Therapy protocols have played a role in the development of the cognitive approach

As outlined in the previous chapter, cognitive therapy has a strong track record in developing clinical trials to test the efficacy of its ideas. In order to do this, it had to develop therapy protocols and manuals so that research trial therapists are all ‘singing from the same hymn sheet’ – otherwise the validity of findings would be compromised. This has however been controversial because it can make cognitive therapy look like a rather ‘mechanical’ set of procedures. The author argues that protocols need to be implemented with flexibility and that more research is needed on the contextual use of skills in this area.