IMPROVING COGNITIVE THERAPY FOR DEPRESSION WITH FUNCTIONAL ANALYTIC-PSYCHOTHERAPY - THEORY AND CASE-STUDY

A behavioral reconceptualization of cognitive therapy is presented to illustrate that clinical behavior analysis (CBA) has much to offer tra ditional cognitive behavior therapy. Particular attention is given to the distinction between cognitive structures and products and the theo retical dilemma facing cognitive therapists when they attempt to devis e interventions aimed at changing nonbehavioral entities. The distinct ion between rule-governed and contingency-shaped behavior and the impl ications of functional analytic psychotherapy (Kohlenberg & Tsai, 1991 ) are used to resolve the dilemma and to suggest methods for enhancing cognitive therapy. In a case study, a CBA-enhanced version of cogniti ve therapy was introduced after 7 weeks of standard cognitive treatmen t for a 35-year-old depressed male. The client-therapist relationship provided opportunities during the therapy session for learning new beh avior called for in the behaviorally reconceptualized cognitive therap y. The enhanced treatment improved clinical efficacy and increased the client's focus on his deficits in interpersonal repertoires. Because the present case study involved only one of several enhancements sugge sted by CBA, the possibility of increased efficacy from a more compreh ensive application is discussed.