Study of the Socratic method during cognitive restructuring

AbstractCognitive restructuring, in particular in the form of the Socratic method, is widely used by clinicians. However, little research has been published with respect to underlying processes, which has hindered well‐accepted explanations of its effectiveness. The aim of this study is to present a new method of analysis of the Socratic method during cognitive restructuring based on the observation of the therapist's verbal behaviour. Using recordings from clinical sessions, 18 sequences were selected in which the Socratic method was applied by six cognitive–behavioural therapists working at a private clinical centre in Madrid. The recordings involved eight patients requiring therapy for various psychological problems. Observations were coded using a category system designed by the authors and that classifies the therapist's verbal behaviour into seven hypothesized functions based on basic behavioural operations. We used the Observer XT software to code the observed sequences. The results are summarized through a preliminary model which considers three different phases of the Socratic method and some functions of the therapist's verbal behaviour in each of these phases: discriminative and reinforcement functions in the starting phase, informative and motivational functions in the course of the debate, and instructional and reinforcement functions in the final phase. We discuss the long‐term potential clinical benefits of the current proposal. Copyright © 2010 John Wiley & Sons, Ltd.Key Practitioner Message:• This article highlights the relevance for clinicians to reflect on the mechanisms that explain the patient's change during therapy, to improve their professional practice.• It also highlights the importance of not using circular explanations to account for change.• This article proposes an alternative to the traditional explanation about the mechanisms that would explain change when the Socratic method is applied.• Additionally, it presents a preliminary descriptive model of the application of this therapeutic procedure emphasizing the hypothesized functions of therapist's verbal behaviour in each phase.• Finally, this work helps the clinician to understand cognitive change through change in the patient's verbalizations.