This book is a succinct and easy to read guide to understanding the core concepts of “Positive CBT” (PCBT). It is accessible to both clinicians who are familiar with the modality and those wanting to gain an initial understanding. The structure and flow of the book is simple to follow and each subsequent chapter builds understanding and knowledge while reinforcing important key messages. The book is broken into three sections: “Theory”, “Applications” and “More Applications” and is completed with a FAQ section that shows the author's appreciation for the realities of implementing this therapy in practice.
In the Theory section, the author clearly explains the research foundation for PCBT. This highlights the positive effect of helping clients build hope, positivity and optimism for their lives and the effect of “problem-focused” talk. A cogent review of the positive aspects of current CBT therapeutic modalities (e.g. dialectical behaviour therapy (DBT), acceptance and commitment therapy (ACT), and applied relaxation) is presented before the author describes her wish for PCBT and its impact on psychology (i.e. improved outcomes, reduced drop out, need for fewer sessions, and better wellbeing for therapists themselves).
A comparison of Traditional CBT (TCBT; e.g. Beck, Reference Beck1967) and PCBT is also offered to note the potential benefits that PCBT could have for the profession, over and above what is captured by current TCBT methods. However, at times this comparison appears simplistic and polarizing (examples from a comparison Table presented are: TCBT – “Clients’ view sometimes is not validated”, PCBT – “Clients’ view is validated (which makes letting go of a point of view easier)”; TCBT – “Focus on problems and weaknesses”, PCBT – “Focus on solutions and strengths” pp. 14–15).
The Application section covers the nature and aspects of the Therapeutic Alliance, Assessment, Changing Clients’ Views, Behaviour (“Doing”) and Feelings, Homework Assignments, Subsequent Sessions and the role of the PCBT Therapist. It contains a very helpful section on the importance of structuring an assessment interview to acknowledge and highlight the person's resources and skills already used for success, termed “finding exceptions”. The section on positive goal creation and the use of positive functional analysis (e.g. what is already working for the client) emphasizes the fundamental nature of PCBT and how this would positively benefit therapists and clients. Focus is also given to how to explore a client's level of motivation and need to adjust treatment accordingly with clear examples of how this is undertaken.
The More Applications section discusses population specific assessment and interventions covering the use of PCBT with individuals, groups, couples, children/adolescents, families and within the work place. This is helpful to gain insight into how many of the interventions and processes of PCBT are consistent across populations and only slight variations, as with TCBT, are needed to adapt the approach effectively. It also offers an interesting commentary on how this approach could help reduce depression and burnout for clinicians themselves.
Throughout the book the author uses helpful stories, metaphors and case vignettes to reinforce the effect of positivity, hope and optimism for human beings. She also discusses the helpful effect of positive future goal creation on improving therapy engagement and outcome. Furthermore, there are numerous suggestions for exercises/homework and “exception finding” questions to be used across population groups and motivational levels. Most CBT therapists will be familiar with many of these and recognize them as techniques used in their daily practice, while others may be new or offer a different perspective (i.e. PCBT). The appendices also offer helpful PCBT resources and protocols.
Overall, the concepts within this book appear to be well referenced from a wide variety of robust psychological research and theory. Indeed, the main themes of PCBT, including concrete positive goals led by the client, finding exceptions, hope, resilience, optimism, positivity, and the use of outcome measures/feedback, are clearly grounded in a strong evidence base. However, little empirical evidence is provided for the implementation of the treatment modality itself. Predominately anecdotal evidence from the author's own experience and discussion with other therapists who have undertaken the practice are instead offered.
This book offers a first step in beginning to understand PCBT, and in fact is the first book detailing this therapy (pp. 251). It was a refreshing read and highlighted the need of clinicians to regularly review their approach and push for positive psychological wellbeing for their clients and themselves beyond distress reduction.
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