Eklektik Bir Psikoterapi Modeli: Bilişsel Analitik Terapiye Bir Bakış

Öz

Bilişsel Analitik Terapi 1980’li yıllarda Anthony Ryle tarafından geliştirilmiştir. Bilişsel Analitik terapi; psikanalitik nesne ilişkilerini, bilişsel terapiyi, davranışçı terapiyi, Vygotsky’nin sosyal öğrenme kuramını içine alan yenilikçi ve bütünleştirici bir model olarak ortaya çıkmıştır. Bu terapi modeli, kendi hayatı üzerinde kontrolünü kaybettiğini düşünen danışanlarda davranış, duygu ve düşünce örüntülerini işleyerek danışanın kendi hayatını yeniden formüle etmesini sağlamaktadır. Terapi süreci ilk oturumlar, çalışma oturumları ve sonlandırma olmak üzere üç aşamadan oluşmaktadır. Süreç; danışana ait formülasyon-diyagram geliştirme ve bu formülasyonu yeniden formüle etme temelinde ilerlemektedir. Bu süreç hem bireyin kendini tanıması hem de bireyin hayatına dair yeni bir bakış açısı geliştirmesi için önemlidir. Terapi süreci yapılandırılmıştır. Bu durum uygulayıcıya kolaylık sağlamaktadır. Bilişsel analitik terapiye dayalı yapılmış olan çalışmalarda; bu terapi modelinin borderline, fobi, anksiyete, obsesif kompulsif bozukluklar, depresyon ve yeme bozuklukları gibi problemlerle gelen danışanlar üzerinde olumlu etkisi olduğu sonucuna ulaşılmıştır. Bunun yanı sıra kurama getirilen eleştirilerden biri yapılan çalışmaların sınırlı olması ve literatürdeki bilimsel çalışmaların çoğunlukla kuramcının kendisinin çalışmalarından oluşmasıdır. Güncel kuramlardan olan bilişsel analitik terapi dünyada ve ülkemizde henüz yeterince tanınmamaktadır. Bu çalışmanın amacı, bilişsel analitik terapinin ülkemizde tanınmasını sağlamaktır. Bu kapsamda mevcut çalışmada bilişsel analitik terapinin tarihi ve gelişimine, kuramsal temellerine ve ilkelerine, temel kavramlarına, terapi sürecine ve terapide kullanılan ilkelere yer verilmiştir. Bilişsel analitik terapi ile ilgili yapılmış çalışmalar ve bu modele getirilmiş olan eleştirilerin yanı sıra terapist olmak için alınacak eğitim sürecine değinilmiştir.

Anahtar Kelimeler

• Bilişsel Terapi
• Analitik
• Eklektik
• Vyogotsky
• Sosyokültürel Gelişim Kuramı

An Eclectic Psychotherapy Model: A Brief Overview of Cognitive Analytical Therapy

Öz

Cognitive Analytical Therapy was developed by Anthony Ryle in the 1980s. Cognitive Analytical therapy; it has emerged as an innovative and integrative model that includes psychoanalytic object relations, cognitive therapy, behavioral therapy, and Vygotsky's social learning theory. This therapy model enables the client to reformulate her/his own life by processing patterns of behavior, emotions and thoughts in clients who think they have lost control over their own life. The therapy process consists of three stages: initial sessions, study sessions and termination. Process; it proceeds on the basis of the client's formulation-diagram development and reformulation of this formulation. This process is important both for the individual to know herself/ himself and to develop a new perspective on her/his life. The therapy process is structured. This situation provides convenience to the practitioner. In studies based on cognitive analytical therapy; It was concluded that this therapy model has a positive effect on clients who come with problems such as borderline, phobia, anxiety, obsessive-compulsive disorders, depression and eating disorders. In addition, one of the criticisms brought to the theory is that the studies are limited and the scientific studies in the literature are mostly composed of the studies of the theorist herself/himself. Cognitive analytical therapy, which is one of the current theories, is not known enough in the world and in our country yet. The aim of this study is to provide recognition of cognitive analytical therapy in our country. In this context, the history and development of cognitive analytical therapy, its theoretical foundations and principles, its basic concepts, the therapy process and the principles used in therapy are included in the present study. The studies on cognitive analytical therapy and the criticisms brought to this model, as well as the education process to be a therapist are mentioned.

