Safran And Segal’s Cognitive-interpersonal Therapy: Its Characteristics
Personality disorders imply an abnormal functioning of the person that significantly interferes in all areas of their life. Its approach is a complex issue, and currently there are few therapies specifically validated for each disorder.
Even so, there are a large number of psychological therapies of different orientations that address personality disorders. Here we will know one of them, Jeremy Safran and Zindel Segal’s Cognitive-Interpersonal Therapy (TCI)
Let’s learn what elements are part of TCI and how changes can be promoted in the person to increase their quality of life.
Safran and Segal cognitive-interpersonal therapy: characteristics
Safran and Segal’s Cognitive-Interpersonal Therapy (1990) is a cognitive therapy that also integrates the interpersonal tradition that Sullivan began in 1953.
In her an essential role is given to interpersonal aspects and the therapeutic alliance to achieve the objectives of psychological intervention. Although the therapy was not initially designed specifically for personality disorders, it is currently one type of disorder it addresses.
Safran and Segal’s Cognitive-Interpersonal Therapy (CIT) places its emphasis on the role of the therapeutic bond between therapist and patient, as well as the nature of the relationship between cognitive and interpersonal processes. Regarding the role of the therapist, this is not objective and neutral, but the therapist is understood as a human being with difficulties and strengths, which will interact with the patient’s problems and weak points. This is constructivist epistemology.
On the other hand, TCI is based on an approach that promotes phenomenological exploration rather than interpretation.
Change mechanisms
In Safran and Segal’s Cognitive-Interpersonal Therapy three specific change mechanisms are used, responsible for the development of a new experience for the patient, which will involve “experiencing self and others” in new ways. These three mechanisms are:
1. Decentering
It is about experiencing one’s own role in the construction of reality.
2. Experiential denial
Consists in challenge dysfunctional beliefs about self and others from new experiences.
3. Access to information on dispositions to action
It involves discovering aspects of one’s own existence or inner life, of which one was previously not aware.
The purpose of the three mechanisms is not so much the understanding or rational analysis of reality, but ways to find new ways to experience it also in relation to oneself and others.
The therapeutic relationship
As mentioned, the therapeutic relationship is a central element in Safran and Segal’s cognitive-interpersonal therapy. All the changes that arise as a result of the three mechanisms will be mediated by this relationship.
So, for example, let’s think about a patient with the obsession that everyone criticizes him. If the therapist attempts to challenge such a belief critically, will reinforce the patient’s idea by acting as he thinks everyone does (against him)
Theoretical models of therapy
Safran and Segal’s cognitive-interpersonal therapy is based on an interpersonal and cognitive approach.
It is interpersonal because it is based on the basic premise that Human beings by nature are interpersonal and social beings and that this has important implications for the development of the person, problems and psychotherapy.
On the other hand, it is a cognitive therapy because it emphasizes the way in which people build mental representations of what they are experiencing, that is, their experience.
In psychotherapy, it is known that an adequate theoretical model, together with an adequate application of its specific techniques, are essential elements to produce and understand therapeutic change.
TCI structure: sessions
Another of the fundamental ideas of Safran and Segal’s cognitive-interpersonal therapy is that the cognitive processes that are separated from the affective experiences with which they were intertwined They do not fully represent patients’ experiences. That is, if cognition and emotion are separated, the patient’s experience will not be complete or real.
To address this, in the first sessions of therapy (sessions 1-3) there will be a mediated emotional exploration, to later carry out the cognitive-interpersonal restructuring (CIR) (in sessions 4-6). This RCI will focus on the patient’s dysfunctional ideas and maladaptive relationship patterns. This is the core of Safran and Segal’s cognitive-interpersonal therapy.
In the following sessions (7-9), the objective will be to promote the generalization of the changes outside the consultation and in all areas of the patient’s life. Furthermore, it is logically sought that the changes last over time. All of this will be done through the exploration of interpersonal events of the patient (external to the consultation), as well as with the elaboration and assignment of behavioral experiments between sessions
The last session (10) will focus on recapitulating the therapeutic process, providing relapse prevention strategies and closing the intervention.
Despite being a strong model in terms of its well-defined theoretical model, currently research has not demonstrated sufficient empirical support for ICT, or at least not what is required in evidence-based clinical psychology.
Even so, there are different studies that support its effectiveness in the general clinical population (with some clinical disorder) and in personality disorders.
