Self-Awareness and Personal Development as a CBT Therapist
Many therapists might already be qualified in another modality before undertaking training in CBT, and so have done prior work on their own development. However, each modality can offer its own insights into personal process.
For example, a therapist who has already qualified in person-centred counselling will be accustomed to focusing on emotions. With the different focus on thoughts and behaviours, CBT theory, tools and techniques can add a new dimension to this.
Formulation
Just as the therapist uses guided discovery (based on Socratic questioning) during the client’s initial assessment to develop a case formulation, so it is helpful too to use this same model on self.
Applying the formulation to themselves allows the therapist to see how their emotions are preceded by thoughts and followed by behavioural patterns, sometimes locking them too into vicious cycles.
This can then lead to deeper work on self (often supported by personal therapy), identifying and working – for example – on predisposing factors, precipitating factors, protective factors and core beliefs.
While core beliefs can’t necessarily be changed – or at least not easily (since they are historic and hence very deep-rooted) – understanding where they come from can increase self-compassion, and enable us to identify which areas we can most easily change, so providing a greater sense of control and a solid first step to breaking vicious cycles.
Indeed, learning about the CBT model can really help therapists not only to identify and so ‘catch’ their own negative automatic thoughts, but also to observe how these impact on their emotions, physical sensations and behaviours, setting up maintenance cycles.
This in turn enables them to identify and use CBT tools and techniques to start to tackle these cycles – for example, using cognitive restructuring to replace irrational with rational thoughts, and from there using the alternative (balanced) thoughts to help overcome fears through a graded-exposure approach.
Learning about the CBT model can really help therapists not only to identify and so ‘catch’ their own negative automatic thoughts, but also to observe how these impact on their emotions, physical sensations and behaviours, setting up maintenance cycles.
Benefits of Self-Awareness in CBT
This has both personal and professional benefits for the therapist.
From a purely personal point of view, it can allow them to live more fully. And from a professional point of view, it can help them better understand how their clients might experience CBT, by having gone through the process themselves (accepting of course that each person is unique, and so will have an idiosyncratic presentation of thoughts/feelings/behaviours and experience of receiving CBT).
This can help the therapist to offer clients empathy, and also explain the CBT model, tools and techniques in a more user-friendly way.
Using CBT to develop their own self-awareness also helps ensure the therapist is a safe and ethical practitioner, helping them to notice any transference, countertransference or parallel process – and to tackle this before it becomes problematic for the therapeutic relationship or for the client’s own CBT work.
Self-awareness and personal development makes it far more likely that the therapist will quickly pick up on such risks (which might otherwise lead either to collusion or to relationship rupture, both of which are potentially damaging and not in the best service of the client).
Therapist self-awareness is also vital to offering the core conditions, and to building and maintaining an effective working alliance in CBT work.
Creating this alliance both offers the client a safe space to share their thought/feeling/behaviour patterns and establishes from the start the importance of collaboration between therapist and client.
Hazards of Use of Self in CBT
Potential hazards of use of self in CBT include transference, countertransference and parallel process, although the danger of these going unnoticed by the therapist and so jeopardising the working alliance is greatly reduced by thorough and ongoing personal-development work.
It is important to ensure that any strong transferential attitudes do not detract from the therapeutic relationship – by noticing patterns of relating, discussing these in supervision, and using congruence and immediacy to explore them with the client.
Self-Disclosure in CBT
Goldfried et al. (2003) see appropriate self-disclosure in CBT as an effective tool for facilitating client change and contributing to the therapeutic relationship, being used to promote learning, and to enhance therapeutic gains and the relationship.
Although CBT emphasises between-session change, therapist self-disclosure within the session can be an effective tool for strengthening the therapeutic bond and facilitating client change through reinforcement and modelling.
These authors suggest that therapist self-disclosure can be used to provide feedback on the interpersonal impact made by the client, enhance positive expectations and motivation, strengthen the therapeutic bond, normalise the client's reaction, reduce the client's fears, and model an effective way of functioning.
Self-disclosure may come in the form of immediacy, disclosing to the client how the therapist is experiencing them in the here-and-now, thus using the therapeutic relationship as a microcosm of how the client may relate to others in their life.
Or it may be based on the therapist’s personal/vicarious experience of existential reality as a human, using considered self-disclosure to gently challenge the client’s negative thoughts relating to how the client’s life compares with other people’s lives (often exacerbated through exposure to mainstream or social media).
Either way, awareness of our own thoughts, feelings and behaviours – and an ability to reflect on their origin and meaning, and to evaluate the usefulness to the client of sharing them – is vital to professional working as a CBT therapist.
Selective self-disclosure may also help produce relational depth, and so strengthen the working alliance – and hence collaboration – through demonstrating the therapist’s own humanness in terms of negative automatic thoughts and maintenance cycles.
This can also help the client feel hopeful and encourage them in developing their own internal CBT therapist. As in all modalities of therapy, it is important to observe appropriate boundaries when we consider self-disclosing, especially considering our own motivations for doing so.
Selective self-disclosure may help produce relational depth, and so strengthen the working alliance – and hence collaboration – through demonstrating the therapist’s own humanness in terms of negative automatic thoughts and maintenance cycles.
Importance of Self-Care
Another key way in which the therapist can use their own self in CBT work is to ensure they practise good self-care – both as an opportunity to model this to clients (so supporting them to break vicious maintenance cycles and establish virtuous ones) and as a way to offer their best service to them, so supporting ethical practice.
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Self-Awareness and Personal Development as a CBT Therapist
Reference
Goldfried M, Burckell L & Eubanks C (2003) ‘Therapist self-disclosure in cognitive-behavior therapy’, Journal of Clinical Psychology