Nailing Down Metaphors in CBT: Definition, Identification and Frequency

Area of Science:

• Psycholinguistics
• Clinical Psychology
• Cognitive Behaviour Therapy

Background:

• Metaphors are prevalent in psychotherapy, offering potential therapeutic benefits.
• Empirical research on metaphors in cognitive behaviour therapy (CBT) is limited due to definitional challenges and methodological difficulties.
• Previous research has often categorized metaphor identification as an art rather than a science.

Purpose of the Study:

• To quantify the frequency of metaphor use in a large sample of CBT sessions.
• To evaluate the reliability and utility of the Discourse Dynamics approach for identifying metaphors.
• To explore the role of metaphors in the therapeutic discourse of CBT.

Main Methods:

• Utilized the Discourse Dynamics approach to identify metaphors in 48 CBT session transcripts.
• Included data from 12 clients and 3 therapists.
• Assessed the reliability of metaphor identification using an independent rater.

Main Results:

• Metaphors occurred at a frequency of 31.5 per 1000 words in CBT conversations.
• Therapists used metaphors twice as often (21.2 per 1000 words) as clients (10.3 per 1000 words).
• The Discourse Dynamics approach demonstrated adequate reliability for metaphor identification.

Conclusions:

• Metaphors are demonstrably present in CBT sessions, with therapists being more frequent users.
• The Discourse Dynamics approach, while detailed, presents challenges in skill acquisition and yielded only adequate reliability.
• Further research is needed to enhance the reliability of metaphor identification and explore its therapeutic implications.