Cognitive-structural psychotherapy: what it is and how it is used in patients

Constructivism is an approach to psychotherapy which sees reality not as something true or false, but as something variable, and which gives the individual an active role in his own experience. Specifically, Cognitive-structural psychotherapy was born from this approach by Guidano and Liotti.

We will discover the characteristics of this type of psychotherapy, which gives an essential role to personal identity in the construction of knowledge about ourselves and the world.


    Cognitive-structural psychotherapy was created by Guidano and Liotti from the constructivist approach. Constructivist models were born in the 1980s.

    This approach is based on how people generate knowledge from our experiences. It gives a proactive role to the individual in his own experience and in the creation of one-way systems; thus, there are as many realities as there are people. In this way, valid knowledge (true or false) cannot be asserted, but viable.

    According to this approach, knowledge is interpersonal, progressive and proactive. He understands reality as a social construction of belief systems and our “realities”. On the other hand, it recovers the role of unconscious or tacit processes.

    On the other hand, constructivism includes the therapeutic expert-to-expert relationship.

    Cognitive-structural psychotherapy: characteristics

    In cognitive-structural psychotherapy, Guidano and Liotti consider the cognitive system of the individual as a scientific theory that tries to describe the world (Creates models of reality) and to oneself (progressive self-knowledge by creating a model of oneself). In this way, knowing people about ourselves also means knowing what others have about us; the construction of our self includes others and the world (Guidano, 1991). Cognitive-structural psychotherapy links problems to the lack of complexity of the cognitive system.

    On the other hand, this type of psychotherapy gives particular importance to the treatment scheduleThat is to say when the different techniques are used and when the different problems of the patient are approached.

    On the other hand, they lead the Liotti they used Bowlby’s theory (1969) as a basis and starting point to establish criteria for distinguishing cognitive organizations.. According to the authors, the origin of individual differences lies in the different developmental pathways, which make it possible to describe the structural aspects, cognitive, emotional, behavioral characteristics and strategic processes of each patient.

      Self-organization levels

      Cognitive-structural psychotherapy establishes two levels of self-organization of knowledge. Personal identity is constituted as an intermediate structure which integrates the two levels. These levels are:

      1. Tacitus the depths

      It is knowledge integration frameworks derived from early affection bonds (Bowlby). Regarding Bowlby’s tilt theory, we know that the child is recognized by the people around him. Interpersonal relationships are essential for cognitive-structural psychotherapy to create self-knowledge.

      2. Explicit, superficial or structural

      These are beliefs about oneself, the appreciation of one’s emotions and behaviors, Assessment of the situation, self-esteem, etc. This level is developed from language and involves the construction of models of representation of reality.

      dynamic balance

      On the other hand, cognitive-structural psychotherapy proposes the concept of dynamic equilibrium to allude to a dissipative self-organization process, which includes two concepts: an evolution (progressive changes) and processes of sustaining the experience. .

      The therapy itself consists of overcome developmental imbalances (gaps) and avoid regressive changes or stagnation. To achieve this, there are two types of modifications, which are not exclusive:

      1. Superficial changes

      They are the first to appear. In general, it is not possible to move on to the second (deep) changes without making them. These changes it generally involves alterations in attitude towards reality, without strongly implying attitude towards oneself. They are usually sufficient to achieve most therapy goals.

      2. Profound changes

      They appear later, from the attitude towards oneself, that is to say towards oneself. Profound changes are often accompanied by a painful processAs the subject makes important variations in his identity, in the attitudes and beliefs that he has always maintained with regard to himself.

      It is recommended not to make such changes unless requested by the patient and voluntarily assume their cost in all directions.

      Process in therapy

      Thus, and in relation to all of the above, there are two types of processes (first and second level) in therapy:

      1. First level process

      It works at the level of tacit or deep organization, that is, on the deep structures of the person’s tacit self-knowledge; these, in turn, they relate in a bidirectional way to the attitude of the person towards himself, And the latter with two concepts: self-identity and self-esteem.

      These two attitudes ultimately determine the patient’s attitude to reality. The attitude towards reality is formed by the rules of assimilation of experience (how we assimilate what we are going through) and by problem-solving procedures.

      2. Second level process

      these they operate at the explicit structural level, Of two types of models: models of self (personal identity) and models of reality. The explicit structural level, in turn, acts in conjunction with level processes, on self-identity, self-esteem, and ultimately, attitude towards reality.

      Bibliographical references:

      • Guidano, V. (1991). The ego in process. Guilford Press. [El Sí-Mismo en Proceso, Paidós, 1994].
      • Bas, F. (1992). Cognitive-behavioral therapies: a second critical review. Clinic and health, COP Madrid, 3 (2).
      • Moltedo, A. (2008). The evolution of the work and the model of Vittorio Guidano: Historical biographical notes. Journal of Psychology, 17 (1), 65 – 85.

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