COGNITIVE PSYCHOTHERAPY TOWARD ANEW MILLENNIUM

COGNITIVE PSYCHOTHERAPY TOWARD ANEW MILLENNIUM SCIENTIFIC FOUNDATIONS AND CLINICAL PRACTICE Edited by

Tullio Scrimali

and

Liria Grimaldi

Department of Psychiatry Medical School University of Catania Catania, Italy

Foreword by Arthur Freeman Springer Science+Business Media, LLC

Proceedings of the International Congress of Cognitive Psychotherapy: Cognitive Psychotherapy Toward a New Millennium, held June 20-24, 2000, in Catania, Italy ISBN 978-1-4613-5135-1 DOI 10.1007/978-1-4615-0567-9

ISBN 978-1-4615-0567-9 (eBook)

©2002 Springer Science+Business Media New York Originally published by Kluwer AcademiclPlenum Publisher, New York in 2002 Softcover reprint of the Hardcover I st edition 2002 http://www.wkap.nl/ 10987654321 A c.I.P. record for this book is available from the Library of Congress All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher

This book is dedicated to Carlo Perris. He was a great Italian and a great man. We have been and we will be forever proud of his friendship. Ciao, Carlo!

Tullio Scrimali Liria Grimaldi

Introduction to the images Hey now, all you sinners Put your lights on, Put your lights on Hey now, all you lovers Put your lights on, Put your lights on

[... J

Because there s a monster living under my bed Whispering in my ear There s an angel with a hand on my head She says I've got Nothing to fear f. .. J "Put your lights on" - from: C. Santana - Supernatural - 1999 We tum on our lights on meeting other sorrowful human beings in therapy. Dancing in the moonlight in company, or crossing the soul's oceans and deserts with our fragmentary maps ... Rashly we take on the task of saving ship-wrecked souls in the storm of emotions. We keep our light on.

Lorenzo Filippone

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"Images" by Lorenzo Filippone

About the Editors Tullio Scrimali

Tullio Scrimali (Catania, Italy, 1952) studied Medicine at the University of Catania and received specialty training in Psychiatry at the University of Milan where he had his Master Degree in 1981. For the past 20 years he has taught cognitive psychotherapy at the University of Catania and has been a Teacher Member of the Italian Association of Cognitive Psychotherapy since 1987. In addition to local teaching, he has lectured or presented workshops in many cities in Europe and North America. Most recently, he set up an international training program in Warsaw, the first cognitive therapy training program in Poland. He has published 6 books and more than 100 scientific articles on topics such as the links between brain functioning and cognition, constructivist approaches to therapy, cognitive therapy and rehabilitation of schizophrenic patients. The articles and chapters of book are published in many languages. He founded the international journal, Complexity and Change and he was Chair of the Scientific Committee and of the Organizing Committee for the International Congress, "Cognitive Psychotherapy Towards a New Millennium," held in Catania in June, 2000. Tullio Scrimali is actually Professor of Psychotherapy at the Department of Psychiatry, the Medical School of the University of Catania and also directs an International School of Cognitive Psychotherapy, called ALETEIA, he founded in Enna, Sicily. Tullio Scrimali is Member of the Board of the International Association for Cognitive Psychotherapy. He is also a founder fellow of the International Academy of Cognitive Therapy. Liria Grimaldi

Liria Grimaldi (Catania, Italy, 1954) studied Medicine at the University of Catania and specialized in Psychiatry at University of Messina. She teaches cognitive psychotherapy at the University of Catania and she is also a Teacher Member of the Italian Association of Cognitive Psychotherapy. She has lectured and presented workshops in many cities, in Europe and North America. She has authored 5 books and more than 100 scientific articles. Together with Tullio Scrimali, she founded the international journal, Complexity and Change and also the school of Cognitive Therapy ALETEIA Liria Grimaldi is Professor of Psychotherapy at the Department of Psychiatry, the Medical School of the University of Catania. Liria Grimaldi is a founder fellow of the International Academy for Cognitive Psychotherapy. IX

