Cognitive-evolutionary psychotherapy

Domain II · Behavioural & cognitive · Giovanni Liotti · 1983 · Rome

What it is

It is an approach to psychotherapy, not a manualised protocol. Farina & Liotti (2018) present it on three linked levels (a general psychological theory, a theory of pathogenesis and a theory of cure) and define no session plan. It grew out of Italian cognitive therapy: Guidano & Liotti (1983)…

Format

• The sources describe no fixed session count, no manualised phases and no formal criteria for moving between phases. Farina & Liotti (2018) describe levels of theory and two treatment strategies: a cooperative relational stance, and integrated treatment across several settings.
• Format and length: usually individual and weekly. The one published AIMIT single case ran 24 weekly sessions over about eight months.

Who practises it, and how they are trained or regulated

• Order of work: Cortina describes Liotti first helping patients feel safe, regulate emotion and feel empowered, including psychoeducation about the effects of trauma, and exploring the trauma only afterwards.
• Build safety, emotion regulation and a sense of empowerment, with psychoeducation about trauma.
• Version followed: Giovanni Liotti's cognitive-evolutionary psychotherapy (psicoterapia cognitivo-evoluzionista, the Rome "relational turn" in cognitive therapy). This guide follows Farina & Liotti's 2018 account of the approach, the alliance and AIMIT work of Liotti & Monticelli (2008, 2014) and Fassone et al. (2012), Ivaldi's (2004) clinical use of the drama triangle and the dual individual-plus-group setting, and…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• escalating exchanges become rarer, and you can name your pull before acting on it.
• your own urge to prove yourself (see 4.3). Success shows when hostility softens into curiosity.
• over-coding, that is, labelling every sentence. Use the coding to guide your next move, not to lecture.
• intellectual answers with no emotion, or sudden confusion or blankness, which may be dissociation (4.11).
• repeated testing of the setting. Treat it as information about motivational patterns, not only as a rule violation.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.