Cognitive-interpersonal therapy of Safran and Segal: its features
This type of therapy is used in some cases in patients with personality disorders.
Personality disorders involve abnormal functioning of the person that interferes significantly in all areas of his or her life. Their approach is a complex issue, and currently there are few therapies validated specifically for each disorder.
Even so, there are a large number of psychological therapies of different orientations that address personality disorders. Here we will learn about one of them, Jeremy Safran and Zindel Segal's Cognitive Interpersonal Therapy (CIT)..
We are going to know what elements are part of the TCI and how changes can be promoted in the person to increase their quality of life.
Cognitive-interpersonal therapy of Safran and Segal: features
Safran and Segal's Cognitive Interpersonal Therapy (1990) is a cognitive therapy that also integrates the interpersonal tradition initiated by Sullivan in 1953.
In this therapy an essential role is given to interpersonal aspects and to the therapeutic alliance in order to achieve the goals of the intervention. to achieve the goals of the psychological intervention. Although the therapy was not initially designed specifically for personality disorders, it is now a type of disorder that it addresses.
Safran and Segal's Cognitive Interpersonal Therapy (CIT) emphasizes the role of the therapeutic bond between therapist and patient, as well as the nature of the relationship between cognitive and interpersonal processes. As for the role of the therapist, this is not objective and neutral, but the therapist is understood as a human being with difficulties. is understood as a human being with difficulties and strengths, who will interact with the problems of the patient.who will interact with the patient's problems and weaknesses. This is constructivist epistemology.
On the other hand, TCI is based on an approach that promotes phenomenological exploration rather than interpretation.
Mechanisms of change
In Safran and Segal's Cognitive-Interpersonal Therapy three specific mechanisms of change are usedresponsible for the development of a new experience for the patient, which will involve "experiencing the self and others" in new ways. These three mechanisms are:
1. Decentering.
It is about experiencing one's own role in the construction of reality.
2. Experiential denial
Consists of refuting dysfunctional beliefs about the self and others based on new from new experiences.
3. Access to information about dispositions to action
It involves discovering aspects of one's own existence or inner life, of which one was previously unaware.
The aim of the three mechanisms is not so much the understanding or rational analysis of reality, but rather ways of finding new ways of experiencing it, also in relation to oneself and others.in relation to oneself and to others.
The therapeutic relationship
As discussed, the therapeutic relationship is a central element in Safran and Segal's cognitive-interpersonal therapy. All changes arising from the three mechanisms will be mediated by this relationship.
So, for example, think of a patient with an obsession that everyone criticizes him. If the therapist attempts to challenge such a belief in a critical way, will reinforce the patient's idea by acting as he thinks everyone does (against him)..
Theoretical models of therapy
Safran and Segal's cognitive-interpersonal therapy is based on an interpersonal and cognitive approach.
It is interpersonal because it starts from the basic assumption that human beings by nature are interpersonal and social beings, and that this has important implications for individual development, problems and psychotherapy.and that this has important implications for the development of the person, problems and psychotherapy.
On the other hand, it is a cognitive therapy because it emphasizes the way in which people construct mental representations of what they are experiencing, that is, of their experience.
In psychotherapy it is known that an adequate theoretical model together with an adequate application of its specific techniques are essential elements to produce and understand therapeutic change.
Structure of ICT: sessions
Another of the fundamental ideas of Safran and Segal's cognitive-interpersonal therapy is that cognitive processes that are detached from the affective experiences with which they were intertwined do not do not fully represent the patient's experiences. That is, if cognition and emotion are separated, the patient's experience will not be complete or real.
To address this, in the first sessions of the therapy (sessions 1-3), a mediated emotional exploration will be conducted. a mediated emotional explorationThe first sessions of therapy (sessions 1-3) will include a mediated emotional exploration, followed by cognitive-interpersonal restructuring (CRI) (in sessions 4-6). This CRI will focus on the patient's dysfunctional ideas and maladaptive relationship patterns. This is the core of Safran and Segal's cognitive-interpersonal therapy.
In the following sessions (7-9), the objective will be to promote the generalization of the changes outside the consultation room and in all areas of the patient's life. In addition, it is logically sought that the changes last over time. All this will be done through the exploration of the patient's interpersonal events (external to the consultation), as well as with the elaboration and assignment of behavioral experiments between sessions. behavioral experiments between sessions.
The last session (10) will be focused on recapitulating the therapeutic process, providing relapse prevention strategies and closing the intervention.
Results of TCI
Despite being a strong model in terms of its well-defined theoretical model, currently research has not shown sufficient empirical support for TCI, or at least not the one required in evidence-based clinical psychology.
Even so, there are different studies that support its efficacy in the general clinical population (with some clinical disorder) and in personality disorders.
(Updated at Apr 12 / 2024)