Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-23T06:01:45.081Z Has data issue: false hasContentIssue false

Knowing our ‘ABCs’: self-reflection using cognitive-behavioural formulation of client–therapist interaction in work with a survivor of torture

Published online by Cambridge University Press:  14 May 2015

Faith Martin*
Affiliation:
Department of Clinical Psychology, University of Bath, Bath, UK
Sobia Khan
Affiliation:
Freedom from Torture West Midlands, Unit 5 Caroline Point, Birmingham, UK
*
*Author for correspondence: Dr F. Martin, Department of Clinical Psychology, 6 West, University of Bath, Bath BA2 7AY, UK (email: faithmartin@nhs.net)

Abstract

Self-reflection can aid therapist development, particularly interpersonal skills. It can be achieved through using cognitive-behavioural therapy techniques, for example, formulations of the therapist's cognitions and behaviours have been used to aid self-reflection. As interpersonal skills may be an area that benefits from self-reflection, an approach to formulating the interaction between client and therapist may be beneficial. This study reports the use of simple ‘antecedent-belief-consequence’ (ABC) formulations for the client and therapist to conceptualize their interaction. This description of a treatment failure focuses on cross-cultural work with a survivor of torture, where self-reflection may be particularly indicated to promote cultural competence and address the impact of the content on the therapist. ABC formulations for the client and therapist were completed and through this structured self-reflection, the therapist was able to identify the impact of her own beliefs on the process of therapy. This method identified areas for further development and generated hypotheses for how to continue therapy with this client. Using ABC formulations then may provide a useful and structured way to conduct self-reflection with explicit focus on the interaction between client and therapist.

Type
Practice article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

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

Recommended follow-up reading

Bennett-Levy, J, Thwaites, R, Chaddock, A, Davis, M (2009). Reflective practice in cognitive behavioural therapy: the engine of lifelong learning. In: Reflection in Counselling and Psychotherapy (ed. Stedmon, J. & Dallos, R.), pp. 115135. Maidenhead: Open University Press.Google Scholar
Moon, JA (2008). Reflection in Learning and Professional Development: Theory and Practice. New York: Routledge.Google Scholar

