Overcoming Blocks in CBT Psychotherapy
Ottavia Ferroni, Anna Bianca Prevedini
This article explores the use of acceptance and commitment therapy (ACT), relational frame theory (RFT), and functional analysis (FA) to overcome a block in CBT psychotherapy. Through the clinical case of a 15-year-old adolescent with learning disorders, social anxiety, and oppositional behaviour, the paper illustrates how a therapeutic impasse was resolved by analysing the patient’s verbal derived relational responses and conducting a functional analysis of both current interactions between therapist and patient and past interactions with attachment figures. This analysis revealed that therapist behaviours intended as reinforcement were, in fact, functioning as punishment. The clinical case serves as a prototypical example of blocks that may arise in CBT psychotherapy when the focus is primarily on the topography of desired behaviours — both those of the therapist (e.g., praise and positive feedback) and of the patient (e.g., agreed-upon therapeutic goals) — at the expense of their function. Core principles from relational frame theory (RFT), functional analysis (FA) of therapist-patient interactions, and a functional-analytic perspective on attachment, which highlights how the patient’s relational style can alter the stimulus functions of current therapeutic contingencies, are essential for overcoming such therapeutic blocks.
Keywords
ACT Processes, Functional analysis of behavior, Relational Frame Theory, Blocks, Adolescence.
