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immediacy achieved by using phenomenological ("here and now") therapist interventions
to explore the "particularities of the patient-therapist relationship," without the therapist
placing premature emphasis on the genetic past.
A central principle in BRT is the therapist's use of Metacommunication (as noted
above) and an emphasis on mindfulness in the therapeutic relationship.
Metacommunication is a process of exploring the interaction that exists between the
therapist and the patient. In contrast to other traditional treatments (e.g., cognitive
behavioral and psychodynamic), the patient, rather than the analyst, is considered the
arbiter of his or her own experience. In BRT, the role of the therapist is to explore
tentatively the interpersonal interactions and to focus on the patient's immediate
emotional experience (Safran & Segal, 1990). The theory of change is conceptualized in
terms of two principles: The first is referred to as "decentering," a process of
disembedding from the dysfunctional interpersonal cycle. The second can be understood
as a process of "disconfirmation," where a therapist and a patient create a new
relationship that provides a corrective experience that challenges the patient's previous
maladaptive experiences of relationships.
Cognitive Behavioral Therapy (CBT: Turner & Muran, 1992). CBT has its
theoretical origins in cognitive theory (e.g. Beck, 1976; Muran, 1991). It is a "self-
schema-based model that depicts personality and behavior as organized by underlying
belief systems about the self that have become structuralized" (Muran, 2000). These self-
schemas are derived from individuals' past experiences and are maintained by
maladaptive behaviors that reinforce the distorted self-schema. A vicious cycle can result,
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