"Images" by Lorenzo Filippone

List of Contributors Darlys J. Alford

Anna Maria Bramante

University of Southern Mississippi, USA

Department ofPsychiatry, University of Catania, ITALY

Liliana H. Ar6stegui Cognitive Therapy Center ofBuenos Aires, ARGENTINA

Claudia Bregman Fundacion Aigle, ARGENTINA

Monica Bacchetta

Celina Brykczynska

Applied Technology for Neuro-Psychology Lab. Istituto Auxologico Italiano, ITALY

Institute ofPsychiatry and Neurology, POLAND

Brogna Barej Nowowiejski Hospital, POLAND

Department ofPsychiatry Medical University of Warsaw, POLAND

Ludwik Bryla

Sara Baringoltz

Paula Budich

Cognitive Therapy Center, ofBuenos Aires, ARGENTINA

Centre of Cognitive Therapy, Buenos Aires, ARGENTINA

Margherita Baruffi

Enrique Camacho

Laboratorio Sperimentale di Ricerche Psicologiche, Istituto Auxologico Italiano, ITALY

UCLA Center for Research on Treatment & Rehabilitation ofPsychosis, USA

Marco Bateni

Giuseppe Cannella

Centro per i disturbi d'Ansia e dell'Umore, Divisione di Psichiatria, Casa di Cura "Villa Margherita ", ITALY

Department ofPsychiatry, University of Catania, ITALY

Antonello Bellomo Department ofPsychiatry, University ofFoggia, ITALY

Associazione di Psicologia Cognitiva (APC), Terzo Centro di Psicoterapia Cognitiva di Roma, ITALY

Antonino Carcione

Maciej Bennewicz

Isabel Caro

Nowowiejski Hospital, POLAND

Universidad de Valencia, SPAIN

Maria Bernardini

Maria Teresa Cattaneo

Centro per i disturbi d'Ansia e dell'Umore, Divisione di Psichiatria, Casa di Cura "Villa Margherita", ITALY

University ofMilan, ITALY

Suma P. Chand

Behrooz Birashk

Sultan Qaboos University, SULTANATE OF OMAN

Tehran Psychiatric Institute, IRAN

Lucio Bizzini Department ofPsychiatry, Clinic of Geriatric Psychiatry of Geneva, SWITZERLAND

Young Hee Choi Seoul Paik Hospital, Inje University, SOUTH KOREA

Kinga Chutkowska

Vera Bizzini

Nowowiejski Hospital, POLAND

Department ofPsychiatry, Clinic of Geriatric Psychiatry of Geneva, SWITZERLAND

Alicia Cortejarena

JohnR. Bola

Cognitive Therapy Center ofBuenos Aires, ARGENTINA

Assistant Professor School of Social Work University of Southern California, Los Angeles, CA

Frank M. Dattilio University ofPennsylvania, School ofMedicine, USA

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Contributors

Gianluigi Dell'Erba

Carlos Giambroni

Centro di Salute Mentale, Gallipoli, ITALY

Cognitive Therapy Center ofBuenos Aires, ARGENTINA

Giorgia Della Giusta Centre for Clinical Sexuology, ITALY

Panteleimon Giannakopoulos

Fabrizio Didonna

Department ofPsychiatry, Clinic of Geriatric Psychiatry of Geneva, SWITZERLAND

Centro per i disturbi d'Ansia e de//,Umore, Divisione di Psichiatria, Casa di cura "Villa Margherita", ITALY

Giuseppe Giancarlo Dimaggio Associazione di Psicologia Cognitiva (APC), Terzo Centro di Psicoterapia Cognitiva di Roma, ITALY

