COGNITIVE-BEHAVIOR THERAPY AND THE DIALOGUE OF SCIENCE The Science and Practice of Cognitive Behaviour Therapy D. M. Clark & C. G. Fairburn (Eds.), Oxford, England: Oxford University Press, 1997,437 pp. $47.50 (paperback). D. M. Clark and C. G. Fairburn have edited an extensive and well-documented text that attempts to scientifically ground the practice of cognitive-behavior therapy (CBT). As someone who holds to postmodern leanings, my interaction with this text gave rise to many questions, cautions, and feelings. First, all the contributors to the text succeeded in relating CBT to the scientific method. Second, Clark and Fairburn constructed a text that offered a solid theoretical base for CBT and documented application of the theory to specific clinical problems and disorders. Third, the language of therapy, medicine, pharmacology, and the scientific method led me to question where I might place this book among the many voices vying for attention in the postmodern world. I experienced this book as an important contribution to the modernist postmodernist dialogue. Science and Practice of Cognitive Behaviour Therapy is organized into two parts. The first section comprises five chapters that deal with theory and other general considerations while the second section addresses cognitive-behavior conceptualizations and therapeutic approaches to specific disorders. I will focus primarily on the first section and somewhat touch on the second. As D. M. Clark's preface indicates, the book seeks to link experimental science with the practice of CBT. Part I of the text, entitled "General Considerations," deals with issues that are primarily theoretical in nature. In chapter 1, S. Rachman traces the evolution of CBT. He outlines a historical process that begins with origins of behavior therapy, proceeds to the rise of cognitive therapy, and concludes with a merging of the two. In line with the spirit of the scientific method, Rachman discusses the importance of the empirical tradition within behavioral therapy that was also embraced by cognitive therapy. Rachman envisions a historical, developmental process in which "cognitive therapy [now] provides the content for behavior therapy." Moreover, Rachman offers D. M. Clark's theory of panic disorder as an example of a scientifically viable theory that contains both parsimony and comprehensive explanatory powers of the data pertaining to panic disorder. He concludes the chapter with a discussion of "future trends" and "growth points" where he envisions the need for cognitive reanalyses of specific disorders, linking CBT with neuroscience and a cognitive conceptualization of a wider degree of medical-psychological problems. In the second chapter, M. Gelder explores the scientific foundations for CBT. Gelder structures his chapter around three major areas: (1) the character of key cognitions in psychiatric disorders, (2) predictions concerning the roles of these cognitions, and (3) studies of the factors that maintain cognitions. Gelder believes that for CBT to continually develop, studies must be grounded in clinical as well as normal populations. True to the scientific method, Gelder argues for a move away from broader models of CBT and for a more focused approach based on clinical observations and abnormalities of cognition. Studies of psychopathology from a cognitive perspective would lean on the areas of cognitive science involving thinking, attention, memory, visual imagery, worry, and metacognition. In chapter 3, A. Mathews discusses the role of information-processing in cognition and emotion. In terms of science, Mathews views the information processing model as an important tool because it provides a framework for generating hypotheses and experimental methods for testing them. Mathews delineates the assumptions of the information-processing model, and then goes on to discuss biases in information processing (encoding, interpretation, and memory) as they relate to psychological disorders. …
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