COMMENTARY

Collaborative Empiricism, Guided Discovery, The text included details regarding the assessment of
depression, common cognitive distortions underlying
and the Socratic Method: Core Processes for
the depressed mood, and strategies for helping clients
Effective Cognitive Therapy to change. The text mentioned collaborative empiri-
James C. Overholser, Case Western Reserve University cism as an important process to facilitate therapy
sessions. A few years later, Beck and Emery (1985)
Cognitive therapy sessions typically blend content and described inductive reasoning and the Socratic method
process issues to help clients make effective changes in as two of the basic principles underlying cognitive
their attitudes, beliefs, and expectations. Collaborative
therapy. These components have helped to establish
cognitive therapy as the premier form of psychother-
empiricism helps therapists and clients work together to
apy, and these components explain the interactive pro-
examine the evidence supporting or refuting the client’s
cesses that underlie cognitive therapy sessions.
beliefs. In a similar manner, guided discovery helps to
Unfortunately, some reports on cognitive therapy
structure the process of therapy toward an exploration
seem to minimize the complex processes that are
of critical issues involved in the client’s struggles. involved in most therapy sessions. Many authors focus
Finally, the Socratic method provides a comprehensive on the content, goals, and measurable outcomes of
framework for the complex processes involved in ther- cognitive therapy while neglecting the importance of
apy, while remaining aligned with the core concepts of the process of therapy. Even recent reports that clearly
cognitive therapy. These process issues may force the describe the process of therapy (e.g., Clark & Beck,
field to confront the mixed blessing derived from 2010; Dimidjian, Martell, Coffman, & Hollon, 2008)
structured treatment manuals, psycho-educational merely allude to these core process issues. Thankfully,
approaches, and directive forms of therapy. the recent article by Tee and Kazantzis (2011) thor-
Key words: alliance, expertise, ignorance, therapy oughly defines and clarifies the use of collaborative
process. [Clin Psychol Sci Prac 18: 62–66, 2011]
empiricism in cognitive therapy. In the text that fol-
lows, collaborative empiricism, guided discovery, and
the Socratic method will be described as clinical strate-

In the classic text Cognitive Therapy of Depression, Beck, gies that help therapy move beyond the rote applica-
tion of a treatment manual.
Rush, Shaw, and Emery (1979) provided a compre-
Tee and Kazantzis (2011) provided useful details that
hensive treatment manual for helping depressed clients.
help to refine the ideas and structure the implementa-
tion of collaborative empiricism. However, several
Address correspondence to James C. Overholser, Department
of Psychology, Case Western Reserve University, 10900 Euclid
issues still need to be confronted. First, a fluid approach
Avenue, Cleveland, OH 44106-7123. E-mail: overholser@ like collaborative empiricism may have difficulty fitting
case.edu. within a structured framework that has been organized