Anahtar Kelimeler

• Cognitive Therapy
• Analytic
• Eclectic
• Vyogotsky
• Sociocultural Developmental Context

Kaynakça

1. Beebe, B. (1998) A procedural theory of therapeutic action: Commentary on the symposium ‘interventions that effect change in psychotherapy’. Infant Mental Health Journal, 19, 333–340.
2. Bell, L. (1999) The spectrum of psychological problems in people with eating disorders: an analysis of 30 eating disordered patients treated with Cognitive Analytic Therapy. Clinical Psychology and Psychotherapy, 6, 29–38.
3. Bennett, D., Parry, G.,Ryle, A. (2006). Resolving threats to the therapeutic alliance in cognitive analytic therapy of borderline personality disorder: A task analysis. Psychology and Psychotherapy: Theory, Research and Practice, 79(3), 395 418.
4. Chanen, A. M., Jackson, H. J., McCutcheon, L. K., Jovev, M., Dudgeon, P., Yuen, H. P., Clarkson, V. (2008). Early intervention for adolescents with borderline personality disorder using cognitive analytic therapy: randomised controlled trial. The British Journal of Psychiatry, 193(6), 477-484.
5. Clarke, S., Thomas, P., & James, K. (2013). Cognitive analytic therapy for personality disorder: randomised controlled trial. The British Journal of Psychiatry, 202(2), 129- 134.
6. Denman, C. (1995) What is the point of a formulation? C. Mace (Ed.) The Art and Science of Psychotherapy. London: Routledge.
7. Denman, C. (2001). Cognitive–analytic therapy. Advances in Psychiatric treatment, 7(4), 243- 252.
8. Freud, S. (1915). Instincts and Their Vicissitudes, The standart edition of the complete psychological works of Sigmund Freud, (14) 1914-1916, on the history of the psycho- analytic movement, papers on metapsychology and other works, 109-140.

