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Attitudes and applications of chairwork amongst CBT therapists: a preliminary survey

Published online by Cambridge University Press:  15 July 2021

Matthew Pugh ,
Tobyn Bell Open the ORCID record for Tobyn Bell [Opens in a new window] ,
Glenn Waller Open the ORCID record for Glenn Waller [Opens in a new window]  and
Emma Petrova
Matthew Pugh*
Affiliation:
Central and North West London NHS Foundation Trust, London, UK
Tobyn Bell
Affiliation:
Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
Glenn Waller
Affiliation:
University of Sheffield, Sheffield, UK
Emma Petrova
Affiliation:
Central and North West London NHS Foundation Trust, London, UK
*
*Corresponding author. Email: matthewpugh@nhs.net
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Abstract

Chairwork refers to a collection of experiential interventions which utilise chairs, their positioning, movement, and dialogue to facilitate therapeutic change. Chair-based methods are used in several models of psychotherapy, including cognitive behavioural therapy (CBT). However, little is known about cognitive behavioural therapists’ use and attitudes towards chairwork. A mixed methods survey was conducted of 102 therapists who provided CBT. Overall, training in chairwork was weak amongst CBT therapists (35%). Quantitative results indicated that most therapists perceived chairwork to be clinically effective and consistent with the cognitive behavioural model, but did not feel competent using these methods. Perceived competence was highest amongst therapists who had been trained in chairwork and practised it frequently, but was unrelated to CBT accreditation or clinical experience. Qualitative feedback identified a number of factors that encouraged the use of chairwork (e.g. overcoming limitations associated with verbal restructuring methods), as well as inhibitors (e.g. therapist anxiety and limited access to training). These preliminary findings highlight a need for further research relating to cognitive behavioural chairwork and suggest that increased training in experiential interventions could go some way towards improving outcomes in CBT.

Key learning aims

As a result of reading this paper, readers should:

  1. (1) Understand cognitive behavioural therapists’ attitudes towards chairwork.

  2. (2) Appreciate therapists’ anxiety and avoidance in relation to chairwork.

  3. (3) Identify the key factors that facilitate or inhibit the use of cognitive behavioural chairwork.

Keywords

CBTchairworkrole playsurvey
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 14 , 2021 , e21
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

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References

Further reading

Pugh, M. (2019a). Cognitive Behavioural Chairwork: Distinctive Features. Oxon, UK: Routledge.CrossRefGoogle Scholar
Pugh, M. (2019b). A little less talk, a little more action. A dialogical approach to cognitive therapy. The Cognitive Behaviour Therapist, 12, 1–24.CrossRefGoogle Scholar

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