Group Therapy Workbook:
Integrating Cognitive Behavioral Therapy with Psychodramatic Theory and Practice
Thomas W. Treadwell
Letitia E. Travaglini, Debbie Dartnell, Maegan Staats, and Kelly Devinney
As Director of Group Psychotherapy at McLean Hospital in Belmont, Massachusetts, I have ample opportunity to experience how important treatment models such as Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Motivational Interviewing, Mentalization – Theory of Mind, Mindfulness, Narrative Therapy, Acceptance and Commitment Therapy, Expressive Therapies, Interpersonal Therapy, Milieu Therapy, Psychopharmacology, Electro Convulsive Therapy, Group Psychotherapy, and other modalities are systematically utilized in a treatment environment encompassing inpatient, residential, partial hospital, and outpatient programs. Though falling under the rubric of “hospital-based” treatments with stabilization and step down programs to assist individuals and families, Cognitive Behavioral Therapy has emerged as an essential part of the hospital’s treatment repertoire across all treatment programs. In fact, one of our excellent partial programs, Adult Behavioral Health, is often described by participants as “being in college,” learning important information and strategies to assist recovery. Psychodrama, because of necessary limitations for more vulnerable treatment populations, is significantly less utilized as a method and finds more applicability as role playing.
Tom Treadwell’s contributions to the integration of action and experiential methods with Cognitive Behavioral Therapy are significant steps for both theoretical models. On the one hand, psychodrama, as practiced in classical styles, often relied on spontaneity and the importance of action rather than just telling. Cognitive Behavioral therapy developed a protocol with systematic methods that integrated thoughts, feelings, and behavior. Mirroring my first exposure to one school of CBT in New York City, a la Albert Ellis, Tom Treadwell has created a bridge in which each method can inform and expand the relationship in the cognitive triad. He introduces a group format that utilizes multiple measures to inform each group member concerning particular areas of concern, educates group members on the Cognitive Behavioral treatment model, and gives feedback that stimulates both the individual and the whole group in behavioral change.
This synthesis is not an easy endeavor. I would suspect that Treadwell, with the support of Aaron Beck, would have to establish a training program that initiates professionals in the utilization of action methods and cognitive behavioral methods and strategies. When I project an image of the two methods on to a Field Diagram created by Freed Bales, I would probably predict that CBT would be rated as an “intellectually controlled, rationally energized” method and Psychodrama would be “more emotionally expressive, intuitive.” Both mirror the oscillating patterns in groups, i.e., the need for task completion and, on the other hand, the need for socio-emotional connection. Treadwell’s Group Therapy Workbook makes a substantial contribution for practitioners in CBT and Psychodrama to practice in their accustomed method by expanding the range and applicability of each method.
I recommend this Workbook for practitioners in both methodological arenas: CBT therapists could well utilize action methods to expand their practice in important concepts such as the cognitive triangle and defeating schemas. Psychodramatists could well utilize the basic components of CBT in the practice of psychodrama, helping protagonists to better understand the internalized thought, feeling, and behavior patterns that are related to the here and now. Treadwell’s contribution is an important milestone in the connection of these two important modalities. As the process unfolds, more learning will emerge and the integration and development of “integrating Cognitive Behavioral Therapy with Psychodramatic Theory and Practice” will certainly make a significant contribution to peoples’ lives.