norton.Google Scholar
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319–345. https://doi.org/10.1016/S0005-7967(99)00123-0 CrossRefGoogle ScholarPubMed
Ellis, A. (1962). Reason and Emotion in Psychotherapy. Lyle Stuart.Google Scholar
Ellis, A., & MacLaren, C. (1998). Rational Emotive Behavior Therapy: A Therapist’s Guide. Impact Publishers.Google Scholar
Foa, E. B., Hembree, E. A., Cahill, S. P., Rauch, S. A. M., Riggs, D. S., Feeny, N. C., & Yadin, E. (2005). Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: outcome at academic and community clinics. Journal of Consulting and Clinical Psychology, 73, 953–964. https://doi.org/10.1037/0022-006X.73.5.953 CrossRefGoogle ScholarPubMed
Greenberg, L. S., & Safran, J. D. (1989). Emotion in psychotherapy. American Psychologist, 44, 19–29. https://doi.org/10.1037/0003-066X.44.1.19 CrossRefGoogle ScholarPubMed
Greenberger, D., & Padesky, C. A. (2015). Mind Over Mood: Change How you Feel by Changing the Way You Think (2nd edn). Guilford Press Google Scholar
Grey, N., Young, K., & Holmes, E. (2002). Cognitive restructuring within reliving: a treatment for peritraumatic emotional ‘hotspots’ in posttraumatic stress disorder. Behavioural and Cognitive Psychotherapy, 30, 37–56. https://doi.org/10.1017/s1352465802001054 CrossRefGoogle Scholar
Grunert, B. K., Smucker, M. R., Weis, J. M., & Rusch, M. D. (2003). When prolonged exposure fails: adding an imagery-based cognitive restructuring component in the treatment of industrial accident victims suffering from PTSD. Cognitive and Behavioral Practice, 10, 333–346. https://doi.org/10.1016/S1077-7229(03)80051-2 CrossRefGoogle Scholar
Guidano, V. F. (1995). Constructivist psychotherapy: a theoretical framework. In Neimeyer, R. A. & Mahoney, M. J. (eds), Constructivism in Psychotherapy (pp. 93–108). American Psychological Association. https://doi.org/10.1037/10170-004 CrossRefGoogle Scholar
Hayes, S. C., Strosahl, K., & Wilson, K. G. (2003). Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change (paperback edn). Guilford Press.Google Scholar
Hofmann, S. G., & Hayes, S. C. (2019). The future of intervention science: process-based therapy. Clinical Psychological Science, 7, 37–50. https://doi.org/10.1177/2167702618772296 CrossRefGoogle ScholarPubMed
James, D. W. (2013). Pragmatism A New Name for Some Old Ways of Thinking. Start Classics.Google Scholar
Lee, J. A., Neimeyer, G. J., & Rice, K. G. (2013). The relationship between therapist epistemology, therapy style, working alliance, and interventions use. American Journal of Psychotherapy, 67, 323–345. https://doi.org/10.1176/appi.psychotherapy.2013.67.4.323 CrossRefGoogle Scholar
Levin, M. E., Haeger, J., An, W., & Twohig, M. P. (2018). Comparing cognitive defusion and cognitive restructuring delivered through a mobile app for individuals high in self-criticism. Cognitive Therapy and Research, 42, 844–855. https://doi.org/10.1007/s10608-018-9944-3 CrossRefGoogle Scholar
Longmore, R. J., & Worrell, M. (2006). Do we Need to Challenge Thoughts in Cognitive Behavior Therapy? https://doi.org/10.1016/j.cpr.2006.08.001 CrossRefGoogle Scholar
Lyddon, W. J. (1991). Epistemic style: implications for cognitive psychotherapy. Psychotherapy, 28, 588–597.CrossRefGoogle Scholar
Mahoney, M. J. (1991). Human Change Processes: The Scientific Foundations of Psychotherapy. https://books.google.com/books?hl=en&lr=&id=GbLSCgAAQBAJ&oi=fnd&pg=PA5&ots=89V00w6-gL&sig=2sTu78QxniRmLnOwK0H64JyvrzE Google Scholar
Mahoney, M. J., & Granvold, D. K. (2005). Constructivism and psychotherapy. World Psychiatry, 4, 74–77.Google ScholarPubMed
Marks, I., Lovell, K., Noshirvani, H., Livanou, M., & Thrasher, S. (1998). Treatment of posttraumatic stress disorder by exposure and/or cognitive restructuring: a controlled study. Archives of General Psychiatry, 55, 317–325. https://doi.org/10.1001/archpsyc.55.4.317 CrossRefGoogle ScholarPubMed
Mattick, R. P., Peters, L., & Clarke, J. C. (1989). Exposure and cognitive restructuring for social phobia: a controlled study. Behavior Therapy, 20, 3–23. https://doi.org/10.1016/S0005-7894(89)80115-7 CrossRefGoogle Scholar
Moorey, S. (1997). When bad things happen to rational people: cognitive therapy in adverse life circumstances. In Frontiers of Cognitive Therapy (pp. 450–469). Guilford Press.Google Scholar
