Cognitive behaviour therapy : from rationalism to constructivism?

Treatment guidelines indicate that the treatment of choice for most psychological problems is cognitive-behavioural therapy. This paper suggests that there are alternative constructions of the evidence base from which such guidelines are drawn, and reviews another relevant evidence base, concerning the relationship between clients' and therapists' philosophical beliefs, personal styles, and treatment preferences. One distinction that will be drawn, and illustrated by approaches to the 'resistant' client, is that between rationalism and constructivism, and possible constructivist trends in cognitive-behavioural therapy will be discussed.