 2011 American Psychological Association. Published by Wiley Periodicals, Inc., on behalf of the American Psychological Association.
All rights reserved. For permissions, please email: permissionsuk@wiley.com 62
according to a treatment manual. Second, collaborative jective experience. Therapist and client combine their
empiricism seems incompatible with psychoeducational perspectives (Kuyken, Padesky, & Dudley, 2008).
formats that are often used in cognitive therapy. Third, Before therapy can move on to strategies for change,
the role of therapist as expert seems to clash with col- the therapist must understand the client’s distress from
laborative discussions. These three issues seem to influ- an internal frame of reference. Collaborative empiri-
ence collaborative empiricism, guided discovery, and cism minimizes the therapist’s preconceived notions
the Socratic method. about the client’s problems, improves the therapist’s
accurate understanding of the client’s view, and
COLLABORATIVE EMPIRICISM strengthens the therapeutic alliance (Tee & Kazantzis,
Collaborative empiricism can be used to help clients 2011). A strong therapeutic alliance, early in therapy,
learn to identify problematic attitudes and devise a has been found to predict improvement in the treat-
means to test the validity of these thoughts. Through a ment of depression (Castonguay, Goldfried, Wiser,
mixture of logical discussion and behavioral experi- Raue, & Hayes, 1996). An effective therapeutic alliance
ments, collaborative empiricism helps clients learn to emphasizes the collaborative nature of therapy and
examine the evidence supporting or refuting different remains flexible in the plan for treatment (Overholser
beliefs (Tee & Kazantzis, 2011). A therapeutic dialogue & Silverman, 1998).
helps therapist and client to jointly devise objective
ways to test the client’s ideas, beliefs, and expectations. GUIDED DISCOVERY
Then, a therapeutic dialogue focuses on devising a plan In a manner that is very similar to collaborative empiri-
to observe, record, and experimentally test the client’s cism, guided discovery is an important therapeutic
beliefs. strategy that is frequently mentioned but rarely
Collaborative empiricism can help balance a thera- described in any detail. Guided discovery involves a
pist’s directive guidance versus nondirective support. thoughtful use of questions, often focused on explor-
As the term implies, collaborative empiricism requires ing, learning, and solving various life problems (Scott
the therapist and client to work together on various & Freeman, 2010). The therapeutic discussion aims to
activities, including negotiating therapy goals, distribut- cultivate adaptive attitudes in the client.
ing the workload, and sharing the leadership when When using guided discovery, the therapist assumes
planning behavioral activities to be completed between the role of a guide, not an expert, and not a teacher. It
sessions (Tee & Kazantzis, 2011). Skilled therapists tend can become difficult to collaborate if therapist and cli-
to respect and value the client’s expertise as a guide for ent are not seen as equals. Unfortunately, when a ther-
therapeutic solutions (Williams & Levitt, 2007). Even apist behaves like an expert, it becomes too easy to tell
when a therapist has ideas for effective change, the clients what they should do instead of helping clients
process of therapy requires a collaborative effort to make their own decisions. Collaborative empiricism
whereby therapist and client work together to explore and guided discovery require trust in each client’s abil-
new ideas, test different options, and discover the best ity to make his or her own decisions. Even if a client
alternatives for each client (Bohart, 2007). The goal of sometimes makes poor decisions, the therapist can
collaborative empiricism is not to replace the client’s retain faith in the client’s ability to learn from a mis-
irrational beliefs, but to develop skill in objective take. When people learn by discovery, the information
thinking and hypothesis testing. Working together, that is learned will more easily transfer to new problem
therapist and client create new and more adaptive situations (McDaniel & Schlager, 1990).
views of the client’s problems and options (Anderson
& Goolishman, 1992). THE SOCRATIC METHOD
The opinions and beliefs held by both the therapist The Socratic method includes a complex view derived
and the client should be seen as hypotheses to be tested from ancient philosophy and incorporates several differ-
(Kirsch, 1990). The therapist can strive to understand ent core elements (Overholser, 2010). Unfortunately,
the problems from the perspective of the client’s sub- many people assume that the Socratic method simply

