Me. Addis et Km. Carpenter, The treatment rationale in cognitive behavioral therapy: Psychological mechanisms and clinical guidelines, COG BEHAV P, 7(2), 2000, pp. 147-156
Clinical experience and an accumulating body of research suggest that clien
ts who enthusiastically buy into a cognitive-behavioral treatment (CBT) rat
ionale show more favorable outcomes. But how should a therapist present and
discuss a CBT rationale effectively? How does one respond to client concer
ns and doubts? What are the psychological processes operating when discussi
ng why a client is suffering and what to do about it? We suggest that the t
reatment rationale is a considerably more subtle and complex process than h
as previously been assumed. It involves generating expectations, negotiatin
g control and assigning blame, and its function may vary depending on the s
tage of treatment. We illustrate these points by considering common reactio
ns to a CBT rationale and alternative therapist responses. We conclude that
much closer attention should be paid to the treatment rationale in the con
text of research and clinical practice.