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Third Wave CBT Integration for Individuals and Teams: Comprehend Cope and Connect Isabel Clarke and Hazel Nicholls Routledge, 2017 ISBN: 978-1138226890

Published online by Cambridge University Press:  27 May 2019

Nicola McGuire
Affiliation:
Glasgow Mental Health Research Facility
Claire Matrunola
Affiliation:
Glasgow Mental Health Research Facility
Charles Heriot-Maitland
Affiliation:
Glasgow Mental Health Research Facility
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Abstract

Type
Book Review
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019 

Comprehend Cope and Connect (CCC) provides a welcome alternative to the traditional medical model of psychopathology, skilfully weaving together insights from ‘Third Wave’ approaches, into a practical format for application in clinical settings. Initially developed in response to pressures on National Health Service mental health services, it presents itself as a scaffold, integrating existing ‘Third Wave’ therapies for differing levels of intensity – examples of both simple and complex cases are given, along with its use in both inpatient and outpatient services.

The book is in three sections. The first introduces the foundations and theory behind CCC, chapters six to nine act as a manual for the delivery of interventions, and is followed by a discussion of how this model has been implemented in practice.

Rather than being technique-specific, CCC is an overarching framework to assist with the delivery of therapy. There is an emphasis on the human-to-human relationship between therapist and client. This creates space where individuals can openly explore what about their current experience is so distressing that it leads to them behaving and coping in certain ways. The model draws on aspects from therapies that focus on the here and now (cognitive behavioural therapy) and the importance of early life experiences (psychodynamic, cognitive analytic therapy).

Through identifying a ‘horrible feeling’ at the centre of the formulation, therapist and client map out triggers, past experiences and identify cyclical patterns of thoughts, feelings and behaviours. This helps to identify what may be required for change, and the skills needed to reduce or break these cycles.

CCC is flexible and applicable to a range of individuals in different settings with differing belief systems. It normalises behaviours that individuals may have developed as coping strategies in response to intolerable internal states. This offers a validating and non-pathologising stance, which places the individual at the centre of the solution.

The second section is a manual for the delivery of CCC, taking the reader systematically through formulation and intervention stages, with helpful suggestions for homework tasks and feedback. It outlines skills-work, predominantly facilitated in groups, starting with basic coping skills, moving on to relationship skills, and including the self-self relationship.

Finally, there are case examples and resources provided for delivering the therapy. The authors are honest about the challenges of implementing the model and explore ways in which adapting the framework has been helpful in a variety of services. In this sense, CCC is not offered as a panacea for mental health difficulties, but rather encourages therapists and clients to determine what elements of CCC are useful for them, given their own resources and experiences.

Although the book is written primarily for clinicians, it is accessible to a range of audiences due to its relatively non-technical language, helpful structure, and clear explanation of important concepts. However, given that many aspects of the model are drawn from existing ‘Third Wave’ therapies, it would be helpful, although not essential, for readers to have a basic understanding of these.

Although there is a strong focus on relationships being at the centre of the self, there is no mention of work with family or other key people in the client’s life. Also, although group work is helpful in terms of cost-effectiveness, this may not suitable for everyone, and it might have been helpful for the book to have more guidance on applications for CCC outside of group formats (e.g. individual, those involving families/carers, and self-help formats).

Overall, this book gives a thoughtful exploration of how we can humanise services and recognise the validity and importance of individual’s unique experiences. It makes headway in identifying practical solutions for psychologically informed working in the bustling, often under-resourced, reality of mental health settings.

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