Adaptation Modification of Standard CT for Depression

According to J. S. Beck (1995), modifying "standard" CT for PDs involves using the therapeutic relationship as a means to improve overall current level of functioning. The term often applied to this clinical phenomenon is "therapeutic alliance." We divide the alliance into two parts, the therapeutic bond and the therapeutic relationship. The choice of using one or the other depends on the goals of the treatment, the disorder being treated, and the personal style of the patient. There may exist a bond but not an alliance. For example, the therapeutic bond (relationship) that works best with younger children may make older children suspicious. Patients with high levels of anxiety may need more relationship or contact. However, the bond alone is not sufficient for change. In working with more ego-syntonic issues such as those inherent in PDs, there may be far greater value in the therapeutic alliance, which requires that there be an agreement or contract on the goals, tasks, and focus of therapy.

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