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What is E-CENT Counselling?
What is Emotive-Cognitive Embodied-Narrative Therapy (E-CENT)?
By Dr Jim Byrne
Copyright (c) 2016-2020, Jim Byrne
Updated on 3rd June 2020
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Seven page extract from our main book on the theory and practice of E-CENT counselling and psychotherapy:
Chapter 2: Key elements of the emotive-cognitive counselling approach
2.1: Overview
Chapter 1 set the scene for this brief chapter, which begins with a summation of a few key features of the Emotive-Cognitive Embodied Narrative Therapy (E-CENT) approach.
This is then followed by:
(1) A basic description of E-CENT counselling and its origins;
(2) The importance of emotions;
(3) E-CENT models of the social individual; and his/her emergence from the interactions of a physical baby and a cultural mother; plus:
(4) Typical client problems and counselling tasks.
E-CENT theory sees humans as essentially physical-emotional story tellers – to ourselves and others – and storytellers who live in a concrete world of narratives and scripts; which include reasonable and unreasonable elements; logical and illogical elements; and defensible and indefensible elements.
These stories are not primarily made up by us, individual humans, though we do embellish them, and produce our own variants of them. But, in essence, these are social stories – stories from our parents, our families, our school and our communities and nations (e.g. via mass media channels).
These are the stories that constitute our social identity, and locate us in a historical web of relationships linked to the past. And these are the stories we inevitably use to interpret our actual, social experiences of our very real lives in the present moment!
One of the basic functions of the central nervous system and perceptual apparatus of a human being (or any mammal) is to help us to classify and evaluate our environmental stimuli (or experiences) into those that we experience as ‘good’ (pleasurable) and those we experience as ‘bad’ (or un-pleasurable).
Humans most often tend to push away (or repress out of conscious awareness) their unpleasant experiences; to refuse or fail to process them; and to then become the (non-conscious) victims of those repressed, denied and undigested experiences. We do this – ‘pushing away’ (or rejecting), and repressing (out of conscious awareness) of our unpleasant experiences – because we are wired up by nature to seek pleasure and to avoid pain (or un-pleasure.) But the solution to most of our problems, paradoxically, resides in our courageous willingness to face the pain of unpleasant experiences (which we cannot avoid); to reframe them; to feel them; and to fully digest them. Only then can they disappear. You cannot, as Albert Ellis foolishly believed, “forget the god-awful past”. You cannot forget it because it is hardwired into your neurology, and your physiology/ musculature. And it manifests in your daily habits today. To get rid of it, you have to digest it; complete it, and then file it away.
And there are no therapists who can “extract” your pain! And no medications that can permanently dissolve your pain (as opposed to hiding it for a while!) Unavoidable Pain has to be faced and processed. Those individuals who attempt to run away from unavoidable pain by taking recreational or prescription drugs, alcohol, painkillers, etc., end up having to face the same old pain when their escapist strategies eventually prove to be not just useless, but self-harming!
And you have to face your unavoidable pain with a moderate degree of Stoic endurance (or willingness to suffer the unavoidable pain of life); a sensible degree of scientific enquiry into the possibility of changing things instead of endlessly enduring them; and acceptance of the need to digest whatever cannot be eliminated by controlling yourself or your environment.
Our emotive-cognitive (E-CENT) theory also sees adult relationships as being the acting out, in the present moment, of childhood experiences of relationship with parents and siblings, because some part of those earlier relationships have not been properly digested and completed. In other words, we internalize ‘models’ of how our parents related to us, and we take them to school. We modify some of our internal models of relationship in school and take them into the wider world. It may be that our childhood script, or life-story, is updated around puberty, to expand into a vision of our autonomous, adult future, coloured by the experiences of childhood. (See McAdams’ view, on page 63 of McLeod, 1997/2006).
And we always relate to others in the present moment on the basis of those old models, (or Working Models), or templates, of “how they (e.g. parent figures and others) related to me; and how I must respond (to them)”. (Byrne, 2009b). This, of course, all goes on at non-consciouslevels of mind, while the conscious mind deludes itself – (like a kid with a plastic steering wheel, on the top deck of a bus, deludes himself into believing that he is steering the bus) – into thinking that it, the conscious ‘me’, is choosing relationships and deciding how to act within them.
