Abstract
Metaphors are common in psychotherapy. The last decade has seen increasing interest in the use of metaphor in
cognitive behaviour therapy (CBT), with attention to client metaphors being asserted as a way of enhancing CBT. However, prior to
this current research there was very little research on the use of metaphor in CBT sessions, and no studies have examined how to
train therapists in this skill.
This article discusses four studies that provide a preliminary empirical basis for the exploration of metaphors in
CBT. The first study evaluated the reliability and utility of an approach to metaphor identification. The second study explored
how clients and therapists co-construct metaphors, contributing to development of a shared language in early therapy sessions and
identified a range of responses to each other’s metaphors. The third study explored the effect of training CBT therapists to
intentionally bring client metaphors into case conceptualisations in terms of building therapeutic alliance and collaboration,
along with an exploration of preference for metaphoric language. The fourth study explored the impact of the metaphor training on
therapist confidence, awareness and use of metaphors, based on therapist self-report ratings and reflections on their ongoing
application of learning over a three month period. These findings suggest that it is possibly to conduct empirical research on
metaphor in CBT, with metaphor having potential as an important therapy process1
variable.
Using Questions in Cognitive Therapy with People with Intellectual Disabilities