Psychoeducation

One important way that cognitive therapists develop a collaborative relationship is through the process of psychoeducation. Cognitive therapists generally want their patients to understand the treatment plan and, as far as they are able, to participate actively in establishing the course oftreatment. A

number of educational materials that highlight the model, value, and clinical utility of CT for depression have been developed for patients, including self-help books (Burns, 1980; Greenberger & Padesky, 1995; Young & Klosko, 1994), web-based materials (Academy of Cognitive Therapy, 2006), and computerized programs (Wright et al., 2002). Thus, in addition to the information that the therapist imparts over the course of therapy, a number of other methods exist to provide this information. It is often helpful to ask patients how they optimally learn new ideas (e.g., reading, video or audio materials, or direct experience), so that the therapist can tailor the delivery of psychoeducation to the patient's best advantage.

Psychoeducation is often a particular feature of early CT sessions. It is common during the initial session for the therapist to hear about difficulties or problems that fit fairly well into the CT model. These situations present the opportunity for the therapist to inform the patient about the role of thinking in depression, and possibly even to draw out a model of the patient's problem, using a diagram similar to Figure 1.1. This may also be an appropriate time to ask the patient whether he/she would like to read about the model. I like to assign Chapters 1 to 4 of Feeling Good (Burns, 1980) to interested patients, if they believe this is a reasonable task at this stage of therapy and for their level of depression.

Psychoeducation also takes place throughout the course of therapy. One of the defining characteristics of cognitive therapists is that they suggest to their patients what techniques or methods might be helpful to overcome depression, then obtain patients' reactions to these suggestions. Only if both therapist and patient think that the method might be helpful do they then collaboratively figure out how best to implement this idea, and work together to set appropriate homework. Through this process, the therapist needs to be able to describe the rationale for the techniques that he/she is proposing. This process also compels the patient to be more active in the treatment process, because he/she needs to think through what methods will and will not be effective, and to assume a role in the treatment implementation.

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