Process Of Change In Cognitive Therapy Research Articles

Change processes in cognitive therapy for social anxiety disorder delivered in routine clinical practice

Most studies examining processes of change in psychological therapy for social anxiety disorder (SAD) have analysed data from randomised controlled trials in research settings. To assess whether these findings are representative of routine clinical practice, we analysed audit data from two samples of patients who received Cognitive Therapy for SAD (total N = 271). Three process variables (self-focused attention, negative social cognitions, and depressed mood) were examined using multilevel structural equation models. Significant indirect effects were observed for all three variables in both samples, with negative social cognitions showing the strongest percent mediation effect. 'Reversed' relationships, where social anxiety predicted subsequent process variable scores, were also supported. The findings suggest the processes of change in this treatment may be similar between research trials and routine care.

Cognitive versus Behavior Therapy: Processes of Change in the Treatment of Obsessive-Compulsive Disorder

Background: Behavior therapy [exposure and response prevention (ERP)] and cognitive therapy (CT) have proven effective in the treatment of obsessive-compulsive disorder. Direct comparisons between these treatment modalities have exposed no differences in efficacy. However, very little research has been conducted into the differences between the change processes in ERP and CT. This investigation is a first attempt to study change by measuring scores on a weekly basis rather than at specific stages in the treatment and follow-up. Methods: We used the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) at weekly intervals to rate and compare the severity of the obsessions and compulsions of 61 completers of either CT or ERP. The aim was to ascertain whether the process of change in CT is different from the process of change in ERP. We expected that ERP would primarily affect behavior, thus reducing compulsions first, while CT would primarily affect thought, thus reducing obsessions first. Results: Firstly, no differences were found between ERP and CT with respect to the change process for obsessions and compulsions. Secondly, it emerged that changes in compulsions predicted all treatment effects better than changes in obsessions. Conclusions: These results suggest that reduction of compulsions is the process through which both ERP and CT affect change.

The big idea: clients' perspectives of change processes in cognitive therapy.

This study reports on analyses carried out by the authors on five 'end of therapy' evaluations conducted with clients who had received a brief course of cognitive therapy for depression. The clients' evaluation was based on Elliott's (1996) Change Interview Schedule. The transcripts were then analysed using grounded theory methods, and arranged into 10 categories and three category clusters. The category clusters included 'the listening therapist', 'the big idea' and 'feeling more comfortable with self'. Clients' reported cognitive and emotional processes fit with Stiles et al.'s (1990) assimilation model.

Schema change processes in cognitive therapy

AbstractSchemas are core beliefs which cognitive therapists hypothesize play a central role in the maintenance of long‐term psychiatric problems. Clinical methods are described which can be used with clients to weaken maladaptive schemas and construct new, more adaptive schemas. Guidelines are presented for identifying maladaptive and alternative, more adaptive schemas. Case examples illustrate the use of continuum methods, positive data logs, historical tests of schema, psychodrama, and core belief worksheets to change schemas. Specification of therapeutic methods for changing schemas can lead to the development of treatment standards and protocols to measure the impact of schema change on chronic problems.