Theoretical Paper Working with the therapeutic relationship in cognitive behavioural therapy from an attachment theory perspective

Abstract

Content and FocusIn counselling psychology the therapeutic relationship is considered as one of the most fundamental aspects of psychological therapy. It can be argued that cognitive behavioural therapy (CBT) is a therapeutic modality which has given more attention to techniques and ‘doing’ therapy, rather than the therapeutic relationship itself. Unsurprisingly, this raises some questions on the use of the therapeutic relationship, especially when working purely from a CBT perspective. The current paper aims to briefly review how the therapeutic relationship is operating in CBT, and furthermore to discuss how attachment theory can inform the practice of counselling psychologists who work with CBT. For the purpose of this paper, I will discuss a composite client presentation based upon my clinical work with an individual who I have named ‘Tom’.ConclusionsOn the basis of the existing literature, it can be understood that views such as ‘the therapeutic relationship in CBT is necessary but not sufficient to bring about change’, are continuously changing. Therefore, the need for counselling psychologists who practise CBT in having a more relational focus in their practice is essential and attachment theory can assist them in working more with the therapeutic relationship.

Adaptation, Academic Performance and Support: Students with and without Disabilities and Future Considerations for Counselling Psychology

“…One of the most powerful therapeutic elements in counselling psychology, which can be utilised to achieve this goal, is the use of the therapeutic relationship [114], and there is a valid reason that we place the therapeutic relationship (TR) at the heart of applying psychological interventions. As a matter of fact, a respectable number of studies show TR to be one of the most reliable predictors of outcomes in many therapeutic approaches, including the discipline of counselling psychology [115][116][117]. Although it might be out of the scope of this paper to analyse how specifically TR can be utilised in the proposed package of interventions, we briefly present a basic theoretical proposition that is grounded in research and which could help us understand its association with our result.…”