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10 Principles of Anxiety Disorder Therapy: Part 3 of 3
♦ Principle 8: Cognitive Therapy is Based on an Educational Model
of cognitive therapy is that one develops anxiety not because of unconscious motivations but because one has learned inappropriate ways of handling life experiences. This
premise suggests that with practice, one can learn more effective ways of leading
One of the therapist's functions is to educate. J. Singer
has expressed a similar view of psychotherapy: "In some ways the psychotherapist
can be viewed as a teacher, as well as a technician. This does not mean that he
gives formal lectures, for even good teachers know that they are not always the
best method of influencing their pupils" (1974, p. 23). It is helpful for
the therapist to view himself as a teacher of anxiety-management skills.
Cognitive therapy, in addition to providing corrective experiences for a patient,
incorporates didactic techniques such as providing information, assigning reading,
listening to audio tapes, written homework, and suggesting that the patient attend
Let's now talk about strategies for the client reluctant to
be taught by therapy. The client has to consent to learn before therapy can develop.
The reluctant client may argue with you or tune out what you are saying. When
I spot this problem, I need to address it. Here's how... I ask Lorraine if she
has ever been in a class where she made up her mind that she was not going to
let the teacher teach her anything. I then ask Lorraine to compare this experience
with the class where she gave the teacher permission to teach her.
of this problem is related to the amount of trust Lorraine had in me. Thus, the
first therapeutic order of business may be to develop trust in the patient by
setting up a system for feedback from her and by continually erring on the side
of honesty with her. The second step I ask Lorraine is how she could benefit by
allowing herself to learn.
For example, one thirty-five-year-old-man,
John, lived with his mother and had only a few dates in his life. He needed to
learn ways to deal with the opposite sex. The therapist focused on first
learning how to learn. The patient had to go places where he could meet women, but with the goal of learning as much about his reactions as possible. He first
had to find out how he was preventing himself from learning his experiences.
The therapist needs to help the patient learn how to remove or transcend the blocks
that have prevented him from learning from his experiences.
♦ Principle 9: Inductive Method
The theory and techniques of cognitive therapy
rely on the inductive method. In other words, the emphasis throughout therapy
is on the client's "getting the facts."
♦ Principle 10: Homework is a Central Feature of Cognitive Therapy
should explain to clients the practical reason for doing homework. The reason
I give is that once-a-week visits are insufficient for overcoming long-held anxieties.
Further, the rationale for particular assignments has to be explained, because
clients are unlikely to carry them out if there is any doubt about their potential
usefulness. I like to present homework as an experiment to prove or disprove a
hypothesis, such as the patient's belief that a traumatic experience will occur
if he faces the feared situation.
Current Diagnosis and Treatment of Anxiety Disorders
- Bystritsky, A., Khalsa, S. S., Cameron, M. E. (2013). Current Diagnosis and Treatment of Anxiety Disorders. P&T, 38(1). p. 30-57.
Peer-Reviewed Journal Article References:
Muir, H. J., Constantino, M. J., Coyne, A. E., Westra, H. A., & Antony, M. M. (2019). Integrating responsive motivational interviewing with cognitive–behavioral therapy (CBT) for generalized anxiety disorder: Direct and indirect effects on interpersonal outcomes.Journal of Psychotherapy Integration. Advance online publication.
Newman, M. G., & Fisher, A. J. (2013). Mediated moderation in combined cognitive behavioral therapy versus component treatments for generalized anxiety disorder.Journal of Consulting and Clinical Psychology, 81(3), 405–414.
Robichaud, M. (2010). Review of Cognitive therapy of anxiety disorders: Science and practice [Review of the book Cognitive therapy of anxiety disorders: Science and practice, by D. A. Clark & A. T. Beck, Eds.]. Canadian Psychology/Psychologie canadienne, 51(4), 282–283.
3 What is one method to motivate a client to do homework? To
select and enter your answer go toTest.