Integrative and Multimodal CBT

A BRIEF SYNOPSIS OF
INTEGRATIVE AND MULTIMODAL COGNITIVE-BEHAVIOR THERAPY

 

I. INTRODUCTION TO IM-CBT

Integrative and Multimodal CBT (IM-CBT) is not a new form of psychotherapy (or a new form of CBT), but a technologically immersed and a comprehensive approach of various “CBT Schools” and “CBT Waves” (i.e., a meta/generic approach), based on clinical cognitive neurogenetic and cross-cultural sciences (see for a general educational view: “A Brief History of Psychotherapy Movie“).

IM-CBT has been developed recently (see below the selected references – more specifically see David et al., 2010; David & Freeman, 2015) and it was stimulated by the Declaration of the 9th Congress of the International Association of Cognitive Psychotherapy in 2017 (See HERE for the Declaration and HERE for the Congress ).

IM-CBT is part of a more general movement towards a meta/generic science and practice of CBTs, beyond fragmentation in various “CBT Schools”, “CBT Waves”, and specific CBT protocols. In this movement, other representative meta/generic frameworks are Barlow’s Unified CBT Treatment Approach, Beck’s Generic CBT Model, Ellis’ Generic ABC Model (including Wessler, 1986), Hayes & Hofmann’s Process-Based CBT, Mennin’s Emotion Regulation CBT, etc. (and the movement is developing continuously, with more new meta/generic approaches). IM-CBT is mainly developed from the Beck and Ellis’ generic models, immersed with technology and clinical cognitive neurogenetic and cross-cultural sciences, thus being able to unite various schools/waves/protocols of CBTs.

IM-CBT is Integrative (see Figure 1), because, based on clinical cognitive neurogenetic sciences, various behavioral and cognitive theories are brought together in a coherent (often transdiagnostic) theoretical framework. Based on such an integration, comprehensive theory-driven cognitive case conceptualizations can be elaborated, guiding a more personalised psychological intervention. Also, the IM-CBT framework can stimulate research in the field, (1) to better understand the mechanisms described in Figure 1, following a multilevel framework, as presented by the Human brain: From cell to society Report of the European Science Foundation (see Figure 2) and (2) testing both the theory and the efficacy/effectiveness of specific IM-CBT psychological protocols (based on the model described in the Table 1 – see also David et al., 2018). Moreover, the new developments in clinical cognitive neurogenetic and cross-cultural sciences (and technology) are continuously assimilated and/or accommodated in IM-CBT.

IM-CBT is Multimodal (see Figure 1), because, based on a coherent integrated theory, various techniques could be used, based on a comprehensive theory-driven cognitive case conceptualization, in personalized evidence-based clinical psychological protocols (and such IM-CBT psychological treatments could be tested for their efficacy/effectiveness, based on the logic presented in Table 1):

 

Figure 1. The Integrative and Multimodal CBT Model, which can be used for (1) human optimization/development, (2) health promotion/prevention of health problems, and/or (3) treatment of subclinical (e.g., life problems) and clinical conditions. Notes: (1) The dysfunctional Schemas could be compensated by various defence mechanisms, which further induce biases; (2) The model can explain both health and illness.

 

Figure 2. A multilevel approach of human mind. (Dr. David was a contributor, part of the Steering Committee, of the Strategic Report “The human brain: From cell to society“, elaborated in 2012, under the umbrella of the European Science Foundation).

The basic clinical strategies of the IM-CBT are (see Figure 1):

Figure 3. A dynamic approach of IM-CBT (based on David & Freeman, 2015).

Table 1. Psychotherapy Classification Framework (based on David & Montgomery, 2011).

Notes:

  1. (a) Well-supported theories are defined as those with evidence based on (a) experimental studies (and sometimes additional ⁄ adjunctive correlational studies) and ⁄ or (b) component analyses, patient ・ treatment interactions, and ⁄ or mediation ⁄ moderation analyses in complex clinical trials (CCTs); thus, the theory can be tested independently of its therapeutic package (e.g., in experimental studies and sometimes their additional ⁄ adjunctive correlational studies) and ⁄ or during a CCT; ‘‘well supported’’ within this framework means that it has been empirically supported in at least two rigorous studies, by two different investigators or investigating teams.
  2. (b) Equivocal evidence for therapeutic package and ⁄ or theory means No (data not yet collected), Preliminary (there is collected data, be they supporting or contradictory, but they do not fit the minimum standards), or Mixed Data (MD; there is both supporting and contradictory evidence).
  3. (c) Strong contradictory evidence (SCE) for therapeutic package and ⁄ or theory means that it has been empirically invalidated in at least two rigorous studies, by two different investigators or investigating teams.
  4. (d) Well-supported therapeutic packages are defined as those with randomized clinical trial (or equivalent) evidence of their efficacy (absolute, relative, and ⁄ or specific) and ⁄ or effectiveness; ‘‘well supported’’ within this framework means that it has been empirically supported in at least two rigorous studies, by two different investigators or investigating teams.

II. IM-CBT – PRESENTATIONS/CONFERENCES/TRAINING/WORKSHOPS/PRACTICUM

IM-CBT is part of the curriculum in the International Institute for the Advanced Study of Psychotherapy and Applied Mental Health and its affiliated International Coaching Institute.

Various workshops/trainings in IM-CBT have been already presented and/or planned in Australia, Greece, Moldavia, Romania, Russia, Turkey, USA, etc.

Those interested in presentations/workshops/trainings in IM-CBT should contact Professor, Ph.D., Daniel David (daniel.david@ubbcluj.ro).

III. SELECTED REFERENCES RELATED TO THE DEVELOPMENT OF IM-CBT:

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