Review of the book entitled Manual de terapias cognitivo-comportamentais

BOOK REVIEW

Review of the book entitled Manual de terapias cognitivo-comportamentais

Patrícia Picon

MSc. in Epidemiology, Harvard University, Boston, USA. PhD in Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Associate professor, Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.

^{Correspondence}

Keith S. Dobson (org.)

Porto Alegre, Artmed, 2006, 2ª edição

Keith. S. Dobson, PhD, is a professor and head of Clinical Psychology at the Department of Psychology of Calgary University, in Alberta, Canada. He is a researcher in depression and cognitive-behavioral psychotherapy, with more than a hundred publications. In this book, an updated version of the first edition in 1988, Dobson groups the works by 23 authors in the area of cognitive-behavioral psychotherapy. The authors belong to renowned academic centers in the USA, Canada and England. Among them, we can cite Aaron T. Beck and Robert J. DeRubeis, at University of Pennsylvania; Albert Ellis, at Albert Ellis Institute of Rational Emotive Behavior Therapy, in New York; Larry E. Bleutler, Roslyn Caldwell, Joan Davdson T. Mark Harwood and Jacqueline B. Persons, at University of California; Windy Dryden, at University of London; and Kirk R. Blanstein and Zindel V. Segal, at University of Toronto.

As a researcher and clinician in the area of cognitive-behavioral psychotherapies, Dobson, over the past 2 decades, had the opportunity of witnessing the growth of clinical richness, as well as advances in efficacy evaluation of his intervention models, as mentioned in the preface. The editor stresses the importance of innovations in cognitive-behavioral psychotherapies and claims that this book reflects such growth. This book aims at approaching cognitive-behavioral therapies from a theoretical perspective, avoiding the type of book model in which psychiatric disorders serve as an organizer for exposure of differentiated treatments. The idea is to explore the growth of many cognitive-behavioral models, providing an updated conceptual framework to interested readers.

Dobson considers cognitive-behavioral psychotherapy as that intervention based on the mediational model, i.e., in which a cognitive change should mediate or lead to a behavioral change. He stresses that some psychotherapies have a more cognitive focus, others are more behavioristic, but that they all search for adaptive changes and that evaluation of outcomes is still essential. Dobson acknowledges the considerable resistance against implementation of empirical psychotherapeutic practices, but supports the current tendency of using empirical criteria to indicate different cognitive-behavioral psychotherapies.

The first part of the book deals with conceptual issues and is divided into five chapters: historical and philosophical bases of the cognitive-behavioral therapies; cognitive assessment: issues and methods; cognitive-behavioral case formulation; cognition and clinical science: from revolution to evolution; and cognitive-behavioral therapy and psychotherapy integration. Chapter five was written by Larry E. Beutler, T. Mark Harwood and Roslyn Caldwell, who basically discuss about the different eclectic approaches of cognitive-behavioral psychotherapies. The authors describe casual eclecticism as the most widely used, however the least systematized approach. They refer that theoretical integrationism is largely practiced, but since it is too abstract, it finds difficulties in providing clear and practical guidance to implement training protocols. Systematic eclecticism, on the other hand, may be discredited for being limited and atheoretical. In this chapter, the authors propose that the theoretical and practical bases of cognitive and cognitive-behavioral psychotherapies, especially the cognitive therapy by Aaron Beck and his followers, provide the theoretical framework and platform of techniques necessary to develop strategic eclectic interventions that can be measured.

Cognitive therapy was developed by Aaron Beck, at University of Pennsylvania, in the early 1960's, as a brief, structured psychotherapy oriented to the present, to depression, guided to solve current problems and change dysfunctional behaviors. Since then, Beck and his followers have been successfully adapting this therapy to a surprisingly varied set of populations and psychiatric disorders, maintaining its basic theoretical presuppositions.¹

In the fifth chapter of the book organized by Dobson, its authors also stress the need of increasing specificity of cognitive and cognitive-behavioral psychotherapy procedures, thorough a higher integration of such procedures to dimensions such as level of limitation, resistance, coping style and patient's level of impairment. Thus, recommendations related to treatment frequency and length, degree of directiveness, focus on symptoms or schematic thoughts and attention to hot cognitions may help increase the effects of cognitive therapy.

The second part of the book has six chapters describing self-management therapies, problem-solving therapies, cognitive-behavioral therapy with youth, rational emotive behavior therapy, cognitive therapy, and varieties of constructivism in psychotherapy.

According to Abreu & Roso, constructivist cognitive conceptions presuppose that work of significance is firstly subordinate to influence of emotions, and not to dialectic of reason. In this theoretical conception, mind functioning not only reflects the outside world, but also transposes it, attributing meanings that often do not have their origins in stimulus itself. Thus, internal reality will be seen as fundamentally derived from how each individual emotionally feels the world, and not only how the world is rationally conceived. In constructivism, emotions find a more central role and precede rational construction of the individual's perception of the world and of himself, as suggested by the cognitive theory developed by Aaron Beck, in which emotions derive from thinking standards that, based on beliefs, guide people on their interpretation of situations they are exposed to.²

In the second part of the book organized by Dobson, chapters are written either by those who developed the different cognitive-behavioral approaches, such as Aaron Beck & Albert Ellis, or by renown experts in each of these therapies. All chapters bring comprehensive reviews, which include, besides historic aspects, description of theoretical models, main techniques and results of efficacy researches with updated data.

References

• 1. Beck J. Terapia cognitiva: teoria e prática. Porto Alegre: Artmed; 1997.
• 2. Abreu CN, Roso M. Psicoterapias cognitiva e construtivista: novas fronteiras da prática clínica. Porto Alegre: Artmed; 2003.

Publication Dates

• Publication in this collection
  31 Mar 2008
• Date of issue
  Dec 2007