In clinical practice, most therapists do not apply a standardized treatment protocol with a homogenous sample of individuals who share a common diagnosis. Instead, clinicians face a variety of clients and take an individualized approach to treatment. A recent study of the effectiveness of cognitive therapy under such “real world” conditions provides important support for the clinical use of cognitive therapy with clients who are diagnosed as having personality disorders… (pg. 102; Pretzer&Beck, 2005)
So what can we conclude from this discussion? There is consensus that personality disorders are prevalent in our society and they are resistant to treatment. Cognitive therapy, and the theory underlying it, has offered a promising avenue for further research. Given the significant impact of personality disorders on both individuals and society as a whole, any promising line of research deserves to be pursued vigorously.
Review of key points
- Personal construct theory emphasizes the cognitions that precede behavior, even more than one’s ability to accurately predict behavior.
- Kelly used the term man-the-scientist to describe how each person creates and tests representations of the world, in an effort to predict and control their environment.
- Our representations, or constructs, are open to revision, and there are always alternatives. The process by which we test and modify our constructs is called constructive alternativism.
- Personal construct theory begins with a fundamental postulate, which is then elaborated with eleven corollaries.
- Personal constructs regularly undergo transition, from ineffective constructs to more effective constructs. Problems with these transitions may result in feelings of threat, fear, guilt, or anxiety.
- There are two typical cycles of transition: the C-P-C Cycle and the Creativity Cycle. The first involves circumspection, preemption, and control. The Creativity Cycle requires beginning with loose constructions and then rapidly testing and pursuing new and effective constructs.
- Creativity appears to be an important component of healthy psychological functioning.
- Both the therapist and the client bring their own conceptualizations about therapy into the therapeutic process. The ultimate goal is to help the client generate movement forward, such that the process can continue after therapy has ended.
- In order to facilitate cognitive-behavioral therapy within his theoretical framework, Kelly developed an assessment tool known as the Role Construct Repertory Test and a therapeutic procedure known as fixed-role therapy.
- In diverse settings, it is essential for therapists to be familiar with cross-cultural issues related to therapy in order to understand the nature of a client’s constructs and schemas.
- Ellis proposed an ABC theory of personality: activating events lead to beliefs about a situation, and those beliefs lead to the consequences of the event.
- Rational emotive behavior therapy was designed to dispute the client’s irrational beliefs, thus leading to effective new philosophies, emotions, and behaviors.
- The straightforward nature of rational emotive behavior therapy, and Ellis’ willingness to write for a popular audience, was a major factor in establishing the self-help genera.
- Rational Recovery, based on rational emotive behavior therapy, was developed as an alternative to Alcoholics Anonymous. In particular, it does not include the religious requirements of AA.
- Rational emotive behavior therapy was challenged as being atheistic. Ellis later wrote that he is not opposed to spirituality, but he is opposed to dysfunctional, dogmatic religious beliefs that hinder one’s personal growth.
- Ellis openly challenged the value placed on self-esteem, suggesting instead that what is important is acceptance of ourselves, including our flaws and mistakes.
- Beck developed his cognitive therapy while conducting research on depression.
- Beck’s cognitive model is based on automatic thoughts, schemas, and cognitive distortions. Depression in particular results from a cognitive triad: a negative view of past, present, and future.
- Cognitive therapy offers an active, directive, time-limited, and structured approach to psychotherapy.
- Cognitive therapy involves collaborative empiricism and guided discovery. Hopefully, the client is able to learn skills that will allow them to continue improving their life even after therapy has ended.
- Acceptance and Commitment Therapy incorporates mindfulness into a modern therapeutic process, emphasizing the acceptance of one’s suffering in life followed by moving forward and living a values-based life. Radical Acceptance incorporates traditional Buddhist mindfulness practice (vipassana) into the therapeutic process.
