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Article published In:
Metaphor in Mental Healthcare
Edited by Dennis Tay
[Metaphor and the Social World 10:2] 2020
► pp. 199–213

Recent applications of metaphor research in cognitive behaviour therapy

| University of Otago
| University of Otago
| University of Otago

Metaphors are common in psychotherapy. The last decade has seen increasing interest in the use of metaphor in cognitive behaviour therapy (CBT), with attention to client metaphors being asserted as a way of enhancing CBT. However, prior to this current research there was very little research on the use of metaphor in CBT sessions, and no studies have examined how to train therapists in this skill.

This article discusses four studies that provide a preliminary empirical basis for the exploration of metaphors in CBT. The first study evaluated the reliability and utility of an approach to metaphor identification. The second study explored how clients and therapists co-construct metaphors, contributing to development of a shared language in early therapy sessions and identified a range of responses to each other’s metaphors. The third study explored the effect of training CBT therapists to intentionally bring client metaphors into case conceptualisations in terms of building therapeutic alliance and collaboration, along with an exploration of preference for metaphoric language. The fourth study explored the impact of the metaphor training on therapist confidence, awareness and use of metaphors, based on therapist self-report ratings and reflections on their ongoing application of learning over a three month period. These findings suggest that it is possibly to conduct empirical research on metaphor in CBT, with metaphor having potential as an important therapy process [1] 1 variable.

Keywords: cognitive behavioral therapy, metaphor identification, metaphor co-construction, case conceptualization, therapy process
Article outline
  • 1.Introduction
  • 2.Metaphor frequency and reliability of identification in CBT sessions
  • 3.Metaphor co-construction in CBT sessions
  • 4.Metaphor as a way of enhancing CBT conceptualisations
  • 5.Training therapists to use metaphor intentionally
  • 6.Discussion
  • 7.Future research directions
  • 8.General recommendations for future research
  • 9.Conclusion
  • Ethical approval
  • Acknowledgements
  • Notes
  • References
Published online: 13 November 2020
DOI logo
https://doi.org/10.1075/msw.00003.mat
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