Categories
l

‘ A Strong Therapeutic Alliance Is an Essential Element of (CBT) Treatment’

so writes Judith Beck, President of the Beck Institute for CBT (2019 Moorey and Lavender) in a book to be published next week, echoing what her father Aaron Beck wrote in 1979 in his seminal work Cognitive Therapy for Depression. But IAPT have made their own fundamentalist translation of Beck’s work, indoctrinating its’ footsoldiers, Psychological Wellbeing Practitioners (PWPs), one of whom from Liverpool (2019 p214 Jackson and Rizq) has written:

‘The PWP role is high volume low intensity, just churn them out… young PWPs straight from universities, who are naively prepared to do as required by the service…There’s a big gap between the data and the reality of what we’re trying to do’.

It is disturbing that the most vociferous critics of IAPT are also fierce critics of CBT, [ see Jackson and Rizq (2019)] creating a caricature of the latter as mechanistic and uninterested in the the therapeutic relationship. But I have just contributed a chapter the Moorey and Lavender (2019) edited volume. Anyone reading my chapter on Group CBT in this work can be in no doubt about the importance I attach to the alliance/ cohesion in a group.

I am still reading the Jackson and Rizq (2019) book and it contains many perfectly valid criticisms of IAPT. But it does engage in unnecessarily distracting polemics about the medical model and diagnosis.

The contributors to the Jackson and Rizq (2019) work seem blissfully unaware that no medic or psychologist has ever espoused anything other than a biopsychosocial model, it is only the mouthpieces for drug companies that have ever voiced purely biological explanations. To say that biology will be involved in psychological reactions isn’t at all to say that the former determines the latter or its course.

Breathtakingly Jackson and Rizq (2019) are profoundly mistaken when they assert that IAPT believes in diagnosis, they do not at all, they pay lip service to it to secure funds!. IAPT never ever perform a standardised diagnostic interview such as the SCID which is the ‘gold standard’ for establishing whether a person has a recognised psychiatric disorder. The first part of the SCID begins with an open ended interview in which clients are given the space to tell their story, only then is their systematic enquiry about each of the symptoms in a diagnostic set and a clinical assessment of which symptoms are significantly interfering with real world functioning. If IAPT started to use the SCID it would stop the production line referred to by the PWP above. There has to be space created for any relationship. But in my personal communication with David Clark, IAPT’s progenitor he baulked at the cost involved, but did not criticise my proposal per se.

Diagnosis provides a common language and it is the least worst way of communicating, try trying to talk about say ‘power threat meaning ‘ in a medico-legal case! Its’ usage does not at all depend on believing in a particular biological pathology rather it is pragmatic and subject to revision.

Jackson and Rizq (2019) reiterate the ‘Dodo verdict’ that all therapies are equal and must have prizes citing Wampold’s work, but Tolin’s findings

https://www.dropbox.com/s/r3bja27takbicnc/Tolin%202015%20Dodo.pdf?dl=0

are very different. But notwithstanding this, in routine practice one does not find evidence of fidelity to any psychotherapeutic protocol, I have yet to see any written evidence in treatment notes of fidelity that would satisfy anyone from any of the psychotherapeutic schools. Manuals are seen as anathema, with a total ignorance that flexibility is an integral part of all such published manuals. Unfortunately the manuals have never been tested out by the Jackson and Rizq (2019) advocates, nor has the viability of using a standardised diagnostic interview, instead theirs is a fundamentalist view that they and their client will somehow find the right way. In their own way they are as ideological as IAPT.

References

Moorey, S and Lavender, A eds (2019) The therapeutic relationship in cognitive behavioural therapy. London: Sage Publications

Jackson, C and Rizq, R (2019) The industrialisation of care counselling, psychotherapy and the impact of IAPT. PCCS books

Dr Mike Scott

57 replies on “‘ A Strong Therapeutic Alliance Is an Essential Element of (CBT) Treatment’”

… [Trackback]

[…] Here you will find 6331 additional Information on that Topic: cbtwatch.com/a-strong-therapeutic-alliance-is-an-essential-element-of-cbt-treatment/ […]

Thanks for revealing your ideas. I might also like to mention that video games have been ever before evolving. Technology advances and inventions have aided create sensible and interactive games. These entertainment games were not really sensible when the actual concept was first being used. Just like other styles of technological innovation, video games too have had to advance by many ages. This is testimony for the fast growth of video games.

Great weblog right here! Also your site loads up fast!
What host are you the use of? Can I am getting your associate hyperlink on your host?
I want my web site loaded up as fast as yours lol

I blog quite often and I seriously appreciate your information. This article has truly peaked my interest.
I’m going to bookmark your website and keep checking for new
details about once per week. I opted in for your Feed as well.

Hiya, I’m really glad I have found this information. Nowadays bloggers publish only about gossips and internet and this is really irritating. A good site with exciting content, that is what I need. Thank you for keeping this web-site, I will be visiting it. Do you do newsletters? Cant find it.