Liria Grimaldi Department ofPsychiatry, University of Catania, ITALY

OlgaGuriz Ankara Residency Training Hospital, Department ofPsychiatry, TURKEY

Michael Dolan

Inga Huld Hermosdottir

Department ofPsychology, Philadelphia College of Osteopathic Medicine, USA

Faculty of Social Science, University ofIceland, ICELAND

Thomas Dowd

Kazuomi Inoue

The University ofAkron, USA

Department ofHuman Development, Naruto University ofEducation, JAPAN

David Edwards Department ofPsychology, Rhodes University, SOUTH AFRICA

Maurizio Falcone Associazione di Psicologia Cognitiva (APC), Terzo Centro di Psicoterapia Cognitiva di Roma, ITALY

Banu Isik Ankara Residency Training Hospital, Department ofPsychiatry, TURKEY

Thomas E. Joiner Jr. Department ofPsychology, Florida State University, USA

Christine Favre

Chryssoula Karba-Schina

Clinique Romande de Readaptation, Sion, SWITZERLAND

Laboratory ofDevelopmental Psychology and Psychopathology, Department ofPreschool Education, University ofThessaly, GREECE

Guillem Feixas University ofBarcelona, SPAlN

Nobuhide Kashiwagi Yamatogawa Junior High School, Osaka, JAPAN

Hector Fernandez-Alvarez

Diana Kirszman

Centre for Cognitive Therapy ofBuenos Aires, ARGENTINA

Fundacion AlGLE ofBuenos Aires, ARGENTINA

Lorenzo Filippone

Andrzej Kokoszka

DSM 1, AUSL 8 di Siracusa, ITALY

Department ofPsychiatry Medical University of Warsaw, POLAND

Arthur Freeman Department ofPsychology, Philadelphia College of Osteopathic Medicine, USA

Katharine Kolcaba

Kenji Fukui

Alex Kopelowicz

Department ofPsychiatry, Kyoto Prefectural University ofMedicine, JAPAN

UCLA School ofMedicine & San Fernando Mental Health Center Los Angeles, USA

The University ofAkron, USA

Dario Galati

Dominic Lam

Department ofPsychology, University of Turin, ITALY

Psychology Department, Institute ofPsychiatry, UNITED KINGDOM

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Contributors

Maria Lidia Lamberto

Maciej Moskwa

Cognitive Therapy Center ofBuenos Aires, ARGENTINA

Department ofPsychiatry, The Medical University of Warsaw &Department ofPhilosophy, Warsaw University, POLAND

Robert L. Leahy Department ofPsychiatry, Weill Cornell University Medical College, New York Presbyterian Hospital, USA

Cecilia Navarrini Institute of General and Clinical Psychology, Faculty ofMedicine and Surgery, University of Siena, ITALY

Robert Paul Liberman UCLA School ofMedicine & San Fernando Mental Health Center Los Angeles, USA

Ghassem Naziri Tehran Psychiatric Institute, IRAN

Grazia Lomunno

Arthur M. Nezu

ALA.M C. (Associazione Italiana di Analisi e Modijicazione del Comportamento), ITALY

MCP Hahnemann University, USA

Lars-Gunnar Lundh

Associazione di Psicologia Cognitiva (APC), Terzo Centro di Psicoterapia Cognitiva di Roma, ITALY

Department of Psychology, Stockholm University, SWEDEN

Giuseppe Nicolo

William J. Lyddon

AynurOzel

University of Southern Mississippi, USA

Ankara Residency Training Hospital, Department ofPsychiatry, TURKEY

Francesco Mancini Scuola di Specializzazione in Psicoterapia Cognitiva, Associazione di Psicologia Cognitiva di Roma, ITALY

Christine A. Padesky Center for Cognitive Therapy, Huntington Beach, USA

Chantal Mansour

Alessandra Palma

Laboratory of Cognitive Psychology, Department ofPsychology, University Saint Joseph de Beyrouth, LlBAN

