Therapeutic cycles in standard cognitive behavioural therapy

Cognitive therapy comprises three main areas of intervention: assessing, disputing and reframing biased beliefs. The Therapeutic Cycle Model (TCM) describes the processes of change that typically occur over a course of psychotherapy in terms of relaxing, reflecting, experiencing and connecting phases. Reflecting is related to abstract thinking, while experiencing and connecting involve emotional activation. In this study, ten individual cognitive therapy sessions with a 30-year-old patient affected by panic attack disorder were analysed in terms of TCM phases. In addition, three independent judges assessed and classified the cognitive therapeutic interventions that took place during the sessions using the Comprehensive Psychotherapeutic Interventions Rating Scale (CPIRS). We expected that cognitive reframing activity would be related to connecting phases, and assessing and disputing current beliefs to reflecting. The results confirmed a relationship between cognitive assessment of biased beliefs and abstract reflection as well as between cognitive reframing and connecting. A more unexpected outcome was the association found between challenging biased beliefs and experiencing