The cloverleaf model of cognitive behaviour therapy as experiential learning: implications for case formulation, therapeutic practice and practitioner development

Abstract

Abstract Cognitive behaviour therapy (CBT) is an evidence-based psychotherapy for a wide variety of psychological problems. While the exact working mechanisms of CBT remain unknown, its mode of action might usefully be conceptualised as facilitated experiential learning. An adapted ‘cloverleaf’ version of Borton’s ‘what, so what, now what’ learning model is presented to elaborate some of the potential benefits of taking an experiential learning perspective on CBT. These include conceptualising the maintenance of client problems as inhibited experiential learning and the CBT therapeutic process as the cultivation of more effective experiential learning. An experiential learning perspective might also provide an accessible way for trainee and early-career CBT therapists to understand more clearly the learning methodology that underlies CBT’s distinctive approach to psychotherapy. The model is also intended to create an overarching conceptual bridge between reflective practice, the therapist’s experiential learning in the client role, and the client’s experience of CBT as facilitated experiential learning. Key learning aims (1) To introduce a modified ‘cloverleaf’ experiential learning process model that can be applied to the conceptualisation of client difficulties, CBT therapeutic processes, and practitioner development. (2) To demonstrate how the model can be used to develop cross-sectional and descriptive maintenance formulations of client problems and client wellbeing. (3) To show how the model can be used as a conceptual and practical tool to help formulate both the therapeutic process and challenges and obstacles to that process. (4) To help practitioners make links between the process of personal and professional development and client change processes.