Department ofPsychology, University ofPalermo, ITALY

Carlos Meza

Department ofPsychology, Florida State University, USA

Cognitive Therapy Center ofBuenos Aires, ARGENTINA

Enrico Molinari Laboratorio Sperimentale di Psicologia, ATN-P Lab. Istituto Auxologico Italiano, Verbania, ITALY Dipart. di Psicologia, Universita Cattolica del Sacro Cuore, Milan, ITALY

Antonella Montano Istituto Skinner di Roma, ITALY

Shirley Morrissey University of Tees side, UNITED KINGDOM

Marisol Perez

Carlo Perris Svenska Institutet for Kognitiv Psykoterapi, SWEDEN

Gianpiero Petriglieri Department of Psychiatry, University of Catania, ITALY

Gianpaolo Pierri Department ofNeurological and Psychiatric Sciences, University ofBari, ITALY

Olimpia Pino Institute ofPsychology, University ofParma, ITALY

Loren R. Mosher Director, Soteria Associates San Diego, & Clinical Professor ofPsychiatry School of Medicine University of California at San Diego, USA

Claudio P. Pia Cognitive Therapy Center ofBuenos Aires, ARGENTINA

Contributors

XIV

Elzbieta Plonecka

Santoni Rutgiu

Nowowiejski Hospital, POLAND

Katia Polopoli

Day Hospital per la diagnosi e la cura dei disturbi del comportamento alimentare presso if Policlinico di Bari, ITALY

Department ofPsychiatry, University of Catania, ITALY

Luis A. Saul University of Salamanca, SPAIN

Igor Pontalti Associazione di Psicologia Cognitiva (APC), Terzo Centro di Psicoterapia Cognitiva di Roma, ITALY

Agnieszka Popiel

Oliver Scheibenbogen Schuhfried Ges.m.b.H., AUSTRIA

George Schreiner University of Southern Mississippi, USA

II Department ofPsychiatry Medical University of Warsaw, POLAND

Jan Scott

Jorg Prieler

Department ofPsychological Medicine, University of Glasgow, UNITED KINGDOM

Schuhfried Ges.m.b.H., AUSTRIA

Michele Procacci Associazione di Psicologia Cognitiva (APC), Terzo Centro di Psicoterapia Cognitiva di Roma, ITALY

Georges Rabbath Laboratory of Cognitive Psychology, Department ofPsychology, University Saint Joseph de Beyrouth, LIBAN

Joseph Reser University ofDurham, Stockton on Tees, UNITED KINGDOM

John H. Riskind

Tullio Scrimali Department of Psychiatry, University of Catania, ITALY

Gabriel E. Sella Ohio Valley Disability Institute, USA

Antonio Semerari Associazione di PSicologia Cognitiva (APC), Terzo Centro di Psicoterapia Cognitiva di Roma, ITALY

Liliana Signorini Institute of General and Clinical Psychology, Faculty ofMedicine and Surgery, University of Siena, ITALY

George Mason University, Virginia, USA

Giuseppe Riva

Steven M. Silverstein Weill Medical College of Cornell University and New York Presbyterian Hospital, USA

Istituto Auxologico Italiano, Verbania, & Dipartimento di Psicologia, Universita Cattolica del Sacro Cuore, Milano, ITALY

Monika Sitarz

RobertRizk

Department ofPsychiatry, Medical University of Warsaw, POLAND

Laboratory of Cognitive Psychology, Department ofPsychology, University of Saint Joseph de Beyrouth, LIBAN

Institute ofPsychiatry and Neurology, POLAND

Roberto A. Rubio

Malgorzata Siwiak-Kobayashi Jakob Smari

Cognitive Therapy Center ofBuenos Aires, ARGENTINA

Faculty of Social Science, University ofIceland, ICELAND

Jeremy D. Safran

Diane Spangler

New School University, USA

Mauricette Saikali Laboratory of Cognitive Psychology, Department ofPsychology, University Saint Joseph de Beyrouth, LIBAN

