Communication in Cognitive Behavioral Therapy

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1 Communication in Cognitive Behavioral Therapy

2

3 Michela Rimondini Editor Communication in Cognitive Behavioral Therapy

4 Editor Michela Rimondini Department of Public Health and Community Medicine University of Verona Piazzale L.A. Scuro Verona Italy ISBN e-isbn DOI / Springer New York Dordrecht Heidelberg London # Springer Science+Business Media, LLC 2011 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Printed on acid-free paper Springer is part of Springer Science+Business Media (

5 Preface There are certainly several books that address the topic of interpersonal communication in the healing context, from a theoretical as well as pragmatic perspective. The peculiarity of the present manual is that it deepens the process of communication in the specific setting of Cognitive Behavioral Therapy (CBT). In psychotherapy the ability to explore and share meanings through a masterful use of communication skills is the main tool in the hands of the clinician. Specific therapeutic strategies such as debating or cognitive restructuring are effective insofar as the clinician shows proficiency in illustrating and applying them through a proper patient centered language. The main aim of this handbook is to provide to the reader a comprehensive overview of the core issues regarding patient therapist communication in CBT, moving from the basic assumption of inter-correlation between research, teaching and clinical activity. Indeed, for several reasons that widen from economical to ethical aspects, an evidence based clinical practice is strongly advocated by patients and healthcare providers. This brings to the need to overcome the methodological difficulties that historically discouraged research of communication in psychotherapy and to promote the development of methods capable to capture the complexity of this multifaceted process. Nevertheless the available clinical evidences and the knowledge collected up to know, have to be spread out to experienced and inexperienced healthcare providers, applying updated teaching methods based on adult learning models. For this reason this book has been written by many different hands, since I have brought together a number of experts in psychotherapy, teaching and research coming from various backgrounds. Therefore the reader will be asked to navigate through the heterogeneity of styles that characterizes each chapter, in order to grasp the common denominator that integrate and collapse all contributions together. Nonetheless each chapter is intended as a stand-alone, not necessarily connected with the previous or the following, for the purpose of prompting answers to highly targeted and specific questions, without implying the reading of the whole book. Hopefully according to this aspect, the volume will be useful to a variety of users, ranging from statisticians or researchers interested in methods of analysis v

6 vi Preface of therapist patient communication, to faculties involved in the teaching of psychotherapy as well as of course to all those approaching at different levels of expertise and title CBT (psychologists, psychiatrists, counselor, nurses, etc...). The book is divided into three main sections, introduced by a general synopsis where the main background theories in interpersonal communication and a selection of the existing systems of analysis of communication in psychotherapy are presented. Part 1 focuses on the core verbal and non verbal communication (Chap. 5) skills applied during the consultation with patients, according to the three main functions of a clinical encounter, which are data gathering (Chap. 2), relationship building (Chap. 3) and information giving (Chap. 4). Part 2 shifts the focus from the general description of communication skills in clinical setting to the analysis of their application in the three main disorder areas: mood disorders (Chap. 6), anxiety disorders (Chap. 7) and psychosis (Chap. 8). Finally, Part 3 collapse together teaching and research insights, offering an outline of the existing methods and evidences. Chapter 9 contains a detailed description of learnercentered techniques that can enhance teaching in psychotherapy. The last chapters treat the theme of how to analysis the communication process in CBT following two different approaches: quantitative (Chap. 10) and qualitative (Chap. 11). Michela Rimondini

7 Contents 1 Background Theories and Main Systems of Analysis of Communication in Cognitive-Behavioral Therapy... 1 Michela Rimondini 2 Assessment Stage: Data Gathering and Structuring the Interview Claudia Goss, Alberto Rossi, and Francesca Moretti 3 Building the Working Alliance in Brief Psychotherapies Christa Zimmermann and Hanneke De Haes 4 Providing Information and Involving the Patient in the Therapeutic Process Claudia Goss and Francesca Moretti 5 Nonverbal Communication in Clinical Contexts Arnstein Finset and Lidia Del Piccolo 6 Communication in Depressive States Franco Baldini 7 Interpersonal Vicious Cycles in Anxiety Disorders Angelo Maria Saliani, Barbara Barcaccia, and Francesco Mancini 8 Cognitive-Behavioral Family Interventions in Psychosis Juliana Onwumere and Elizabeth Kuipers 9 Learner-Centered Interactive Methods for Improving Communication Skills Jonathan Silverman and Michela Rimondini vii

8 viii Contents 10 Quantitative Methods for the Analysis of Verbal Interactions in Psychotherapy Maria Angela Mazzi 11 Qualitative Methods for the Analysis of Verbal Interactions in Psychotherapy Rolf Wynn and Svein Bergvik Index

9 Contributors Barbara Barcaccia Associazione di Psicologia Cognitivia APC, Rome, Italy Franco Baldini Associazione di Psicologia Cognitiva, Svein Hugo Bergvik Department of Clinical Psychiatry, University of Tromsø, Tromsø, Norway Hanneke De Haes Department of Medical Psychology, Academic Medical Centre, Amsterdam, The Netherlands Lidia Del Piccolo Arnstein Finset Department of Behavioural Science in Medicine, University of Oslo, Oslo, Norway Claudia Goss Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology Organisation, University of Verona, Elizabeth Kuipers Department of Psychology, Institute of Psychiatry, King s College London, London, UK Francesco Mancini Associazione di Psicologia Cognitivia APC, Rome, Italy ix

10 x Contributors Maria Angela Mazzi Francesca Moretti Juliana Onwumere Department of Psychology, Institute of Psychiatry, King s College London, London, England Michela Rimondini Alberto Rossi Angelo Maria Saliani Associazione di Psicologia Cognitivia APC, Rome, Italy Jonathan Silverman School of Clinical Medicine, Addenbrooke s Hospital, Cambridge, UK Rolf Wynn Institute of Clinical Medicine (FT), University of Tromsø, Tromsø, Norway Christa Zimmermann

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