References

Bennett-Levy, J (2006). Therapist skills: a cognitive model of their acquisition and refinement. Behavioural and Cognitive Psychotherapy 34, 5778.CrossRefGoogle Scholar
Bennett-Levy, J, Thwaites, R (2007). Self and self-reflection in the therapeutic relationship. In: The Therapeutic Relationship in the Cognitive Behavioral Psychotherapies (ed. Gilbert, P. & Leahy, R. L.), pp. 255281. Hove, East Sussex: Routledge.Google Scholar
Bennett-Levy, J, Turner, F, Beaty, T, Smith, M, Paterson, B, Farmer, S (2001). The value of self-practice of cognitive therapy techniques and self-reflection in the training of cognitive therapists. Behavioural and Cognitive Psychotherapy 29, 203220.CrossRefGoogle Scholar
Betancourt, JR, Green, AR, Carrillo, JE, Ananeh-Firempong, O (2003). Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports 118, 293.Google Scholar
Brown, LS (2008). Cultural Competence in Trauma Therapy: Beyond the Flashback. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
Chadwick, P (2006). Person-based Cognitive Therapy for Distressing Psychosis. Chichester, UK: John Wiley & Sons.CrossRefGoogle Scholar
Courtois, CA (2008). Complex trauma, complex reactions: assessment and treatment. Psychotherapy: Theory, Research, Practice, Training 41, 412425.Google Scholar
Dossa, NI, Hatem, M (2012). Cognitive-behavioral therapy versus other PTSD psychotherapies as treatment for women victims of war-related violence: a systematic review. Scientific World Journal. Article ID 181847. doi.org/10.1100/2012/181847.Google Scholar
Ehlers, A, Clark, DM (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy 38, 319345.CrossRefGoogle ScholarPubMed
Ehlers, A, Grey, N, Wild, J, Stott, R, Liness, S, Deale, A, Handley, R, Albert, I, Cullen, D, Hackmann, A, Manley, J, McManus, F, Brady, F, Salkovskis, P, Clark, DM (2013). Implementation of Cognitive Therapy for PTSD in routine clinical care: effectiveness and moderators of outcome in a consecutive sample. Behaviour Research and Therapy 51, 742752.Google Scholar
El-Leithy, S (2014). Working with diversity in CBT. In: How to Become a More Effective CBT Therapist: Mastering Metacompetence in Clinical Practice (ed. Whittington, A. & Grey, N.), pp. 4462. Chichester, UK: John Wiley & Sons.Google Scholar
Ertl, V, Pfeiffer, A, Schauer, E, Elbert, T, Neuner, F (2011). Community-implemented trauma therapy for former child soldiers in Northern Uganda: a randomized controlled trial. Journal of the American Medical Association 306, 503512.CrossRefGoogle ScholarPubMed
Ghanean, H, Nojomi, M, Jacobsson, L (2011). Internalized stigma of mental illness in Tehran, Iran. Stigma Research and Action 1, 1117.Google Scholar
Grey, N, Young, K (2008). Cognitive behaviour therapy with refugees and asylum seekers experiencing traumatic stress symptoms. Behavioural and Cognitive Psychotherapy 36, 319.CrossRefGoogle Scholar
Grey, N, Young, K (2010). Post-traumatic stress disorder. In: Mental Health of Refugees and Asylum Seekers (ed. Bhugra, D., Craig, T. & Bhui, K.), pp. 177194. Oxford: OUP.CrossRefGoogle Scholar
Haarhoff, B (2006). The importance of identifying and understanding therapist schema in cognitive therapy training and supervision. New Zealand Journal of Psychology 35, 126.Google Scholar
Herman, L (1997). Trauma and Recovery. New York: Basic Books.Google Scholar
Kennerley, H, Mueller, M, Fennell, M (2010). Looking after yourself. In: Oxford Guide to Surviving as a CBT Therapist (ed. Mueller, M., Kennerley, H., McManus, F. & Westbrook, D.), pp. 5782. Oxford: OUP.Google Scholar
Laireiter, A-R, Willutzki, U (2003). Self-reflection and self-practice in training of cognitive behaviour therapy: an overview. Clinical Psychology & Psychotherapy 10, 1930.Google Scholar
Lauber, C, Rössler, W (2007). Stigma towards people with mental illness in developing countries in Asia. International Review of Psychiatry 19, 157178.CrossRefGoogle ScholarPubMed
Leahy, RL (2008). The therapeutic relationship in cognitive-behavioral therapy. Behavioural and Cognitive Psychotherapy 36, 769.Google Scholar
Leahy, RL (2009). Emotional schemas in treatment-resistant anxiety. In: Treatment Resistant Anxiety Disorders: Resolving Impasses to Symptom Remission (ed. Sookman, D. & Leahy, R.), pp. 135164. London: Routledge.Google Scholar
Meaden, A, Hacker, D (2010). Problematic and Risk Behaviours in Psychosis: A Shared Formulation Approach. London: Routledge.Google Scholar
NICE (2005). Post-traumatic stress disorder (PTSD): the management of PTSD in adults and children in primary and secondary care (CG26). London: National Institute for Health and Clinical Excellence.Google Scholar
Neuner, F, Kurreck, S, Ruf, M, Odenwald, M, Elbert, T, Schauer, M (2009). Can asylum-seekers with posttraumatic stress disorder be successfully treated? a randomized controlled pilot study. Cognitive Behaviour Therapy 39, 8191.Google Scholar
Nicholl, C, Thompson, A (2004). The psychological treatment of post traumatic stress disorder (PTSD) in adult refugees: a review of the current state of psychological therapies. Journal of Mental Health 13, 351362.Google Scholar
Nickerson, A, Bryant, RA, Silove, D, Steel, Z (2011). A critical review of psychological treatments of posttraumatic stress disorder in refugees. Clinical Psychology Review 31, 399417.Google Scholar
Novin, S, Banerjee, R, Dadkhah, A, Rieffe, C (2009). Self-reported use of emotional display rules in the Netherlands and Iran: evidence for sociocultural influence. Social Development 18, 397411.Google Scholar
Paunovic, N, Öst, L-G (2001). Cognitive-behavior therapy vs exposure therapy in the treatment of PTSD in refugees. Behaviour Research and Therapy 39, 11831197.CrossRefGoogle ScholarPubMed
Robjant, K, Fazel, M (2010). The emerging evidence for narrative exposure therapy: a review. Clinical Psychology Review 30, 10301039.CrossRefGoogle ScholarPubMed
Ruiz, P, Gupta, S, Bhugra, D (2010). Dealing with cultural differences. In: Mental Health of Refugees and Asylum Seekers (ed. Bhugra, D., Craig, T. & Bhui, K.), pp. 105114. Oxford: OUP.Google Scholar
Schauer, M, Neuner, F, Elbert, T (2005). Narrative exposure therapy: a short term intervention for traumatic stress disorders after war, terror or torture. Göttingen, Germay: Hogrefe & Huber.Google Scholar
Slobodin, O, de Jong, JT (2014). Mental health interventions for traumatized asylum seekers and refugees: What do we know about their efficacy? International Journal of Social Psychiatry. Published online: 27 May 2014. doi:10.1177/0020764014535752.Google Scholar
Stallworthy, P (2009). Cognitive therapy for people with post-traumatic stress disorder to multiple events. In: A Casebook of Cognitive Therapy for Traumatic Stress Reactions (ed. Grey, N.), pp. 194212. Hove, East Sussex: Routledge.Google Scholar
Vaughn, L (2010). Psychology and Culture: Thinking, Feeling and Behaving in a Global Context. Hove, East Sussex: Psychology Press.Google Scholar
Weck, F, Grikscheit, F, Jakob, M, Hofling, V, Stangier, U (2014). Treatment failure in cognitive-behavioural therapy: therapeutic alliance as a precondition for an adherent and competent implementation of techniques. British Journal of Clinical Psychology. Published online: 13 August 2014. doi:10.1111/bjc.12063 Google Scholar
Worrell, M (2014). What to do when CBT isn't working? In: How to Become a More Effective CBT Therapist: Mastering Metacompetence in Clinical Practice (ed. Whittington, A. & Grey, N.), pp. 146160. Chichester, UK: John Wiley & Sons.Google Scholar
Young, K (2009). Cognitive therapy for survivors of torture. In: A Casebook of Cognitive Therapy for Traumatic Stress Reactions (ed. Grey, N.), pp. 247264. Hove, East Sussex: Routledge.Google Scholar
Submit a response

Comments

No Comments have been published for this article.