Psychodynamic and Cognitive-Behavioral Therapies Are More Different Than You Think: Conceptualizations of Mental Problems and Consequences for Studying Mechanisms of Change

Abstract

The purpose of this study was to examine the conceptualization of mental problems and disorders inherent in the therapeutic theories used in psychodynamic (PDT) and cognitive-behavioral therapy (CBT). Supportive-expressive (SET) and cognitive (CT) therapy for social anxiety disorder (SAD) were used as representative examples. Based on the typology proposed by Kendler, Zachar, and Craver, we found that PDT models accord with an essentialist model of mental disorders, while CBT models align with a mechanistic property cluster (MPC) model. Because the PDT explanatory concepts represent definitions of symptoms rather than causal explanations of them, PDT models cannot be examined with regard to mechanisms of change. Moreover, because these concepts are treated as latent constructs, they are not able to represent within-person causal/mechanistic relationships between observable phenomena. PDT models cannot while CBT models can lead to testable predictions and knowledge accumulation.

Keywords

psychodynamic therapy cognitive therapy/CBT essentialist models mechanistic property cluster models mechanism of change

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