Cognitive Therapy in Israel: Thinking with One's Heart

Article excerpt

There is an Israeli saying: "When two Israelis meet there are three opinions." When we started to think about what is cognitive therapy in Israel we soon discovered that we have at least three opinions about cognitive therapy in Israel: (a)"Doing cognitive therapy in Israel is not different from what is done in Philadelphia or in Kent, Ohio"; (b) "The Israeli client reacts to cognitive therapy completely different from the average client in the Western world"; (c) "The clients in Israel are not different from the clients in the rest of the world, however, the average Israeli therapist is uniquely different from his or her colleagues in the Western world." We are sure that our three different opinions are all true reflections of the practice of cognitive therapy in Israel. Furthermore, we both agree that when any one of our cognitive therapist colleagues in Israel will read our paper, he or she will have another two opinions about cognitive therapy in Israel that will be different from ours. Does this sound completely irrational? May be. But in Israel we think not only with our heads but also with our hearts. Things may feel right and that is what makes them right, even if they are logically contradictory. Just watch two Israelis arguing to become convinced that emotions and cognitions are closely linked to each other and none has a primacy over the other.

With all that said, we are not claiming that the Israeli psychotherapists are not interested in cognitive therapy. Workshops on cognitive therapy are usually well attended with an eager, but often skeptical audience of social workers, psychologists and psychiatrists. In fact, since we have introduced cognitive methods to the practice of behavior therapy, we were able to attract the interest and attention of many of our colleagues who were raised in the psychodynamic tradition. Behavior therapy without the addition of the word "cognitive" was never well accepted by Israeli psychotherapists. The old brand of behavior therapy was often conceived as being too mechanical, inhuman, too technical, superficial, reductionist, dangerous, limited in scope, and not respectful of the client (Rosenbaum, 1988).

Following the lead of the European Association of Behavioral & Cognitive Therapies, the Israeli Association of Behavioral and Cognitive Therapies (IABCT) has just recently added the term "cognitive" to its name. The association has currently over 100 registered members. Under the active leadership of the second author, Dr. Tammie Ronen, IABCT has invited outstanding cognitive- behavior therapists from abroad to lead one- or two-day workshops. Invitations included people such as: Albert Ellis. Edna Foa, Fred Kanfer, Isaac Marx, and Bob Niemeyer. We are grateful to those people who were willing to give workshops for nominal fees and thus enabled the attendance of many Israeli professionals who are generally on low salaries. Indeed, our workshops are very well attended and not only by members of IABCT.

Almost every psychology or social work department in Israel offers one or two courses in cognitive-behavior therapy. A few. years ago the School of Social Work at Tel Aviv University offered a two-year training program in cognitive-behavior therapy for psychiatrists, social workers and psychologists. About 40 people completed this program (which was highly rated by the participants). Because of lack of funds the program had to be suspended. A number of Israeli psychiatric hospitals have established outpatient therapy units that solely use cognitive-behavioral techniques. Although such units reflect on the growth of cognitive-behavior therapy in Israel, they also reflect on the fact that cognitive-behavior therapy is not in the main stream of psychological treatments in Israel. The most dominant therapeutic orientation in the academic and clinical institutions in Israel is still the psychodynamic orientation.

Israel is blessed with a high proportion of clinical psychologists who practice psychotherapy. …