Department ofPsychology, Brigham Young University, USA

Cheri Lynn Sparks University of Southern Mississippi, USA

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Contributors

SiguIjon Stefansson Department ofNeurology, University ofIceland, ICELAND

CSPP Research and Service Foundation, California, USA

Richard Steiner

Ruth Irene Wilner

The University ofAkron, USA

Jakub Szumanski II Department ofPsychiatry, Medical University of Warsaw, POLAND

Lydia Tineo Cognitive Therapy Center ofBuenos Aires, ARGENTINA

M. Hakan Turkcapar Ankara Residency Training Hospital, Department ofPsychiatry, TURKEY

Berardina Valerii DEA (Dipartimento Emergenza Accettazione), Azienda Ospedaliera Policlinico "Umberto I", Roma, ITALY

Francesco Vincelli Laboratorio Sperimentale di Psicologia, ATN-P Lab. Istituto Auxologico Italiano, Verbania, & Department ofPsychology, Universita Cattolica di Milan, ITALY

Brenda Wiederhold Center for Advanced Multimedia Psychotherapy,

Cognitive Therapy Center ofBuenos Aires, ARGENTINA

Michael Wohlman Department ofPsychology, Rhodes University, SOUTH AFRICA

Grace Wong Psychology Department, Institute ofPsychiatry, London, UNITED KINGDOM Michi Hatashita-Wong Weill Medical College of Cornell University and New York Presbyterian Hospital, USA

Maria Zafiropoulou Laboratory ofDevelopmental Psychology and Psychopathology, Department ofPreschool Education, University ofThessaly, GREECE

Marek Zebrowski Nowowiejski Hospital, POLAND

Anna Zinetti Department ofPsychiatry, Clinic of Geriatric Psychiatry of Geneva, SWITZERLAND

o

"Images" by Lorenzo FI" llppone

Foreword In the roughly two decades since Aaron T. Beck published the now classic "Cognitive Therapy of Depression," and Michael J. Mahoney declared the "Cognitive Revolution," much has happened. What was proposed as the "cognitive revolution" has now become the zeitgeist, and Cognitive Therapy (CT) has grown exponentially with each passing year. A treatment model that was once seen as different, strange, or even alien, is now commonplace. In fact, many people have allied themselves with CT claiming that they have always done CT. Even my psychoanalytic colleagues have claimed that they often use CT. "After all," they say, "Psychoanalysis is a cognitive therapy." Cognitive Therapy (or Cognitive Psychotherapy) has become a kaleidoscope model of treatment, with influences coming from many sources. Some of these contributory streams have been information processing, behavior therapy, Constructivist psychology, and dynamic psychotherapy. Each of these sources have added color, shading, and depth to the CT model. What was originally unidimensional in terms of the CT focus on depression has become multidimensional as the CT model has been applied to virtually every patient population, treatment setting, and therapy context. CT must now be seen as a general model of psychotherapy that, with modifications, can be applied to the broad range of clinical problems and syndromes. What has tied these various applications of CT together is the emphasis on a strong grounding in cognitive theory, a commitment to empirical support, and a dedication to broadening the model. It is said that Freud was concerned that his psychoanalysis was being derided as the "Viennese Science". After all, psychoanalysis was founded in Vienna, promoted in Vienna, and the most visible practitioners were Viennese. Freud's inclusion of Jung in the early circle gave the movement a more international flair by including a Swiss member (albeit a German Swiss).

