Distinctive activities of cognitive–behavioral therapy: A review of the comparative psychotherapy process literature

The present review examined the comparative psychotherapy process literature in order to identify the distinctive activities of cognitive–behavioral (CB) treatment. Six techniques and interventions were found to distinguish CB from psychodynamic–interpersonal (PI) therapy: (1) use of homework and outside-of-session activities; (2) direction of session activity; (3) teaching of skills used by patients to cope with symptoms; (4) emphasis on patientsʹ future experiences; (5) providing patients with information about their treatment, disorder, or symptoms; and (6) an intrapersonal/cognitive (C) focus. Identifying the distinctive features of CB therapy can improve the measurement of process–outcome correlations by more accurately specifying and operationalizing the treatment-specific processes of CB treatment, help researchers differentiate between common and treatment-specific factors, and aid in development of more psychometrically sound instruments assessing adherence and competence in CB therapy. In addition, this review can improve training of CB therapists by providing a guide for clinical practice.