The Socratic Method in Cognitive Behavioural Therapy: A Narrative Review
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The Socratic Method has been described as an important component of CBT interventions yet an empirical case for its use has not been made. The objective of this paper is to review the role of the Socratic Method in CBT in four stages. First, a review of the literature describes how the Socratic Method is applied and defined within CBT, with assumptions regarding its proposed benefits identified. Second, a review of empirical literature demonstrates that multiple challenges to the evaluation of the Socratic Method exist and that no direct evidence supports the premise that it is beneficial in CBT. Evidence is examined which may suggest why the Socratic Method could be beneficial in therapy. Finally, the hypothesised function of the Socratic Method within therapy is discussed in reference to the Interacting Cognitive Subsystems framework. A number of avenues for future research are proposed in order to determine whether this potentially valuable therapeutic component contributes to the efficacy of CBT.
KeywordsCognitive therapy/CBT Socratic dialogue Socratic Method Socratic questioning Guided discovery
Compliance with Ethical Standards
Conflict of Interest
Gavin I. Clark and Sarah J. Egan declare that they have no conflict of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (national and institutional).
No animals were used in the present study.
- American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
- American Psychiatric Association. (2009). Treatment of patients with panic disorder (2nd ed.). Washington, DC: APA Practice Guidelines.Google Scholar
- Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). New York: Guilford Press.Google Scholar
- Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.Google Scholar
- Beck, A. T., Wright, F. D., Newman, C. F., & Liese, B. S. (1993). Cognitive therapy of substance abuse. New York: Guilford Press.Google Scholar
- Blackburn, I. M., James, I. A., Milne, D. L., Reichelt, F. K., Garland, A., Baker, C., & Claydon, A. (2000). Cognitive Therapy Scale-revised (CTS-R). Newcastle-upon-Tyne: Newcastle Cognitive and Behavioural Therapies Centre.Google Scholar
- Chi, M. T., De Leeuw, N., Chiu, M.-H., & LaVancher, C. (1994). Eliciting self-explanations improves understanding. Cognitive Science, 18(3), 439–477.Google Scholar
- DeRubeis, R. J., Webb, C. A., Tang, T. Z., & Beck, A. T. (2009). Cognitive therapy. In K. S. Dobson (Ed.), Handbook of cognitive–behavioral therapies (3rd ed., pp. 277–316). New York, NY: Guilford.Google Scholar
- Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. New York: Guilford Press.Google Scholar
- Frusha, C. E. (2002). Rhetoric of change: A Socratic rhetorical inquiry into family therapy dialogue. Dissertation Abstracts International: Section B—The Sciences & Engineering, 63(5-B), 2297.Google Scholar
- Goldin, P. R., Ziv, M., Jazaieri, H., Werner, K., Kraemer, H., Heimberg, R. G., & Gross, J. J. (2012). Cognitive reappraisal self-efficacy mediates the effects of individual cognitive–behavioral therapy for social anxiety disorder. Journal of Consulting and Clinical Psychology, 80(6), 1034–1040.PubMedCentralCrossRefPubMedGoogle Scholar
- Greenberger, D., & Padesky, C. A. (1995). Mind over mood. New York: Guilford press.Google Scholar
- Haubert, L. C., & Dobson, K. S. (2007). Treatment of depression and mechanisms of change: Strengthening the links among theory, research, and practice. Clinical Psychology: Science and Practice, 14(3), 247–251.Google Scholar
- Horvath, A. O., & Greenberg, L. S. (Eds.). (1994). The working alliance: Theory, research, and practice (Vol. 173). New Jersey: Wiley.Google Scholar
- Jarrett, R. B., Vittengl, J. R., Doyle, K., & Clark, L. A. (2007). Changes in cognitive content during and following cognitive therapy for recurrent depression: Substantial and enduring, but not predictive of change in depressive symptoms. Journal of Consulting and Clinical Psychology, 75(3), 432–446.PubMedCentralCrossRefPubMedGoogle Scholar
- Kennerley, H. (2007). Socratic method. Oxford, England: Oxford Cognitive Therapy Centre Essential Guides.Google Scholar
- Liness, S., & Muston, J. (2011). National curriculum for high intensity cognitive behavioural therapy courses. Department of Health. Retrieved from http://www.iapt.nhs.uk/.