Furthermore, there are significant disruptions that can occur at various stages in the early childhood experience of the individual which can produce specific forms of relationship dysfunction in later life. Most of these have to do with disruption of attachment relationships, which render the individual ‘insecure’ in future attachment relationships. (The lucky ‘few’ [which might actually be 50—60% of us!] end up with ‘secure attachment styles’ of relating to parents, and later to significant others, like lovers, spouses, etc. About 20+% acquire the Avoidant Attachment Style, and another 20+% acquire the Anxious-Ambivalent [clinging] Attachment Style).
And, because we are body-minds, and not floating heads, the state of our bodies affects our emotions and thoughts, and thereby our actions in the world. At the most basic level, we are either in a physically relaxed mode (with the parasympathetic nervous system activated) resulting in a feeling of emotional wellbeing; or we are in a physically tense mode (with the sympathetic nervous system activated) resulting in a feeling of anxious or angry over-arousal and a general state of unhappiness and dissatisfaction. This we normally call ‘stress’, or distress.
If we live like couch potatoes who eat junk food and subject our nervous systems to information overload; and/or struggle with economic insecurity and poor housing conditions; and/ or aim too high and are never satisfied with our material possessions; and/ or surround ourselves with relationship conflict, in a chaotic world; then we cannot hope to function well emotionally and mentally.
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Lifestyle Counselling and Coaching for the Whole Person:
Or how to integrate nutritional insights, exercise and sleep coaching into talk therapy.
Author Jim Byrne (with Renata Taylor-Byrne). Cover design by Charles Saul
People who eat junk food are much more likely to be angry, anxious and depressed than people who eat a healthy diet of organic wholefoods. Counsellors and psychotherapists who aren’t aware of this fact cannot be maximally effective with all clients, because, for example, in the UK, more than 50% of all food consumed is now junk – laced with sugar, salt, gluten, and various mind altering additives. And in America, the proportion is likely to be much higher.
People who don’t get enough sleep will show up as much more neurotic than people who get the right amount of sleep every single night. But trying to help them exclusively with a talking cure will not work, if their lack of sleep is not addressed.
There are similar problems with diet and exercise, and physical tension and relaxation.
This book will show you how to incorporate counselling on diet, exercise, and sleep into any system of talk therapy. It has been found in practice to be very helpful to counsellors and psychotherapists who want to understand the role of lifestyle factors in human disturbance.
Because diet, exercise and sleep are increasingly seen to be important determinants of mental health and emotional well-being, it is now necessary to rethink our models of counselling and therapy.
This book will also help self-help enthusiasts to take better care of their own mental and physical health, and emotional well-being.
Emotive-Cognitive Embodied-Narrative Therapy (E-CENT) is a system of counselling and psychotherapy which integrates:
(1) A reformed and expanded version of the Stimulus-Organism-Response (Holistic-SOR) model (adapted from neobehaviourism and Behaviour Therapy):
(2) Freud’s model of the ‘it’ (or body-brain-mind), the ‘ego’ (or socialized personality) and the ‘superego’ (or internalized conscience of significant others, like mother/father, etc.);
(3) Some elements of the mother-child relationship from Object Relations theory (Klein, Fairbairn, Guntrip);
(4) The Parent-Adult-Child (PAC) model from Transactional Analysis (TA);
(5) The concepts of the ‘secure base’, and ‘attachment style’, from Attachment theory; and the need for re-parenting of the insecure client;
(6) Some elements of moderate Zen Buddhist and moderate Stoic philosophy;
(7) Moral philosophy (especially the Golden Rule) and the importance of egalitarian relationships (especially in marriage):
(8) Plus several other elements of emotive, cognitive, narrative and psychodynamic therapies.
(And all of this is combined with an awareness of the importance of keeping the body-mind healthy through diet, exercise, sleep, self-talk – or inner dialogue – plus emotional self-management, and development of a capacity to conduct happy relationships).
The E-CENT counselling theory is not an eclectic system which has bolted elements of different counselling systems together. It is a truly integrative system which began by revisiting the basic model of the human personality developed by Sigmund Freud and asking: How does this model link up with the ABC model used in REBT/CBT?What are the necessary implications of assuming that there is substantial truth in both models? (When the ABC model outlived its usefulness to us, and became a liability, we replaced it with the Stimulus-Organism-Response (SOR) model, in which the organism is seen to be affected by a whole range of factors, like diet, exercise, self-talk, relaxation, meditation, hydration, sleep, relationships, personal history, and so on).
