A comparative analysis of the therapeutic focus in cognitive–behavioral and psychodynamic–interpersonal sessions.

Abstract

This study compared therapeutic foci in a sampling of 30 cognitive-behavioral and 27 psychodynamic-interpersonal manual-driven treatments for depression. High-and low-impact sessions were coded for each client, with the Coding System of Therapeutic Focus. Results indicated that psychodynamic-interpersonal sessions focused more on such variables as emotion, patterns, incongruities, the impact that others made on clients, clients' expected reaction of others, the tendency to avoid therapeutic progress, therapists themselves, clients' parents, and links between people and time periods in clients' lives. Cognitive-behavioral sessions placed greater emphasis on external circumstances and clients' ability to make decisions, gave more support and information and encouraged between-session experiences, and focused more on the future. Relatively few differences emerged as a function of session impact. Results are discussed in terms of the different and similar theoretical conceptions of the change process.

Interpersonal process and outcome in variants of cognitive–behavioral psychotherapy

“…Qualitative comparison of the treatment profiles is consistent with research documenting similarities and differences in standard technical interventions (e.g., reflection, interpretation, advisement, and so on) associated with CBT versus PI therapy (Goldfried et al, 1997;Stiles & Shapiro, 1995;Wiser & Goldfried, 1996). In past studies, as in the present comparison, clear-cut distinctions between "brands" of treatment are often difficult to make based solely on empirical process variables.…”

“…Although previous research provides us with this prediction regarding hostile behaviors in general, results have not been entirely uniform in terms of specific SASB clusters. In addition, differences have been documented between typical verbal interventions used in psychodynamic and cognitive-behavioral therapies suggesting that different interpersonal stances may be associated with these two general treatment approaches (Goldfried, Castonguay, Hayes, Drozd, & Shapiro, 1997;Stiles & Shapiro, 1995;Wiser & Goldfried, 1996). Furthermore, Bordin (1979) has suggested that different kinds of client-therapist alliances (and, by implication, interpersonal processes) may be predictive of outcome in different therapies.…”

The pursuit of consensus in psychotherapy research and practice.

“…In comparative process studies that examined the differences between cognitive‐behavior therapy and psychodynamic‐interpersonal therapy, our own research group came up with findings that bear on this discrepancy between research and practice. In analyzing manual‐driven therapy sessions conducted within the context of a controlled clinical trial, we found clear, theoretically consistent differences between the two orientations, with few differences between high‐ and low‐impact sessions (Goldfried, Castonguay, Hayes, Drozd, & Shapiro, 1997). However, different findings emerged with a comparable process analysis involving master therapists working within a naturalistic setting, each of whom had been nominated by experts as a person from their own orientation to whom they would refer a friend or relative (Goldfried, Raue, & Castonguay, 1998).…”

Psychodynamic-Interpersonal Therapy: An Overview of the Treatment Approach and Evidence Base

“…For example, PIT has a greater focus on within session experiences and the client's past and current relationships and emotional issues compared to CBT that tends to focus on external situations and the future (Goldfried, Castonguay, Hayes, Drozd, & Shapiro, 1997). …”