Perceptions of Socratic and non-Socratic presentation of information in cognitive behaviour therapy

• Published in: Journal of behavior therapy and experimental psychiatry 2018-03, Vol.58, p.106-113
• Main Authors: Heiniger, Louise E., Clark, Gavin I., Egan, Sarah J.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Autonomy; Behavior modification; Cognitive behavioral therapy; Cognitive behaviour therapy; Cognitive therapy; Cognitive Therapy - methods; Efficacy; Empathy; Empathy - physiology; Female; Guided discovery; Helping behavior; Humans; Male; Middle Aged; Panic Disorder - therapy; Patient Education as Topic - methods; Patient Preference; Perceptions; Preference; Professional-Patient Relations; Socratic method; Socratic questioning; Therapeutic alliances; Therapists; Young Adult
• ISSN: 0005-7916; 1873-7943
• DOI: 10.1016/j.jbtep.2017.09.004

Socratic Method is a style of inquiry used in cognitive behavioural therapy (CBT) that encourages clients to reflect on their problems and draw conclusions from newly-gained insights. However, assumptions about the superior efficacy of Socratic Method over non-Socratic (didactic) approaches remain largely untested. The aim of this study was to compare the perceived helpfulness of therapists' questions, autonomy supportiveness, likelihood of engaging in therapeutic tasks and preference for Socratic Method versus a didactic approach using a video analogue and ratings of lay observers. The mediating effects of therapeutic alliance and empathy were also examined. Participants (N = 144, mean age = 37, SD = 13) completed an online survey where they rated two videoed therapy analogues. Socratic Method had higher mean scores on perceived helpfulness of therapists’ questions, autonomy supportiveness, and likelihood of engaging in therapeutic tasks and preference than didactic presentation. Perceived helpfulness and preference ratings were higher for Socratic Method after accounting for potential confounders. Perceived therapeutic alliance and empathy both mediated the effect of therapy condition on autonomy and engagement. The findings support the use of Socratic Method in CBT. •Assumptions about the benefits of Socratic Method in CBT remain largely untested.•This study evaluated perceptions of Socratic versus didactic therapy analogues.•Socratic Method condition was rated as more helpful, empathic and autonomy supporting.•Participants reported a preference for therapy which employs Socratic questioning.•The findings predominantly support the use of Socratic Method in CBT.