Experimental and Psychotherapeutic Demand Characteristics and the Cognitive Therapy Rationale: An Analogue Study

Abstract

In cognitive therapy (CT) for depression, the treatment rationale is presented in lay terms as an ABC sequence such that A represents a recent event, B represents automatic thoughts about the event, and C represents the resulting affective response. The role of demand characteristics in rationales such as this has been extensively explored in research on systematic desensitization but little has been done with regards to CT. This study investigated the influence of the CT rationale and an alternative rationale on participants' self-reported thoughts and feelings in response to images. While the CT rationale assumes that cognition precedes and causes affect, the alternative rationale flipped the terms of ABC into an ACB theory in which affect is assumed to precede and cause cognition. We found that both rationales influenced reporting: Those who received the ABC rationale reported that more automatic thoughts were evoked first, while those who received the ACB rationale reported that more automatic feelings were evoked first. The rationales also were more influential on high arousal images and less influential for participants with previous therapy experience. Results are discussed in terms of experimental demand characteristics (conscious compliance) and psychotherapeutic demand characteristics (nonconscious changes in clinically relevant behavior) and implications for therapy.