9. Gansle, K. A. (2005). The effectiveness of school based interventions and programs: A meta- analysis. Journal of School Psychology, 43, 321-341.
10. Hamill, M., Ried, M., & Reynolds, S. (2008). Letters in cognitive analytic therapy: The patient's experience. Psychotherapy Research, 18(5), 573-583.
11. Jellema, A. (1999) Cognitive analytic therapy: developing its theory and practice via attachment theory. Clinical Psychology and Psychotherapy, 6, 16–28.
12. Kelly, G. A. (1955). The Psychology of Personal Constructs. New York: W.W. Norton & Company.
13. Llewelyn, S. (2003). Cognitive Analytic Therapy: time and process. Psychodynamic Practice, 9(4), 501-520.
14. Marriott, M., & Kellett, S. (2009). Evaluating a cognitive analytic therapy service; practice‐based outcomes and comparisons with person‐centred and cognitive‐behavioural therapies. Psychology and Psychotherapy: Theory, Research and Practice, 82(1), 57-72. Martin, E., Byrne, G., Connon, G., & Power, L. (2020). An exploration of group cognitive analytic therapy for anxiety and depression. Psychology and Psychotherapy: Theory, Research and Practice, e12299.
15. O'Keefe, P., & Berk, M. (2009). Writing letters to patients. Acta Neuropsychiatrica, 21(6), 314- 316.
16. Özakkaş, T. (2014). 13. Bütüncül terapi eğitimi, teorik dönem ders notları. İstanbul: Psikoterapi Enstitüsü.
17. Özakkaş, T. (2018). Alan kuramının diğer psikanalitik kuramlarla ilişkisi. Türkiye Bütüncül Psikoterapi Dergisi, 1(2), 1-28.
18. Öztan, N. (1989) Eklektik Bir Psikoterapi Modeli (Prochaska). Ankara Üniversitesi Eğitim Bilimleri Fakültesi Dergisi, 22(2), 801-820.
19. Rycroft, C. (1991). On selfhood and self awareness. In: Viewpoints, pp. 147–162. London: The Hogarth Press.
20. Ryle, A. (1979). The focus in brief interpretive psychotherapy: Dilemmas, traps and snags as target problems. British Journal of Psychiatry, 134, 46-64.
21. Ryle, A. (1985). Cognitive theory, object relations and the self. British Journal of Medical Psychology, 58, 1-7.
22. Ryle, A. (1991) Object relations theory and activity theory; a proposed link by way of the procedural sequence model. British Journal of Medical Psychology, 64, 307–316.
23. Ryle, A., & Beard, H. (1993) The integrative effect of reformulation: cognitive analytic therapy with a patient with borderline personality disorder. British Journal of Medical Psychology, 66, 249–258.
24. Ryle, A., & Low, J. (1993). Cognitive Analytic Therapy Stricker, G., Gold, J. R. (Ed.), Comprehensive Handbook of Psychotherapy Integration (syf: 87-100). New York: Plenum Press.
25. Ryle, A. (1995). Cognitive Analytic Therapy: Developments in theory and practice. John Wiley & Sons.
26. Ryle, A. (1998). Transferences and countertransferences: The cognitive analytic therapy perspective. British Journal of Psychotherapy, 14(3), 303-309. Ryle, A., & Kerr, I. B. (2003). Introducing cognitive analytic therapy: Principles and practice. John Wiley & Sons.
27. Sandhu, S. K., Kellett, S., & Hardy, G. (2017). The development of a change model of “exits” during cognitive analytic therapy for the treatment of depression. Clinical psychology & psychotherapy, 24(6), 1263-1272.
28. Shine, L., & Westacott, M. (2010). Reformulation in cognitive analytic therapy: Effects on the working alliance and the client's perspective on change. Psychology and Psychotherapy: Theory, Research and Practice, 83(2), 161-177.
29. Skinner, B. F. (1938). The Behavior of organisms: An experimental analysis. New York: Appleton-Century.
30. Sobell, L.C., Sobell, M.B., & Agrawal, S. (2009) Randomized controlled trial of a cognitive– behavioral motivational intervention in a group versus individual format for substance use disorders. Psychol Addict Behav, 23, 672-683.
31. Sutton, L. (2003). When late life brings a diagnosis of Alzheimer's Disease and early life brought trauma. A cognitive‐analytic understanding of loss of mind. Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice, 10(3), 156-164.
32. Terzi, Ş. I., & Tekinalp, B. E. (2013). Psikolojik Danışmada Güncel Kuramlar. Pegem Akademi: Ankara.
33. Türk, F., & Katmer, A. N. (2019). A Study on the Effectiveness of Coping with Test Anxiety Program Based on Cognitive-Behavioral Approach. International Journal of Evaluation and Research in Education, 8(4), 666-675.
34. Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes. M. Cole (Ed.). Harvard University Press: Cambridge.
35. Vygotsky, L. S. (1985). Düşünce ve Dil (çev. S.Koray). İstanbul: Sistem yay.
36. Wachtel, P. L. (2012). Bütüncül İlişkisel Psikoterapi Atölye Çalışması. İstanbul: Psikoterapi Enstitüsü Eğitim Yayınları.
37. Yıldırım, Z. E., & Sütcü, S. T. (2016). Madde ile ilişkili bozuklukların tedavisinde bilişsel davranışçı grup terapisi etkililiği: sistematik bir gözden geçirme. Psikiyatride Guncel Yaklasimlar-Current Approaches in Psychiatry, 8, 108-128.