Blog: Principles and Protocols
Principles are broad guidelines based on the concepts of theory and research. Protocols are specific interventions for specific problems.
Most of evidence-based CBT has been developed for a diagnosis: depression, panic, social anxiety, PTSD, substance abuse. Participants in research studies are typically homogeneous groups with one diagnosis. This “controls” for the diagnosis so that protocols can be tested and researchers can be confident that the protocol is effective for this type of patient. Very important, but there is an inherent limitation. In real world clinical practice, these diagnostically “pure” patients don’t show up very often. Instead, we see heterogeneous patients with depression, AND anxiety, AND a personality disorder. Or, maybe someone suffering from PTSD who also has depression, AND substance abuse, AND something else.
Flexible CBT is about fitting protocols to patients, rather than trying to fit patients to protocols. It starts with the seven Fixed Values that provide a framework. Principles help you determine priorities for treatment in the context of an individual patient’s needs, which in turn inform your decision-making to choose a protocol to address a specific problem. When you run into roadblocks, the principles help you stay focused on the priorities of treatment while you’re figuring out ways to tweak things to be more effective for your patient.
Principles and Protocols are introduced in MODULE 2.
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Posted by Ed on Dec 22, 2010