The same process was conducted with the Parent-Adult-Child (PAC) model from Transactional Analysis and aspects of cognitive science (for example: Hofstadter, 2007)[i]. The resulting synthesis (or synthetic model) was then compared with the implications of the British ‘Object Relations’ tradition. Moral philosophy and Zen Buddhism were also interrogated in this process of model building.
Before that system of integration of models was begun, I had studied thirteen different systems of counselling and therapy, including: Freud and Jung, Rogers and Perls, Behaviour Therapy theory and practice, Cognitive Therapy and REBT, Reality Therapy and Transactional Analysis, Existential Therapy and Logotherapy, Multimodal Therapy and Cognitive-Humanistic Therapy; and also committed myself to the proposition that all systems of counselling and therapy that are designed to be therapeutic are broadly equivalent in terms of the outcomes achieved, as argued by Wampold (2001)[ii], and Messer and Wampold (2000)[iii].
E-CENT theory and practice evolved in phases. 1968 to 1998 was a kind of incubation of some core ideas. 1999 to 2007 saw an intensification of thinking and learning about the core elements. Then, in the period 2007 to 2010 – after the death of Dr Albert Ellis, and my own ‘post-mortem’, designed to find out how REBT could have produced the mess that was the final three years of Ellis’s life – I wrote the first version of this book. Over several years then – of developing and applying the emerging E-CENT model – a basic theory of human personality and psychological disturbance emerged. And I have continued to refine E-CENT with each passing year.
~~~
Lifestyle Counselling and Coaching for the Whole Person:
Or how to integrate nutritional insights, exercise and sleep coaching into talk therapy.
Author Jim Byrne (with Renata Taylor-Byrne). Cover design by Charles Saul
People who eat junk food are much more likely to be angry, anxious and depressed than people who eat a healthy diet of organic wholefoods. Counsellors and psychotherapists who aren’t aware of this fact cannot be maximally effective with all clients, because, for example, in the UK, more than 50% of all food consumed is now junk – laced with sugar, salt, gluten, and various mind altering additives. And in America, the proportion is likely to be much higher.
People who don’t get enough sleep will show up as much more neurotic than people who get the right amount of sleep every single night. But trying to help them exclusively with a talking cure will not work, if their lack of sleep is not addressed.
There are similar problems with diet and exercise, and physical tension and relaxation.
This book will show you how to incorporate counselling on diet, exercise, and sleep into any system of talk therapy. It has been found in practice to be very helpful to counsellors and psychotherapists who want to understand the role of lifestyle factors in human disturbance.
Because diet, exercise and sleep are increasingly seen to be important determinants of mental health and emotional well-being, it is now necessary to rethink our models of counselling and therapy.
This book will also help self-help enthusiasts to take better care of their own mental and physical health, and emotional well-being.
The basic theory of E-CENT begins with the relationship between the archetypal new baby and its mother. This is (for the baby) a feeling relationship. And the baby stores, in permanent memory, beyond conscious awareness, every emotionally significant event in that most fundamental relationship. This relationship between mother and baby gives rise (in the baby’s body-mind) to emotionally-coloured expectations, attitudes, and ways of seeing itself and the world, which shape the later life of the child. The ‘sea’ in which the child swims is ‘the sea of emotionally significant experience (which later includes language)’ and the common currency of that language is the ‘story’. (Of course, those stories are about ‘something’ – real, concrete – and not just sounds in the air. And one of those concrete forces that is reflected in our social stories is the question of power; physical power – the power to hurt or be hurt physically; and emotion power – the power to love or hate another, and to be loved or hated by another.
We grow up imbibing stories about ‘the nature of reality’ from our mothers, fathers, siblings, peers, family relatives, teachers, and so on. In most of the stage directions, we will tend to find lines for ourselves which put us in ‘bit parts’; ‘supporting cast’; or ‘timid crowd-scene member’.
However, some of us, and perhaps most of us (at least some of the time), will find ourselves justifying the playing of bullying roles in some of our stories.