Moorey, S. (in press). Guided discovery with adversity. In Padesky, C. A. & Kennerley, H. (eds), Dialogues for Discovery. Oxford University Press.Google Scholar
Moorey, S., & Lavender, A. (2019). The foundations of the therapeutic relationship: therapist characteristics and change. In Moorey, S. & Lavender, A. (eds), The Therapeutic Relationship in Cognitive Behaviour Therapy (1st edn), pp. 3–15. Sage.CrossRefGoogle Scholar
Murguia, E., & Díaz, K. (2015). The philosophical foundations of cognitive behavioural therapy: Stoicism, Buddhism, Taoism, and Existentialism. Journal of Evidence Based Psychotherapies, 15, 37–50.Google Scholar
Neimeyer, G. J., & Morton, R. J. (1997). Personal epistemologies and preferences for rationalist versus constructivist psychotherapies. Journal of Constructivist Psychology, 10, 109–123. https://doi.org/10.1080/10720539708404616 CrossRefGoogle Scholar
Neimeyer, R. A. (1993). Constructivism and the cognitive psychotherapies: some conceptual and strategic contrasts. Journal of Cognitive Psychotherapy, 7, 159–171. https://doi.org/10.1891/0889-8391.7.3.159 CrossRefGoogle Scholar
Neimeyer, R. A. (2009). Constructivist Psychotherapy: Distinctive Features. Routledge. https://doi.org/10.4324/9780203882405 CrossRefGoogle Scholar
Norton, A. R., & Abbott, M. J. (2016). The efficacy of imagery rescripting compared to cognitive restructuring for social anxiety disorder. Journal of Anxiety Disorders, 40, 18–28. https://doi.org/10.1016/j.janxdis.2016.03.009 CrossRefGoogle ScholarPubMed
Padesky, C. A. (1993). Socratic Questioning: Changing Minds or Guiding Discovery? www.padesky.com Google Scholar
Padesky, C.A. & Kennerley, H (eds) (in press). Dialogues for Discovery. Oxford University Press.Google Scholar
Power, M. J., & Dalgleish, T. (1999). Two routes to emotion: Some implications of multi-level theories of emotion for therapeutic practice. Behavioural and Cognitive Psychotherapy, 27, 129–141. https://doi.org/10.1017/S1352465899272049 CrossRefGoogle Scholar
Royce, J. R. (1964). The Encapsulated Man: An Interdisciplinary Search for Meaning. Princeton, NJ: Van Nostrand.Google Scholar
Royce, J., R., Coward, H., Egan, E., Kessel, F., & Mos, L. P. (1978). Psychological epistemology: a critical review of the empirical literature and the theoretical issues. Genetic Psychology Monographs, 97, 265–353.Google Scholar
Salkovskis, P. M. (1996). Anxiety, beliefs and safety seeking behaviours. In Salkovskis, P. M. (ed), Frontiers of Cognitive Therapy (pp. 48–74). Guilford Press.Google Scholar
Segal, Z. (2001). Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. Guilford Press.Google Scholar
Teasdale, J. D., & Barnard, P. J. (1993). Affect, Cognition and Change: Re-modelling Depressive Thought. Lawrence Erlbaum.Google Scholar
Teasdale, J. D. (1996). Clinically relevant theory: integrating clinical insight with cognitive science. In Salkovskis, P. (ed), Frontiers of Cognitive Therapy (pp. 26–47). Guilford Press.Google Scholar
Tee, J., & Kazantzis, N. (2011). Collaborative empiricism in cognitive therapy: a definition and theory for the relationship construct. Clinical Psychology: Science and Practice, 18, 47–61. https://doi.org/10.1111/j.1468-2850.2010.01234.x Google Scholar
Toska, G. A., Neimeyer, G. J., Taylor, J. M., Kavas, A. B., & Rice, K. G. (2010). Epistemology and allegiance: exploring the role of therapists’ epistemic commitments on psychotherapy outcomes. European Journal of Psychotherapy and Counselling, 12, 65–75. https://doi.org/10.1080/13642531003637783 CrossRefGoogle Scholar
Wells, A. (2011). Metacognitive Therapy for Anxiety and Depression. Guilford Press.Google Scholar
Williams, J. M. G. (2003). Suicidal patients. In Scott, J., Williams, J. M. G., & Beck, A. T. (eds), Cognitive Therapy in Clinical Practice: An Illustrative Casebook. Routledge.Google Scholar
Winter, D. A., & Watson, S. (1999). Personal construct psychotherapy and the cognitive therapies: different in theory but can they be differentiated in practice? Journal of Constructivist Psychology, 12, 1–22. https://doi.org/10.1080/107205399266190 Google Scholar
Yovel, I., Mor, N., & Shakarov, H. (2014). Examination of the core cognitive components of cognitive behavioral therapy and acceptance and commitment therapy: an analogue investigation. Behavior Therapy, 45, 482–494. https://doi.org/10.1016/j.beth.2014.02.007 CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.