Further Reflections on the Complexities of Therapeutic Change Mechanisms in a Case Study of Social Phobia

Authors

  • Esben Hougaard
  • Vicki L. Jensen
  • Daniel B. Fishman

DOI:

https://doi.org/10.14713/pcsp.v9i3.1827

Keywords:

social phobia, cognitive-behavior therapy, group therapy, case study, clinical case study, change mechanisms, psychotherapy process

Abstract

The paper is a response to a commentary by Rogojanski and Rego (2013) on our case study of Sara (Jensen, Hougaard, & Fishman, 2013). Sara was a client who achieved a remarkable and durable change in her longstanding social phobia (SP) after short-term group cognitive-behavior therapy (CBT). Our response deals with the following topics: (1) safety behavior; (2) the idiographic arrangement of exposure as behavioral experiments; (3) acceptance as a mechanism of action in CBT; (4) the specific format of the Aarhus treatment program; and (5) recent advances in quantitative research on change mechanisms in CBT for anxiety disorders. We conclude that Rogojanski and Rego's commentary and our further reflections underline the original conclusion from our case study: that generally, change mechanisms in psychotherapy are highly complex, and that specifically, the data from Sara’s case could be consistent with several disparate theories of change mechanisms in CBT, revealing a high degree of overlap and  intertwining among the theories.

Author Biographies

Esben Hougaard

Vicki L. Jensen

Vicki Jensen

Daniel B. Fishman

Daniel B. Fishman

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Published

2013-10-27

Issue

Section

Part 1: The Case of "Sara"