The key conception of the human individual which is held by E-CENT counsellors suggests that each of us is:
(a) primarily a social body-mind;
(b) which has innate potential to develop good and bad tendencies, and:
(c) which accumulates interpretative, emotionally-significant experiences – in the form of schemas, scripts, stories and frames (or ‘ways of seeing the world’) and other narrativized and non-narrativized forms – which are stored in non-conscious, electro-chemical representations; and:
(d) which manifest in Parent, Adult and Child forms of thinking/ feeling/ behaving (or perfinking/acting). And furthermore:
(e) The ‘emergent I’ in each individual has internalized ‘Working Models’ (or ‘templates’) of relationship (from their social encounters in their family of origin), which include Attachment Styles and Personality Adaptations, which dictate the patterns and limitations of relationships to which they will gravitate and be attracted in their adult lives.
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Another way of saying this is that:
The social/emotional intelligence of the socialized individual is determined by their experience in their family of origin, and this sets the upper and lower limits of their ability to relate to others – all other things being equal.
Of course, it is possible to meet new ‘curative’ individuals, such as good friends, lovers, or counsellors, or others, who can begin to help the individual to reform and reshape their Internal Working Models of relationship, and to raise their social/emotional intelligence – but this involves hard work, and it is by no means guaranteed to happen!
~~~
Lifestyle Counselling and Coaching for the Whole Person:
Or how to integrate nutritional insights, exercise and sleep coaching into talk therapy.
Author Jim Byrne (with Renata Taylor-Byrne). Cover design by Charles Saul
People who eat junk food are much more likely to be angry, anxious and depressed than people who eat a healthy diet of organic wholefoods. Counsellors and psychotherapists who aren’t aware of this fact cannot be maximally effective with all clients, because, for example, in the UK, more than 50% of all food consumed is now junk – laced with sugar, salt, gluten, and various mind altering additives. And in America, the proportion is likely to be much higher.
People who don’t get enough sleep will show up as much more neurotic than people who get the right amount of sleep every single night. But trying to help them exclusively with a talking cure will not work, if their lack of sleep is not addressed.
There are similar problems with diet and exercise, and physical tension and relaxation.
This book will show you how to incorporate counselling on diet, exercise, and sleep into any system of talk therapy. It has been found in practice to be very helpful to counsellors and psychotherapists who want to understand the role of lifestyle factors in human disturbance.
Because diet, exercise and sleep are increasingly seen to be important determinants of mental health and emotional well-being, it is now necessary to rethink our models of counselling and therapy.
This book will also help self-help enthusiasts to take better care of their own mental and physical health, and emotional well-being.
In E-CENT counselling, I deal with the client’s emotions. I offer them a ‘safe harbour’, and a ‘secure base’ from which to explore their life.
I look at the connection between their lifestyle and their feelings; their relationships and their moods; their thinking and their emotions; their physical state (in terms of diet, exercise, sleep, etc.); their experiences and their emotions; their meanings and their emotions; the links between emotions, goals and behaviours; and the emotional stories within which they live their lives.
I encourage them to change their self-talk; their habitual behaviours; to work on their bodily health (through diet and exercise; relaxation, sleep and meditation; vitamin and mineral supplementation); and to work on the story of their lives.
I try to provide the best possible analysis of the potential reasons, in the basement of their minds, for their current dysfunctional thoughts-feelings-behaviours. But I do not offer ‘definitive analyses’ characteristic of the Freudian approach.
I provide each client with ‘a secure base’, to re-grow or re-train their attachment style, from insecure to secure.
I work on their emotional intelligence by helping them to understand their own emotions, the emotions of those with whom they normally relate, and how to communicate their emotions to others.
And when I think diet may be a feature of their emotional problem, I refer them to information packs on some educational approaches to diet and nutrition. One of those was compiled by Renata Taylor-Byrne, my wife, who has a diploma in nutrition, and who has done a lot of research on this subject. (Please see Taylor-Byrne and Byrne, 2017, in the References list). I also have a lot of experience of managing my own diet, in order to control Candida Albicans, which is widely known to cause feelings of anxiety and depression. So this is not ‘medical counselling’ so much as it is coaching in wellbeing! And I always advise my clients to see a nutritional therapist before they make any significant changes to their diets. I also teach the importance of adequate sleep; and regular physical exercise.
~~~
Lifestyle Counselling and Coaching for the Whole Person:
Or how to integrate nutritional insights, exercise and sleep coaching into talk therapy.
Author Jim Byrne (with Renata Taylor-Byrne). Cover design by Charles Saul
People who eat junk food are much more likely to be angry, anxious and depressed than people who eat a healthy diet of organic wholefoods. Counsellors and psychotherapists who aren’t aware of this fact cannot be maximally effective with all clients, because, for example, in the UK, more than 50% of all food consumed is now junk – laced with sugar, salt, gluten, and various mind altering additives. And in America, the proportion is likely to be much higher.
