Therapists' thoughts on therapy: clinicians' perceptions of the therapy processes that distinguish schema, cognitive behavioural and psychodynamic approaches.

OBJECTIVE: Debates continue over shared factors in therapy processes between different theoretical orientations. By seeking the opinions of practicing clinicians, this study aimed to elucidate the similarities and differences between cognitive-behavioural (CBT), psychodynamic (PDT), and schema therapy (ST) approaches. METHOD: Forty-eight practitioners aligning with one of the three approaches were asked to identify crucial processes in their therapy using a modified online version of the Psychotherapy Process Q-set. RESULTS: Distinct differences between each theoretical orientation with few shared common factors were found. A comparison with ratings from previous studies indicated that CBT therapists have not changed over the last 20 years, whereas PDT therapists have changed and the differences appeared consistent with modern PDT theory. CONCLUSIONS: The differences between the therapy approaches were consistent with theories underlying each model. PDT therapists valued a neutral relationship, CBT therapists emphasized a didactic interaction, and therapists form a ST orientation placed a greater emphasis on emotional involvement.