Positive CBT: The Flip Side of the Coin

Positive Cognitive-behavioral therapy (PCBT) can be defined as a “strengths-based approach” with its roots in positive psychology. Its philosophy is based on the idea that we are capable beings and that we possess abilities within ourselves that influence behavior and our interpretation of experiences (Bannink, 2013).

Positive CBT versus CBT

Cognitive-behavioral therapy (CBT)’s main assumption is that our thoughts affect our emotion, which affect our behavior, which then have a direct result on our interpretation of that event. It has evolved to address a broad range of issues with an impressive body of evidence from research to support their resources, but their outcomes, specifically their long-term outcomes, is less successful than one would hope (The Journal of Happiness and Well-being, 2013).

Positive CBT (Bannink, 2012; 2013) is a recent combination, which has emerged because practitioners are looking for a way to move CBT forward in finding more long-term results. Positive psychology practitioners and coaches believe that it is the client’s abilities, strengths, and resources that are most important in helping them change as opposed to focusing on their limitations and deficiencies.

It draws on research and applications taken from positive psychology and solution-focused brief therapy (SFBT), simply described as finding the best route to take to know what works for the client (The Journal of Happiness and Well-being, 2013). It emphasizes the construction of solutions as opposed to the more traditional emphasis on analyzing problems.

CBT and Positive CBT (PCBT) also differ in their theoretical views.

CBT uses a logical positivist view where they view the foundations of science as being the most important kind of observations since it is objective and quantifiable. Positive CBT and SFBT use a social constructionist view, where it is the individual’s belief of what is real, such as his abilities and problems, that is constructed in communication with others (The Journal of Happiness and Well-being, 2013).

Positive CBT In Practice

The focus of Positive CBT is not on pathology, but like positive psychology itself, building on clients’ strengths and what works for them. It can be seen as the other side of the CBT coin.

Kuyken, Padesky, & Dudley (2009) state that CBT literature has a tendency to place greater emphasis on identifying precipitating, predisposing, and perpetuating factors for problems other than strengths; they argue that we should always be including strengths building resources for every case (The Journal of Happiness and Well-being, 2013).

This focus adds to the well-being of the clients, as you ask them to describe their preferred future and find solutions to reach their goals.

Positive CBT practitioners listen respectfully if a client wants to talk about problems, but they would not ask for details. In order to shift the attention, they may ask a question such as, “How is this a problem for you?” in order to change the client’s focus into talking about how they can meet their goals.

Another way to shift the attention is to gather all symptoms, problems, and complaints and then translate them into goals by asking the client, “What would you like to see next?” or “If these problems were not there, how would your life/relationship be different?”

Kuyken et al. (2009) proposes that positive CBT practitioners should notice strategies that clients employ in coping with problems in order start finding ways to build resilience. Settings goals is a great way to accomplish that because you help the client understand the process and it keeps them motivated to reach their goal.

The Positive CBT Therapist

A practitioner taking notes during his session.

Rather than being the only expert in the room that analyzes and advises, the positive CBT therapist’s role is seen as a co-expert where both practitioner and client work together to answer solution-focused questions.

The practitioner focuses his or her attention on positive reinforcement of strengths and solutions-talk, i.e. paying close attention to a person’s goal setting, possibilities, and strengths, and negative punishment of problem-talk, ie. not paying attention to to conversations about problems, weaknesses, and causes.

The alliance between the practitioner and client is obviously important, not only to build trust, but for creating an active and collaborative engagement to help the client. Positive CBT therapists should create a positive alliance by asking questions that extract useful information about strengths and solutions that are already present in the client’s life. For example questions such as:

Suppose tonight a miracle happens and your problems are all solved. But because you are asleep, you don’t know that this miracle happens. What will be the first thing you notice tomorrow morning that will tell you that this miracle has happened? What will be the first thing you notice yourself doing differently that will let you know that this miracle occurred?

and

When things are going somewhat better, what have you noticed that you or others do differently? What other consequences have you noticed?

set the tone for a more light-hearted conversation for the client and it activates their engagement in the conversation.

Upward Arrow Technique

Unlike the traditional downward arrow technique used in CBT, this technique is focused on positive reaction to a given situation.

The downward arrow technique follows questions, such as “What is the worst case scenario?” “What was bad about that experience”, while the upward arrow technique questions are, “How would you like to behave differently?” “What is the best outcome to this situation?”

Truthfully, it is quite difficult to find many therapists and practitioners who take on the role of Positive CBT. It is still very new, but its techniques look promising and effective. It can

You can also watch Aaron Beck, a pioneer of CBT, discuss the marriage between positive psychology and CBT.

Would Positive CBT fit in your practice? Let us know below!

References

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