Evaluating the role and proposed benefits of the Socratic Method in CBT

Abstract

The Socratic Method has been described as an important and distinctive component of CBT interventions. However, it has been subject to little empirical investigation and its value within therapy remains unclear. A survey of expert CBT researchers (N=13) was conducted regarding the role of the Socratic Method within evidence-based CBT interventions. Thematic analysis of responses suggests that the Socratic Method is considered a potentially useful though non-essential component of CBT. A systematic review of the literature identified five assumptions regarding the proposed benefits of employing the Socratic Method: (i) engaging patients in the Socratic Method will help reduce distress associated with, and belief in, unhelpful cognitions; (ii) engaging in the Socratic Method will allow patients to develop skills in the re-evaluation of cognitions and unhelpful processes; (iii) conclusions reached by patients through the Socratic Method are more likely to be memorable and convincing; (iv) the Socratic Method will increase patient engagement and reduce resistance in therapy; and (v) Socratic questioning will improve CBT outcome. Two experimental studies were conducted to evaluate whether assumptions (i) and (iii) were supported when comparing an online analogue of the Socratic Method versus a didactic-information giving approach. Results supported assumption (iii) and partially supported assumption (i), though the superiority of a Socratic versus didactic approach in promoting belief change was not demonstrated. The findings of the study will be discussed in terms of areas for future research and mechanisms through which the Socratic Method may be hypothesised to exert beneficial effects within therapy.