Re:Contraindications for Cognitive Therapy

There aren't that many contraindications to CT. It is a flexible approach which can be used effectively with a wide range of problems and populations. Obviously, adjustments need to be made when working with different age groups, and different problems, but if appropriate adjustments are made, CT can be used with most clients.

Here are a few contraindications which come to mind:

1. CT relies heavily on verbal interventions. If an individual is not verbally communicative, it will be difficult to use CT effectively. If the client is non-communicative due to severe depression or psychosis, appropriate medication may be needed to get the client to the point where they are communicative enough for CT to be effective.

2. CT relies on abstract thought a fair amount. If an individual's capability for abstract thought is limited by neurological impairments, a more behavioral approach may be needed.

3. For some problems, such as schizophrenia and bipolar disorder, the client needs to take appropriate medication in order for CT to be effective. If the individual cannot be persuaded to take their medication consistently, CT may be contraindicated. However, CT often can be quite useful in improving compliance with medication.

4. CT is a collaborative approach where therapist and client work together towards mutually agreeable goals. If a client initially is not motivated to change or cannot identify goals towards which he or she is willing to work, therapy needs to begin with the therapist working to establish a collaboraitve relationship, to elicit motivation for change, and helping the client to identify goals towards which he or she is willing to work. Usually it is possible to elicit motivation for change and identify mutually agreeablt goals. However, if this cannot be done, it is difficult to do CT effectively.

5. Sometimes an individual enters with strong preconceptions about what type of treatment they need. Is they are convinced that they another approach (for example, exploring childhood conflicts) and are not willing to give CT a good try, it probably is pointless to try to force CT upon them. If they are skeptical but are willing to give CT a try, they often are pleasantly surprised.

These are the main contraindications I can think of at the moment, I'd encourage others to suggest other contraindicatiosn which come to mind.

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