People who don’t get enough sleep will show up as much more neurotic than people who get the right amount of sleep every single night. But trying to help them exclusively with a talking cure will not work, if their lack of sleep is not addressed.
There are similar problems with diet and exercise, and physical tension and relaxation.
This book will show you how to incorporate counselling on diet, exercise, and sleep into any system of talk therapy. It has been found in practice to be very helpful to counsellors and psychotherapists who want to understand the role of lifestyle factors in human disturbance.
Because diet, exercise and sleep are increasingly seen to be important determinants of mental health and emotional well-being, it is now necessary to rethink our models of counselling and therapy.
This book will also help self-help enthusiasts to take better care of their own mental and physical health, and emotional well-being.
2.5: Brief introduction to the E-CENT models of mind
From ancient Greece to modern Europe and America, philosophers and psychologists have struggled to understand the human mind. In the process they have developed many interesting models of the mind, to help us with our self-understanding.
After almost fifteen years of studying, exploring and developing models of the human mind (between 2001 and 2015), I concluded that tripartite (or three-part) models – like Freud’s ‘It’, ‘Ego’ and ‘Super-ego’ model, which we have adapted as shown here – have more explanatory power than ‘binary (two-part) models’; and that both are preferable to the ‘black box’ model of behaviourism (and behaviour therapy).
Of course, the human brain-mind is the most complex entity in the known universe, and therefore any attempt to sum it up – to ‘simplify it’ – is fraught with difficulty and danger. However, in the interest of making the management of mind accessible to counselling clients, I have to take some risks in summing up what I have learned about the human brain-mind.
The most important and interesting (if incomplete) models seem to have come from the following sources:
Plato: Plato produced a model of the psyche(or soul, or mind) which had three parts: The charioteer (or reason) and the two horses which pull the chariot. The chariot represents the life of a person, and the two horses represent the will and passion which animate that person. When these elements of the individual mind are in unstable balance, problems emerge. If the will and passion are united against the reasoning of the charioteer, then the chariot runs out of control. Plato’s solution was to advocate getting your will to support your reason against your passions. This model is contradicted by affective neuroscience, (Panksepp, 1998), which suggests that the charioteer is actually a set of innate emotional control systems, which are, of course, socialized by the family of origins. Reason (or cognition) depends upon emotion. And the will is a function of the socialized ego.
Sigmund Freud: One of Freud’s main models has three parts to the psyche, or mind: The ‘it’ (or physical-emotional baby/person), the ‘superego’ (or internalized mother/other, as a social-regulator [the ‘over-I’]); and the ‘ego’ (or self-concept; self-identity; virtual self, or personality). We made good use of this model, in developing E-CENT theory, in a form which never occurred to Freud, because he overlooked the importance of the bond between mother and baby. And, although he had the concept of the super-ego, or over-I, he did not see how it interacted with the ‘it’ to promote the emergence of the ego.
Eric Berne. Berne posited the existence of three states of the person’s ‘ego’, or self-functioning: (The ‘Parent’ ego state; the ‘Adult’ ego state; and the ‘Child’ ego state).
These are shown in the E-CENT model as emergent forms of the socialized ego. (See Figure 2.3, later in this chapter, for an illustration of how the PAC fits into the relationships between the mother and baby, as internalized).
The illustration above is a brief representation of the Parent-Adult-Child model developed by Berne and his associates.
And then there is:
4. Neo-behaviourism: The neo-Behaviourists (e.g. Tolman and Hull) rejected the black box view of the ‘mind’ of their research animals, which had been created by Pavlov, Watson and Skinner, and insisted that goals and thoughts were essential parts of animal behaviour. They overlooked the importance of emotion, or affect, however; and this omission was a central and enduring feature of the entire cognitive revolution. (Emotion was only ever given a brief chapter – and afterthought – at the end of textbooks on cognitive psychology).
But neo-behaviourism gave us the Stimulus-Organism-Response model, which we have modified in E-CENT, to include emotion (including complex trauma), diet, exercise, sleep, and many other features apart from thoughts and goals.
