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Meta-analytic research has highlighted the clinical similarity in outcome between psychodynamic and cognitive–behavioral therapies (Leichsenring, 2001; Stiles, Barkham, Mellor-Clark, & Connell, 2008), yet patients’ understanding of the 2 therapies is qualitatively different (Nilsson, Svensson, Sandell, & Clinton, 2007). Through common mechanistic factors exemplified in the pioneering works of Aaron Beck, Steven Hayes, Keith Dobson, Hanna Segal, Peter Fonagy, and Donald Winnicott, among others, this article discusses the theoretical convergence of cognitive and psychodynamic therapy through the aid of illuminative clinical material that will contrast the mechanistic similarities and differences between the 2 therapies. A central aim of this article is to better inform early career trainee therapists of the structural overlap and divergence between the 2 theoretical orientations that are often seen as squarely oppositional in function and practice. Four theoretical platforms will be presented that identify both common factors between the 2 therapies, as well as sharp divergent models of change, with direct clinical relevance and case examples: absolutism versus multiplicity, the “healthy” dissociation, “self as change” (modeled through top-down vs. bottom-up processing routes), and developmental considerations.

La investigación de meta-análisis ha puesto de relieve la similitud clínica en los resultados entre las terapias psicodinámicas y cognitivo-conductual (Leichsenring, 2001; Stiles, Barkham, Mellor-Clark, y Connell, 2008), sin embargo, la comprensión de los pacientes de los 2 tratamientos es cualitativamente diferente (Nilsson, Svensson, Sandell, y Clinton, 2007). A través de factores mecánicos comunes ejemplificados en los trabajos pioneros de Aaron Beck, Steven Hayes, Keith Dobson, Hanna Segal, Peter Fonagy, y Donald Winnicott, entre otros, este artículo analiza la convergencia teórica de la terapia cognitiva y la psicodinámica a través de la ayuda de material clínico que contrastarán las similitudes mecánicas y las diferencias entre las 2 terapias. El objetivo central de este artículo es informar terapeutas principiantes de la superposición estructural y divergencia de las 2 orientaciones teóricas que a menudo son vistas como opuestas en función y practica. Cuatro plataformas teoricas seran...