On reviewing the material of the last two seminars, I decided to discus some of the similarities and differences between the specific techniques used by practitioners of cognitive behavioural therapy and narrative therapy, as these are two frequently used methods of therapy.

One cannot consider the techniques used by a therapeutic method fully without first considering the theoretical background of the method, as this influences what techniques that form of therapy will adopt. Cognitive Behavioural Therapy (CBT) draws on the phenomenological philosophy as propounded by Husserl (Leahy, 2003) whilst narrative therapy, according to Roberts & Holmes (1999) changes its theoretical background with the type of narrative used; psychodynamic narratives draw upon Freudian theories while feminist narratives draw upon feminist and Marxist critical theories. In general, Roberts and Holmes (1999) classify narrative therapy’s theoretical background as critical-constructivist. These theories are evident in the ways that therapists in the two modes of therapy approach the therapy sessions, for example the narrative therapist’s collaborative approach versus the CBT therapist’s more expert approach.

CBT is based on a model that hypothesises that psychiatric or psychologically dysfunctional states are maintained or aggravated by the patient’s thoughts and behaviours (Leahy, 2003). As mentioned in the post by J Pederick citing Merrick & Dattilio (2006), it is a popular, well- researched method that contains elements from other forms of psychotherapy. Narrative therapy is based on the hypothesis that the act of narration gives a patient insight into the reasons for the actions of the protagonists in their life (Lieblich, McAdams & Josselson, 2004). This insight creates an environment enabling the patient to acknowledge their own problems in a different light, and perhaps find a solution to them (Leiblich, McAdams & Josselson, 2004).

The techniques used in CBT can be broadly classified into those techniques eliciting cognitive changes and those eliciting behavioural changes. The CBT techniques used to achieve cognitive change include thought challenging, use of perspective, emotional processing techniques, and schema-focused therapy (Leahy, 2003). These methods are used after eliciting and evaluating the patient’s dysfunctional thoughts. Thought challenging techniques include challenging assumptions and rules, evaluating methods of processing information, errors of logic and cognitive distortions amongst others (Leahy, 2003). Emotional processing techniques include written ventilation, imagery rescripting, use of emotional schemas and narrative (Leahy, 2003). Schema- focused therapy includes activation of early memories, letter writing, motivation building, role play and use of alternative positive schemas (Leahy, 2003). Techniques used to achieve behavioural change include self-observation, stimulus control, response planning, flooding, relaxation, sanctions, aversion, positive reinforcement, exposure and time-outs to mention but a few (Lanyon & Lanyon, 1978, The Royal College of Psychiatrists, 1997, Caballo, 1998). Due to the wide range of techniques available for use in CBT and the wide variety of disorders which CBT is a treatment modality for, choice of techniques is disorder-specific (Caballo, 1998).