This is how the S-O-R model works: A living organism (O) is conceptualized as being sandwiched between incoming stimuli (or signals) – which are appraised as good or bad – and outgoing emotional and behavioural responses. This model is central to the E-CENT approach, as mentioned above. But as we will show later, there are lots of determinants of the state of the Organism, and therefore lots of causes of emotional and behavioural responses – and not just thoughts and beliefs, which is asserted by REBT/CBT. The cognitive and rational therapy theorists (like Ellis and Beck) make the mistake of assuming that ‘thoughts cause feelings’. Then, along comes the ‘emotional revolution’ (of Schore, Panksepp, Siegel and others) which assumes that emotions (or affects) are both regulated and regulating. To simplify this model, we would say that it’s our feelings about situations that regulate our feelings about those situations. But this is to miss a crucial point: People perceive-feel-think in response to incoming stimuli. Our attention (A) is captured by an incoming stimulus (S). We respond to that stimulus from memory (M), which sets in train a process of Perfinking (or perceiving-feeling-thinking). And our perfinking capacities are both regulated and regulating. And we cannot separate out our ‘thinking’ from our ‘feeling’. Typically, when we perfink that we are ‘thinking’, we are overlooking the unavoidable fact that we cannot ‘think’ without the feelings which allow us to evaluate the objects of our perfinking! (Damasio, 1994, on the case study of Eliot).
5. Other models: Some years after I developed the E-CENT tripartite model- (in which the mother and baby’s minds overlap or interpenetrate each other, and give rise to an emergent ego or personality of the baby, as shown in Figure 1.2 in Chapter 1) – interpersonal neurobiology(IPNB) was announced by Dr Daniel Siegel, and I agree with his basic model of (1) the brain (of the baby) and (2) relationships (mainly with mother, initially), giving rise to (3) the mind of the individual child.
(However, the Hindu/Buddhist binary model – of the Elephant and Rider – is also helpful, up to a point. [It seems the Elephant and Rider model was first mentioned by Lord Krishna in the Maharabhata]. And Freud’s other model, [the binary distinction between the Life urge {Eros} and the Death urge {Thanatos}] also needs to be taken into account]. These models are helpful in those situations where the client mainly seems to be split into two ‘warring factions’: one of which wants to be expansive or exploratory, and one of which wants to be cautious and withdrawn, for examples. We can related to those two elements as either the conscious Rider and the non-conscious Horse; place them on two chairs, and use Gestalt chair work to help the client to resolve the ‘split’. [And those two elements could just as easily be labelled as the Life urge {expansive} and the Death urge {shrinking/ withdrawing}]).
From the main elements of the tripartite models of Plato, Freud and Eric Berne, I infer the following two conclusions:
Lifestyle Counselling and Coaching for the Whole Person:
Or how to integrate nutritional insights, exercise and sleep coaching into talk therapy.
Author Jim Byrne (with Renata Taylor-Byrne). Cover design by Charles Saul
People who eat junk food are much more likely to be angry, anxious and depressed than people who eat a healthy diet of organic wholefoods. Counsellors and psychotherapists who aren’t aware of this fact cannot be maximally effective with all clients, because, for example, in the UK, more than 50% of all food consumed is now junk – laced with sugar, salt, gluten, and various mind altering additives. And in America, the proportion is likely to be much higher.
People who don’t get enough sleep will show up as much more neurotic than people who get the right amount of sleep every single night. But trying to help them exclusively with a talking cure will not work, if their lack of sleep is not addressed.
There are similar problems with diet and exercise, and physical tension and relaxation.
This book will show you how to incorporate counselling on diet, exercise, and sleep into any system of talk therapy. It has been found in practice to be very helpful to counsellors and psychotherapists who want to understand the role of lifestyle factors in human disturbance.
Because diet, exercise and sleep are increasingly seen to be important determinants of mental health and emotional well-being, it is now necessary to rethink our models of counselling and therapy.
This book will also help self-help enthusiasts to take better care of their own mental and physical health, and emotional well-being.
[i] Hofstadter, D. (2007) I am a Strange Loop. New York: Basic Books.
[ii] Wampold, B.E. (2001) The Great Psychotherapy Debate: Model, methods, and findings. Mahwah, NJ: Lawrence Erlbaum.
[iii] Messer, S. and Wampold, B. (2002) Let’s face facts: Common factors are more potent than specific therapy ingredients. Clinical Psychology: Science and Practice. 9: 21-25.
ABC Counselling and Psychotherapy, Hebden Bridge 