CT has not had that same experience. From the earliest days, CT included the cognitive and behavioral work of many contributors. Practitioners and researchers in both Britain and Sweden were early in the fold, notably John Teasdale and Ivy Blackburn in England and the late Carlo Perris in Sweden. I was fortunate by being in the best place, with the right people, at the perfect time. That place was the University of Pennsylvania, the time was the late 1970's and the group of people were led by Aaron T. Beck. Part of Beck's genius was to draw in some of the most brilliant researchers, teachers, and theoreticians into the group. Some of the early group included Maria Kovacs, Brian Shaw, Steve Hollon, Gary Emery, John Rush, and Ruth Greenberg. I recall being at a psychological congress with Dr. Beck in 1979, before the depression book was published. We put signs around the conference venue asking people interested in discussing Cognitive Therapy to meet that evening in one of the hotel meeting rooms. About ten people showed up. Two years later, a symposium at the annual meeting of the American Psychological Association filled a room with over 500 people. The symposium had the rather pretentious title, "New Directions in Cognitive Therapy". The pretension came from the fact that in 1981 we had barely established old directions for CT. Denise Davis, a young psychologist at that meeting was so taken with what she heard that she sought training from Dr. Beck, and is now a colleague and collaborator with Dr. Beck and me. Denise also serxvii

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Foreword

ved as the founding editor of the journal, Cognitive and Behavioral Practice. After that meeting, I shared a taxi with Dr. Beck from the hotel to the airport. He was enthusiastic about the great display of interest we had just seen. With his typical humility he wondered how long this interest would last and where we would go with this new movement. He had no idea of how his work would grow over the next 20 years. There is an American folk-hero. His name was John Chairman. He is better known as Johnny Appleseed. Chairman traveled throughout the frontier during the early years of the United States planting apple trees. Several years after he was gone, there were thousands of apple trees resulting from his planting the seeds. In the past two decades I have been honored and privileged to help to plant a number of seeds around the world. We have heard the terms, "cultural diversity," "cultural sensitivity," or cross cultural awareness". The implication of these terms is that different cultures may be so very different that models of assessment or treatment developed in one culture may not be valid in another culture. I was not terribly surprised, however, that when I taught in the United Kingdom that the English said, "We are interested in CT because it well suits the English mind." It also made sense when I heard the same message in Sweden. It was, however, when I traveled to the East, to Japan and China, that being told the CT was interesting because " ... .it well suits the Chinese (or Japanese) mind". Now I was really puzzled. Having now traveled to 22 countries, I have seen this phenomenon again and again. The basic CT model has been able to fit many cultures, often quite different one from the other. CT books in English have been translated into many other languages. How could this be so? The answer is quite simple. CT is not content based but rather process based. The goal of the cognitive therapist, wherever they practice, is to help the patient to understand the basic templates that we all develop for perceiving and understanding the world. These "schema" influence every aspect of our responses. CT has been, from its earliest formulation, schema-based and schema focused. What differs from culture to culture are the schema. The process for understanding the schema transcends the particular culture. Beck could not have predicted in the early days the contribution and influence that CT would have. There is now an international association for cognitive psychotherapy (IACP) that sponsors and supports a triennial international conference. The association's journal, The Journal of Cognitive Psychotherapy: An International Quarterly publishes articles by professionals from around the world. IACP is a constituent member of the World Congress Committee and thereby has an effect on another international meeting, the triennial World Congress of Behavioral and Cognitive Therapies. The Academy of Cognitive Therapy is working to set performance standards for what is considered the highest level of practice of CT. The editors of this volume, Tullio Scrimali and Liria Grimaldi, are two of the foremost practitioners, researchers and teachers of cognitive therapy. They have, in a very brief time, created a series of miracles.

