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The business of cognitive therapy is to transform meanings. What
better way to achieve this than through a metaphor? Metaphors
straddle two different domains at once, providing a conceptual
bridge from a problematic interpretation to a fresh new perspective
that can cast one's experiences in a new light. Even the simplest
metaphor can be used again and again with different clients, yet
still achieve the desired effect. One such example is the 'broken
leg' metaphor for depression. Clients with depression are
understandably frustrated with their symptoms. They may often push
themselves to get better or tell themselves that they should be
better by now. As a therapist, it is fair to ask, would the client
be so harsh and demanding on herself after getting a broken leg? A
broken leg needs time to heal and you need to begin to walk on it
gradually as it builds up in strength. "You can't run before you
can walk," and if you try, you are likely to make it worse. For
many clients this simple metaphor is enlightening, changing their
view of their symptoms as a sign of their own laziness and
worthlessness, to a view of them as part of an understandable
illness, that while open to improvement, cannot get better over
night.
The therapeutic relationship in CBT is often reduced to a cursory description of establishing warmth, genuineness and empathy in order to foster a collaborative relationship. This does not reflect the different approaches needed to establish a therapeutic partnership for the wide range of disorders and settings in which CBT is applied. This book takes a client group and disorder approach with chapters split into four sections: General issues in the therapeutic relationship in CBT Therapeutic relationship issues in specific disorders Working with specific client groups Interpersonal considerations in particular delivery situations Each chapter outlines key challenges therapists face in a specific context, how to predict and prevent ruptures in the therapeutic alliance and how to work with these ruptures when they occur. With clinical vignettes, dialogue examples and 'tips for therapists' this book is key reading for CBT therapists at all levels.
The therapeutic relationship in CBT is often reduced to a cursory description of establishing warmth, genuineness and empathy in order to foster a collaborative relationship. This does not reflect the different approaches needed to establish a therapeutic partnership for the wide range of disorders and settings in which CBT is applied. This book takes a client group and disorder approach with chapters split into four sections: General issues in the therapeutic relationship in CBT Therapeutic relationship issues in specific disorders Working with specific client groups Interpersonal considerations in particular delivery situations Each chapter outlines key challenges therapists face in a specific context, how to predict and prevent ruptures in the therapeutic alliance and how to work with these ruptures when they occur. With clinical vignettes, dialogue examples and 'tips for therapists' this book is key reading for CBT therapists at all levels.
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