COMMENTARY ON TEE & KAZANTZIS 63

revolves around an extensive reliance on questions to of their life problems. Thus, the emotional distress can
guide therapy sessions (see Carey & Mullan, 2004). A be quickly reduced through a shift of perspective.
systematic series of questions can be used to guide ther-
apy sessions (Overholser, 1993). However, each ques- CONCLUSIONS
tion should fit a broader vision for the direction of the Most therapy sessions can benefit from an integration
discussion (Mitchell, 2006). Often, the process involves of collaborative empiricism, guided discovery, and the
examining the person’s beliefs and confronting any Socratic method. These processes are often used but
contradictions among beliefs (Leigh, 2007). The most rarely described in any detailed or useful manner. In
useful focus is not on the intellectual output, but cen- addition, it can be helpful to combine these processes
ters on the process of self-reflection (Evans, 1990). with a strong foundation in basic listening skills, rap-
Together, therapist and client search for and evaluate port, and the therapeutic alliance.
the evidence that supports or refutes the client’s beliefs It can be important for therapy to promote auton-
by evaluating the quality, quantity, and logical coher- omy and independent decision making in clients. Most
ence of the evidence (Overholser, 2010). Sometimes, people do not like to be told what to do or what they
the Socratic dialogue aims to promote philosophical should believe. When therapists pressure their clients to
inquiry as a lifelong habit of self-reflection and self- make specific changes, the therapy suffers (Castonguay
improvement (King, 2008). et al., 1996). It works best when therapy strives to pro-
The notion of Socratic ignorance, or the disavowal mote active alliance instead of passive compliance with
of knowledge, is especially relevant to the process of therapy (Frank, Kupfer, & Siegel, 1995). The Socratic
therapy (Overholser, 1995). Socratic ignorance com- method can help move from power struggles toward
bines collaborative empiricism with sincere intellectual cooperative effort (Vitousek et al., 1998). Therapy can
modesty and a genuine desire for learning about clients facilitate autonomy and promote an internal locus for
and their struggles (Overholser, 1995). Socrates avoided change (Ryan & Deci, 2008), often through self-
the role of teacher or expert, and instead viewed his awareness, self-direction, and self-regulation. The ther-
role as a partner in search of knowledge (Vlastos, apeutic goal is not to change the client’s beliefs, but to
1991). This partnership can be attained when therapists improve the client’s skills in objective thinking and
respect the limits of their professional knowledge, and hypothesis testing. Clients can learn to bring the scien-
they value the wisdom, insight, and knowledge that are tific method to their own perceptions and interpreta-
possessed by each client. Therapists may possess knowl- tions. Therapy helps clients to become more objective
edge of psychology, research, and theories, but clients in their social perceptions, interpretations, and emo-
hold expertise about their life events, interpersonal tional reactions to assorted people and various life
relationships, and subjective reactions (Vitousek, Wat- events.
son, & Wilson, 1998). The therapeutic dialogue creates The emphasis on evidence-based practice has cre-
an interactive flow between the therapist’s professional ated an interest in structured treatment manuals to
background and the client’s personal experiences, join- guide each therapy session. The empirical support and
ing these two different sets of knowledge, skills, and structure that is provided by therapy manuals must be
backgrounds. balanced with flexibility to adapt the treatment to each
The Socratic method is based on striving toward client (Kendall & Beidas, 2007). Treatment manuals
wisdom, sometimes defined as skill in general aspects of can be useful, especially in treatment-outcome research
life, dealing with complex matters, and outstanding and for guiding the novice therapist. However, there is
insight (Baltes & Staudinger, 1993). In the Socratic a risk of excessive reliance on predetermined structure
method, a core aspect of wisdom includes respecting for therapy sessions. Problems arise when the therapist
that there is very little knowledge that most people rigidly follows the plans from the manual, when manu-
really know with any degree of certainty (Meacham, als are written by researchers who have discontinued
1983). Furthermore, a useful aspect of Socratic wisdom their front-line involvement with the delivery of
includes helping clients to see the trivial nature of most services, and when therapists rely excessively on the

CLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE • V18 N1, MARCH 2011 64

preplanned structure for therapy sessions. There is Carey, T., & Mullan, R. (2004). What is Socratic question-
a risk that novice therapists will fail to appreciate ing? Psychotherapy: Theory, Research, Practice, and Training,
the flexible structure, spontaneous dialogue, and 41(3), 217–226.
idiographic nature that serves as the foundation for Castonguay, L., Goldfried, M., Wiser, S., Raue, P., & Hayes,
A. (1996). Predicting the effect of cognitive therapy for
psychotherapy sessions.
depression. Journal of Consulting and Clinical Psychology,
The Socratic method, guided discovery, and collab-
64(3), 497–504.
orative empiricism can help therapists to balance pro-
Clark, D., & Beck, A. T. (2010). Cognitive therapy of anxiety
fessional expertise with a disavowal of knowledge. Too disorders: Science and practice. New York: Guilford.
often, treatment manuals rely on bibliotherapy and psy- Dimidjian, S., Martell, C., Coffman, S., & Hollon, S.
choeducational classes to guide therapy sessions. An (2008). Severe depression. In M. Whisman (Ed.), Adapt-
educational focus during therapy sessions may convert ing cognitive therapy for depression (pp. 65–87). New York:
the therapeutic relationship into the roles of teacher Guilford.
and student. Although a psychoeducational format and Evans, J. (1990). Socratic ignorance—Socratic wisdom. Mod-
bibliotherapy can help the motivated client, these for- ern Schoolman, 67, 91–110.
mats reduce the value of the therapeutic relationship Frank, E., Kupfer, D., & Siegel, L. (1995). Alliance, not
and may diminish the process of therapy. A therapeutic compliance: A philosophy of outpatient care. Journal of
Clinical Psychiatry, 56(Suppl. 1), 11–16.
dialogue remains the irreplaceable component of psy-
Kendall, P., & Beidas, R. (2007). Smoothing the trail for dis-
chotherapy.
semination of evidence-based practices for youth. Profes-
It seems important to increase the focus on therapy
sional Psychology: Research and Practice, 38(1), 13–20.
process and reduce the somewhat narrow focus on the King, C. (2008). Wisdom, moderation, and elenchus in Pla-
content of therapy sessions (Ryan & Deci, 2008). Col- to’s Apology. Metaphilosophy, 39(3), 345–362.
laborative empiricism can help to balance a structured Kirsch, I. (1990). Changing expectations: A key to effective psy-
plan for therapy with spontaneous flexibility within chotherapy. Pacific Grove, CA: Brooks ⁄ Cole.
each session, striving for a balance between the content Kuyken, W., Padesky, C., & Dudley, R. (2008). The science
and process of therapy sessions. Future work can con- and practice of case conceptualization. Behavioural and
tinue to focus on, clarify, and expand our understanding Cognitive Psychotherapy, 36, 757–768.
of therapy processes. Although it can be extremely diffi- Leigh, F. (2007). Platonic dialogue, maieutic method and
cult to study psychotherapy process issues in a con- critical thinking. Journal of Philosophy of Education, 41(3),
309–323.
trolled manner, it is hoped that the field will continue
McDaniel, M., & Schlager, M. (1990). Discovery learning
to explore and refine our understanding of collaborative
and transfer of problem-solving skills. Cognition and Instruc-
empiricism, guided discovery, and the Socratic method.
tion, 7(2), 129–159.
Meacham, J. (1983). Wisdom and the context of knowledge.
REFERENCES
Contributions to Human Development, 8, 111–143.
Anderson, H., & Goolishman, H. (1992). The client is the
Mitchell, S. (2006). Socratic dialogue, the humanities and the
expert. In S. McNamee & K. Gergen (Eds.), Therapy as
art of the question. Arts & Humanities in Higher Education,
social construction (pp. 25–39). London: Sage.
5(2), 181–197.
Baltes, P., & Staudinger, U. (1993). The search for a psychol-
Overholser, J. C. (1993). Elements of the Socratic method: I.
ogy of wisdom. Current Directions in Psychological Science, 2,
Systematic questioning. Psychotherapy, 30(1), 67–74.
75–80.
Overholser, J. C. (1995). Elements of the Socratic method:
Beck, A. T., & Emery, G. (1985). Anxiety disorders and pho-
IV. Disavowal of knowledge. Psychotherapy, 32(2), 283–
bias: A cognitive perspective. New York: Basic Books.
292.
Beck, A. T., Rush, A. J., Shaw, B., & Emery, G. (1979).
Overholser, J. C. (2010). Psychotherapy according to the
Cognitive therapy of depression. New York: Guilford.
Socratic method: Integrating ancient philosophy with
Bohart, A. (2007). An alternative view of concrete operating
contemporary cognitive therapy. Journal of Cognitive
procedures from the perspective of the client as active
Psychotherapy, 24(4), 354–363.
self-healer. Journal of Psychotherapy Integration, 17(1), 125–
137.

COMMENTARY ON TEE & KAZANTZIS 65

Overholser, J. C., & Silverman, E. (1998). Cognitive-behav- tionship construct. Clinical Psychology: Science and Practice,
ioral treatment of depression: Part VIII. Development and 18, 47–61.
utilization of the therapeutic relationship. Journal of Vitousek, K., Watson, S., & Wilson, G. T. (1998). Enhanc-
Contemporary Psychotherapy, 28(2), 199–214. ing motivation for change in treatment-resistant eating
Ryan, R., & Deci, E. (2008). A self-determination theory disorders. Clinical Psychology Review, 18(4), 391–420.
approach to psychotherapy: The motivational basis for Vlastos, G. (1991). Socrates: Ironist and moral philosopher. Ithaca,
effective change. Canadian Psychology, 49(3), 186–193. NY: Cornell University Press.
Scott, J., & Freeman, A. (2010). Beck’s cognitive therapy. In Williams, D., & Levitt, H. (2007). A qualitative investigation
N. Kazantzis, M. Reinecke, & A. Freeman (Eds.), Cogni- of eminent therapists’ values within psychotherapy. Journal
tive and behavioral theories in clinical practice (pp. 28–75). of Psychotherapy Integration, 17(2), 159–184.
New York: Guilford.
Tee, J., & Kazantzis, N. (2011). Collaborative empiricism in Received July 21, 2010; accepted July 22, 2010.
cognitive therapy: A definition and theory for the rela-

CLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE • V18 N1, MARCH 2011 66