Aw, this was a really nice post. In concept I want to put in writing like this additionally ?taking time and actual effort to make a very good article?but what can I say?I procrastinate alot and not at all appear to get something done.

First off I want to say awesome blog! I had a quick question that I’d like to ask if
you do not mind. I was curious to find out how you center yourself and clear your head before writing.
I’ve had a difficult time clearing my mind in getting my ideas
out. I do enjoy writing however it just seems like
the first 10 to 15 minutes tend to be wasted just trying to figure out how to begin. Any ideas or hints?
Thanks!

First of all I want to say great blog! I had a quick question in which I’d
like to ask if you do not mind. I was curious to find out how you center yourself and clear
your thoughts prior to writing. I have had a tough time clearing my thoughts in getting my
thoughts out there. I do take pleasure in writing
but it just seems like the first 10 to 15 minutes are
generally lost simply just trying to figure out how to begin. Any
recommendations or hints? Many thanks!

Does your site have a contact page? I’m having problems locating it but, I’d like to
shoot you an e-mail. I’ve got some ideas for your blog you might
be interested in hearing. Either way, great website and I look
forward to seeing it expand over time.

I like the valuable info you provide in your articles.
I will bookmark your weblog and check again here frequently.
I’m quite sure I’ll learn many new stuff right
here! Good luck for the next!

One more issue is that video games are usually serious naturally with the primary focus on mastering rather than enjoyment. Although, there’s an entertainment element to keep children engaged, each and every game is generally designed to work towards a specific expertise or curriculum, such as math concepts or scientific research. Thanks for your article.

Heya fantastic website! Does running a blog such as this take a large amount of work?
I have very little expertise in coding but I was hoping to start my own blog in the near future.
Anyway, if you have any suggestions or techniques for new blog owners
please share. I know this is off topic but I simply needed to ask.
Thanks a lot!

Appreciating the dedication you put into your site and in depth information you offer.
It’s great to come across a blog every once in a while that isn’t the same out
of date rehashed material. Fantastic read!
I’ve saved your site and I’m adding your RSS feeds to my Google account.

Good post. I learn something new and challenging on blogs I stumbleupon on a daily basis.
It’s always interesting to read through content from other authors and
use a little something from other web sites.

This is very interesting, You’re a very skilled blogger.

I have joined your rss feed and look forward to seeking more of your
great post. Also, I’ve shared your site in my social networks!

I抦 impressed, I must say. Actually not often do I encounter a blog that抯 both educative and entertaining, and let me tell you, you could have hit the nail on the head. Your idea is outstanding; the difficulty is one thing that not enough individuals are talking intelligently about. I’m very blissful that I stumbled throughout this in my seek for something referring to this.

You are so awesome! I do not believe I’ve truly read through a single thing like that before.
So wonderful to find someone with some unique thoughts on this issue.

Really.. thank you for starting this up. This site is something that’s needed on the internet,
someone with a little originality!

Thanks for any other informative website.

The place else could I get that type of information written in such a perfect
approach? I have a project that I am simply now running on, and
I’ve been at the glance out for such info.

An outstanding share! I have just forwarded this onto a coworker who had been doing a little research on this.
And he actually bought me dinner because I discovered it for him…
lol. So allow me to reword this…. Thank YOU for the meal!!

But yeah, thanx for spending the time to talk about this issue here on your site.

Excellent post. I was checking constantly this blog and I’m impressed!
Very useful information particularly the last
part 🙂 I care for such information much. I was seeking this particular
info for a very long time. Thank you and best of
luck.

That is a good tip especially to those new to
the blogosphere. Simple but very precise information… Appreciate your sharing this one.
A must read post!

Hey There. I found your blog the use of msn. This is an extremely well written article.
I’ll be sure to bookmark it and come back to learn more of your useful info.
Thank you for the post. I will definitely comeback.

Hmm it seems like your site ate my first comment (it was super
long) so I guess I’ll just sum it up what I had written and
say, I’m thoroughly enjoying your blog. I as well am an aspiring
blog blogger but I’m still new to the whole thing.
Do you have any points for inexperienced blog writers?
I’d certainly appreciate it.

Great blog! Is your theme custom made or did you download it from somewhere?
A theme like yours with a few simple adjustements would really make my blog stand out.

Please let me know where you got your design. Thanks

Hi there! Quick question that’s entirely off topic.
Do you know how to make your site mobile friendly?
My website looks weird when viewing from my
iphone. I’m trying to find a template or plugin that might be able to fix this problem.
If you have any suggestions, please share.
With thanks!

Hello, Neat post. There is a problem together with your web site in web explorer, might check this?

IE still is the marketplace chief and a large component to other people will leave out your excellent writing because of this problem.

It is the best time to make a few plans for the long run and it’s time to be happy.
I’ve read this post and if I may just I want to recommend you some fascinating
issues or suggestions. Maybe you could write subsequent articles regarding this article.
I desire to read even more issues about it!

Leave a Reply

Your email address will not be published. Required fields are marked *