If word of these miracles traveled from the University in Catania in Sicily north to the Vatican and who knows what honors these two would receive? Their miracles have included the establishment of the

Foreword

XIX

first chair in Cognitive Psychotherapy in any Italian University. They have established a state accredited training school for the education and training of cognitive therapists. They have exported their training model to other countries, most notably Poland. Tullio and Liria have produced a superb journal, Complexity and Change, with articles in both Italian and English. Tullio almost single-handedly organized, promoted, and ran a most successful and inspiring congress in Catania in the summer of 2000. Tullio and Liria have published several volumes and far too many chapters and journal article to record here. One of their crowning achievements to date, however, is this volume. Nowhere is this intemational focus of CT more clear and obvious than in this book. Tullio and Liria have sought contributions from the preeminent cognitive therapists in the world. Contributors from 14 countries have addressed the broadest range of clinical topics. As the reader will quickly see, cognitive therapists are not of one mind nor are we moving lock-step in a parochial or orthodox manner. While this lack of orthodoxy is troubling to some cognitive therapists it is thrilling to me. It shows the breadth and depth of the model and the diversity within the model. It is also fitting and notable the the publishers of this volume, Kluwer AcademiclPlenum, were pioneers in publishing the earliest texts in CT. Some of the early work of Mahoney, Meichenbaum, Foreyt and Rathgen, Freeman, and others was published under the Plenum imprint. Creative applications of CT, expansion of the model to new populations, and ongoing outcome research will continue to drive our work. The continued growth of CT will be based on how the basic process is understood and used in new cultural settings. The watchwords for the future are process, structure, and empiricism. The need and emphasis for empirical support of the model will continue to be a hallmark of CT. A final, and more personal note. I have been blessed and privileged to have met Tullio and Liria many years ago. To count them among my very dearest friends has been wonderful, both personally and professionally. This is why their request for me to write this foreword is so flattering. I commend this volume as a standard for the dissemination of information about CT. I commend their choice of contributors. Finally, I commend the excellence of the individual contributions. With this volume and the conference upon which it was based, CT has moved strongly and forcefully into the 21 st century.

Arthur Freeman Philadelphia, Pennsylvania

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"Images"

by Lorenzo Filippone

Preface At the beginning of the new millennium, and after a turbulent development process of almost fifty years, Cognitive Psychotherapy still does not seem to have reached a full epistemological, doctrinaire and applicative maturity. However, at a clinical level, Cognitive Psychotherapy may be considered as one of the most valid and efficient instruments. It is supported by an enormous mass of research and experimental data, covering a numerous series of clinical problems such as mood disorders, with particular reference to depression, as well as anxiety, personality and eating disorders. Recently, also in the field of schizophrenia, several works have been carried out, capable of suggesting an original cognitive approach to the therapy and rehabilitation of psychotic patients. Along with the standard approach, by the Philadelphia School, started by A. T. Beck, a pool of further evolutions of the original cognitive paradigm have been taking place and are still under development. Among these, the relational and constructivist approach, seem to be particularly relevant. In June 2000, an international Congress, proposed by the International Association for Cognitive Psychotherapy, and organised by our team, was held in Catania. This Conference was attended by some of the most important Authors from the different International Schools of Cognitive Psychotherapy. The Congress was a very important chance to compare the different positions and to summarize the current orientations of Clinical Cognitivism and Cognitive Psychotherapy. This book includes a series of contributions presented at the Congress. We hope it will be a useful instrument, giving an extensive review of the various outlines of contemporary Cognitive Psychotherapy. The theoretical chapters, of the first part of the book, are focused on the great issues of Contemporary Cognitive Psychotherapy. The second part includes a series of chapters dealing with clinical applications. The third part covers almost all psychiatric disorders. Hopefully this volume is going to be a useful contribution to the critical reflection about the development of Cognitive Psychotherapy at the beginning of the third millennium.

Tullio Scrimali Liria Grimaldi

XXI

"Images" by Lorenzo Filippone

Acknowledgments We wish to thank all the Colleagues who gave their contribution and also the Publisher Kluwer Academic who supported us in the difficult effort of pUblication. We would like also to thank to Dr. Katia Popolopoli who worked extremely hard to help us in editing the work and in preparing the index. We are gratetul to Angela Del Popolo for her translations into English and to Elena Passarello for the final revision of the English of our chapters. Tullio Scrimali Liria Grimaldi

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