- Mason, J. (2011). Cognitive engagement and questioning online. Education in a technological world: communicating current and emerging research and technological efforts. Formatex, Badajoz, Spain.Google Scholar
- Naeem, F., Phiri, P., Rathod, S., & Kingdon, D. (2010). Using CBT with diverse patients: Working with South Asian Muslims. In M. Mueller, H. Kennerley, F. McManus, & D. Westbrook (Eds.), Oxford guide to surviving as a CBT therapist. Oxford: Oxford University Press.Google Scholar
- Neimeyer, R. A., Kazantzis, N., Kassler, D. M., Baker, K. D., & Fletcher, R. (2008). Group cognitive behavioural therapy for depression outcomes predicted by willingness to engage in homework, compliance with homework, and cognitive restructuring skill acquisition. Cognitive Behaviour Therapy, 37(4), 199–215.CrossRefPubMedGoogle Scholar
- NICE. (2013). Clinical Guideline 159: Social anxiety disorder: recognition, assessment and treatment. London: National Institute for clinical excellence. www.nice.org.uk.
- Overholser, J. C. (2011). Collaborative empiricism, guided discovery, and the Socratic method: Core processes for effective cognitive therapy. Clinical Psychology: Science and Practice, 18(1), 62–66.Google Scholar
- Padesky, C. A. (1993). Socratic questioning: Changing minds or guiding discovery. Paper presented at the A keynote address delivered at the European Congress of Behavioural and Cognitive Therapies, London.Google Scholar
- Rachman, S. (1997). The evolution of CBT. In D. M. Clark & C. Fairburn (Eds.), The science and practice of CBT (pp. 3–26). Oxford: Oxford University Press.Google Scholar
- Rosé, C. P., Moore, J. D., VanLehn, K., & Allbritton, D. (2001). A comparative evaluation of socratic versus didactic tutoring. Proceedings of the 23rd Annual Conference of the Cognitive Sciences Society, Edinburgh, Scotland, UK (pp. 869–874).Google Scholar
- Roth, A. D., & Pilling, S. (2007). The competences required to deliver effective cognitive and behavioural therapy for people with depression and with anxiety disorders. London: HMSO, Department of Health.Google Scholar
- Schmidt, N. B., Woolaway-Bickel, K., Trakowski, J., Santiago, H., Storey, J., Koselka, M., & Cook, J. (2000). Dismantling cognitive–behavioral treatment for panic disorder: Questioning the utility of breathing retraining. Journal of Consulting and Clinical Psychology, 68(3), 417–424.CrossRefPubMedGoogle Scholar
- Slamecka, N. J., & Graf, P. (1978). The generation effect: Delineation of a phenomenon. Journal of Experimental Psychology: Human Learning and Memory, 4(6), 592–604.Google Scholar
- Teasdale, J. D. (1996). Clinically relevant theory: Integrating clinical insight with cognitive science. In P. M. Salkovskis (Ed.), Frontiers of cognitive therapy (pp. 26–47). New York: Guilford Press.Google Scholar
- Wells, A. (1997). Cognitive therapy of anxiety disorders: A practice manual and conceptual guide. New Jersey: Wiley.Google Scholar
- Westbrook, D., Kennerley, H., & Kirk, J. (2011). An introduction to cognitive behaviour therapy: Skills & applications. London: SAGE.Google Scholar
- Yengin, I., & Karahoca, A. (2012). What is Socratic method? The analysis of Socratic method through self determination theory and unified learning model. Global Journal on Technology, 2, 357–365.Google Scholar
- Young, J. (1990). Cognitive therapy for personality disorders: A schema-focused approach. Sarasota, FL: Professional Resource Exchange.Google Scholar
- Young, J., & Beck, A. (1980). Cognitive therapy scale: rating manual. Unpublished Manuscript.Google Scholar