Hmm, so do you mean that TEAM does not actually assume issues to necessarily have a positive function, the idea that they might have is just one way of overcoming resistance?
Based on these studies, I radically changed the approach to treatment that I’d been using for years, and developed the Paradoxical Agenda Setting (PAS) techniques that are now at the heart of T.E.A.M. Therapy. The PAS methods are beyond the scope of this document, (see Burns, 2005, for more information), but the basic idea is to melt away the patient’s resistance prior to using any techniques to help patients with their depression, anxiety, relationship conflicts, or habits and addictions.
To facilitate this process, I developed the list of the eight most common patterns of therapeutic resistance, as along with many techniques to reverse each pattern. Certainly more research is needed, but from a clinical perspective, these PAS techniques appear to have revolutionized treatment and have produced high-speed recovery for many patients who had failed to make significant progress after years of more conventional therapy, including “Beckian” CBT.
My colleagues and I are convinced that failures of Agenda Setting represent the most common cause of therapeutic failure. We also believe that the vast majority of therapeutic failures can be quickly and dramatically reversed with the skillful and compassionate use of the PAS techniques I’ve developed.
To me this view is not about whether issues have positive function.
David Burns also writes:
“Over the years, I’ve developed many techniques to help patients challenge and defeat the negative thoughts that trigger depression, hopelessness, and low self-esteem, as well as fears, phobias, anxiety, and feelings of panic. My treatment philosophy has always been to “fail as fast as you can,” since you can never predict what technique will work for what patient or problem.”
Burns seems to me agnostic about what issues really are about and just wants the therapist to try a bunch of different techniques and measure the effects.
TEAMs is more processed based then content based. It doesn’t depend on beliefs about the true nature of mental disease.
My thoughts on Prediction-Based Medicine are partly a extension of the ideas of TEAMs. The way Burns proposes TEAMs to be done involves patients filling out forms before and after sessions to allow the therapist to learn when he’s empathic and what results his actions have on his patients.
Filling out the forms in paper instead of doing that digitally means that it’s harder to do statistics and that it takes longer till the data that the patient filled out makes it to the therapist. If the therapist has to put down a probability on the patient having found the therapist empathic the therapist will be faster at learning when he’s perceived as empathic by their patients then if the therapist just sees the numbers. The same goes for other effects of their interaction with the patient.
My post on TOTE is also partly about the importance of fast feedback loops for therapists to develop treatment skills.
Besides process the theoretical beliefs of TEAM are: Empathy is really important, alliance between therapist and patient is really important and resistance to change has to be dealt with before actually doing the problem specific change-work.
If the therapist has to put down a probability on the patient having found the therapist empathic the therapist will be faster at learning when he’s perceived as empathic by their patients then if the therapist just sees the numbers.
I wonder how accurate these kinds of answers are going to be. At one point my self-improvement group was doing peer coaching sessions that involved giving your coach feedback at the end. I don’t remember our exact questions, but questions about the coach’s perceived empathy definitely sound like the kind of thing that could have been on the list.
I remember that when I’d been coached, I felt significantly averse to giving the person-who’d-just-done-their-best-to-help-me any critical feedback, especially on a trait such as empathy that people often interpret as reflecting on them as a person. I’d imagine that the status differential between a client and a therapist could easily make this worse, particularly in the case of clients who are specifically looking for help on something like poor self-esteem or excess people-pleasing. (Might not be a problem with patients who are there for being too disagreeable, though!)
Thanks, that’s useful. I’d heard of some other reconsolidation-fans read Burns’s new book and also highlight the “what’s good about this” aspect of it as CBT “also coming around” to the “positive purpose” idea. So then when I thought I saw it in this post as well, I assumed that to be correct. Especially since that would have helped explain why TEAM is so effective.
Though interestingly this makes me somewhat more interested in TEAM, since it’s obviously doing something different from what I already know, rather than just confirming my previous prejudices without adding new information. :-)
It doesn’t depend on beliefs about the true nature of mental disease.
Just a tiny correction here: CBT and TEAM both have the underlying assumption that your thoughts shape how you feel, which is an assumption about at least a part of the cause of mental diseases.
If you thought that for example depression was always just an imbalance in your neurochemistry, you’d never do a talk-based therapy and instead would focus on antidepressants.
Otherwise, I think your description of TEAM is spot-on.
Hmm, so do you mean that TEAM does not actually assume issues to necessarily have a positive function, the idea that they might have is just one way of overcoming resistance?
I take https://feelinggood.com/science-behind-t-e-a-m-therapy/ as a canonical source about what TEAM is about.
In it David Burns writes:
To me this view is not about whether issues have positive function.
David Burns also writes:
Burns seems to me agnostic about what issues really are about and just wants the therapist to try a bunch of different techniques and measure the effects.
TEAMs is more processed based then content based. It doesn’t depend on beliefs about the true nature of mental disease.
My thoughts on Prediction-Based Medicine are partly a extension of the ideas of TEAMs. The way Burns proposes TEAMs to be done involves patients filling out forms before and after sessions to allow the therapist to learn when he’s empathic and what results his actions have on his patients.
Filling out the forms in paper instead of doing that digitally means that it’s harder to do statistics and that it takes longer till the data that the patient filled out makes it to the therapist. If the therapist has to put down a probability on the patient having found the therapist empathic the therapist will be faster at learning when he’s perceived as empathic by their patients then if the therapist just sees the numbers. The same goes for other effects of their interaction with the patient.
My post on TOTE is also partly about the importance of fast feedback loops for therapists to develop treatment skills.
Besides process the theoretical beliefs of TEAM are: Empathy is really important, alliance between therapist and patient is really important and resistance to change has to be dealt with before actually doing the problem specific change-work.
I wonder how accurate these kinds of answers are going to be. At one point my self-improvement group was doing peer coaching sessions that involved giving your coach feedback at the end. I don’t remember our exact questions, but questions about the coach’s perceived empathy definitely sound like the kind of thing that could have been on the list.
I remember that when I’d been coached, I felt significantly averse to giving the person-who’d-just-done-their-best-to-help-me any critical feedback, especially on a trait such as empathy that people often interpret as reflecting on them as a person. I’d imagine that the status differential between a client and a therapist could easily make this worse, particularly in the case of clients who are specifically looking for help on something like poor self-esteem or excess people-pleasing. (Might not be a problem with patients who are there for being too disagreeable, though!)
Thanks, that’s useful. I’d heard of some other reconsolidation-fans read Burns’s new book and also highlight the “what’s good about this” aspect of it as CBT “also coming around” to the “positive purpose” idea. So then when I thought I saw it in this post as well, I assumed that to be correct. Especially since that would have helped explain why TEAM is so effective.
Though interestingly this makes me somewhat more interested in TEAM, since it’s obviously doing something different from what I already know, rather than just confirming my previous prejudices without adding new information. :-)
Just a tiny correction here: CBT and TEAM both have the underlying assumption that your thoughts shape how you feel, which is an assumption about at least a part of the cause of mental diseases.
If you thought that for example depression was always just an imbalance in your neurochemistry, you’d never do a talk-based therapy and instead would focus on antidepressants.
Otherwise, I think your description of TEAM is spot-on.