Cognitive Behavioral and Psychodynamic Therapies: Points of Intersection and Divergence

Abstract

Cognitive behavioral therapy (CBT) and psychodynamic therapy (PDT) are two major paradigms in the mental health care field. The present article reviews broad similarities and differences between each tradition while acknowledging that such generalizations may overlook heterogeneity within each. However, it is believed that a comparison between CBT and PDT is beneficial in dispelling myths about each tradition, fostering dialogue, encouraging further scholarship and research. While not an exhaustive account, this article will examine how CBT and PDT differ in how they view several topics such as the unconscious, the therapeutic alliance, the role of homework, symptom reduction, and therapeutic heuristics. Commentary is also offered on how research may be more effectively and collaboratively integrated with clinical work from both traditions. Future directions for partnership and improving mental health treatments are also discussed.

OMG, R U OK? Therapeutic Relationships between Caregivers and Youth at Risk on Social Media

“…For example, simply the beginning of a treatment may arouse patient’s expectations for symptom relief, which in turn inspire hope and motivation to change ( Arnkoff, Glass, & Shapiro, 2002 ). And above all, all approaches highlight the therapeutic alliance as an essential condition for treatment ( Pilecki, Thoma, & McKay, 2015 ). The quality of the relationship between patients and therapists is one of most researched therapeutic component, which has been proven to significantly contribute to outcomes of treatments, independent of the specific type of the examined therapy ( Norcross & Wampold, 2011 ).…”

Socioeconomic status and the therapeutic alliance: An empirical investigation using structural equation modeling

“…In psychodynamic therapies, the conceptualization of the therapeutic relationship traditionally places a greater emphasis on the importance of the potential for clients to reproduce important aspects of early important relationships in the relationship with the therapist (i.e., transference; Cooper, 1987, Saketopoulou, 1999). To facilitate this process, the traditional psychodynamic therapeutic stance emphasizes non‐judgmental neutrality and the “anonymity” of the therapist to a larger extent than what is the case in cognitive behavioral therapies (Pilecki et al, 2015). In contrast, the conceptualization of the therapeutic relationship in cognitive behavioral therapies stresses the collaborative nature of the therapeutic relationship, where the client and therapist both take active part in the formulation of treatment goals, the structuring of therapy sessions, and the development of homework exercises (J. S. Beck, 2020).…”

“…Based on the above, a tentative assumption is that the more active, direct, and open therapeutic approach employed in cognitive behavioral therapies might feel less strange to clients with lower education and less psychological mindedness compared to the therapeutic stance generally employed in psychodynamic therapies. In addition, the fact that psychodynamic therapies to a larger extent emphasize verbality, reflection, and introspection, whereas cognitive behavioral therapies are more goal oriented and emphasize direct behavior change (Pilecki et al, 2015), might lead to a stronger sense of estrangement from the therapy in lower SES clients receiving psychodynamic therapy, since the norms of introspection, verbality, and psychological mindedness are suggested to be less typical of clients with lower socioeconomic status (Sue & Sue, 2008).…”

Reconsidering Graduate Training and Clinical Practice: The Importance of Psychodynamic Thinking

“…The integration of different approaches has a rich history of interest. The Society for the Exploration of Psychotherapy Integration and the Journal of Psychotherapy Integration explore the strengths of various approaches (Pikecki, Thoma, & McKay, 2015). In their article "Cognitive Behavioral and Psychodynamic Therapies: Points of Intersection and Divergence," Pikecki and colleagues (2015) offer a candid look at the benefits of both cognitive-behavioral and psychodynamic therapies.…”