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Narrative Changes Predict a Decrease in Symptoms in CBT for Depression: An Exploratory Study.

Miguel M Gonçalves1, Joana Ribeiro Silva1, Inês Mendes1

  • 1University of Minho, School of Psychology, Braga, Portugal.

Clinical Psychology & Psychotherapy
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Summary
This summary is machine-generated.

Innovative moments, or new ways of thinking and feeling in therapy, predict symptom reduction in cognitive behavioural therapy (CBT). Specifically, reflection 2 innovative moments, focusing on change processes, are key to improving depressive symptoms.

Keywords:
Cognitive Behavioural TherapyDepressionInnovative MomentsProcess of ChangePsychotherapy

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Area of Science:

  • Psychotherapy Research
  • Clinical Psychology
  • Cognitive Behavioral Therapy

Background:

  • Innovative moments (IMs) represent new ways of thinking, feeling, acting, and relating that emerge during psychotherapy.
  • Prior research indicates IMs differentiate between recovered and unchanged psychotherapy cases.
  • Studies specifically examining IMs within cognitive behavioural therapy (CBT) were lacking.

Purpose of the Study:

  • To determine if IMs can be reliably identified in CBT sessions.
  • To investigate the association between IMs and symptom improvement in CBT for depression.
  • To explore whether IMs predict symptom decrease or vice versa.

Main Methods:

  • The study analyzed data from six cases of CBT for depression, totaling 111 sessions.
  • Symptomatology was assessed using the Outcome Questionnaire-10 (OQ-10).
  • Hierarchical linear models were employed to test the predictive relationship between IMs and symptom changes.

Main Results:

  • Innovative moments were found to be stronger predictors of symptom decrease than symptom changes were of IM emergence.
  • A higher proportion of 'reflection 2' IMs in a session predicted a decrease in symptoms in the subsequent session.
  • Clients elaborating on positive contrasts or change processes within IMs showed a reduction in symptoms.

Conclusions:

  • The expression and elaboration of 'reflection 2' IMs appear to facilitate the reduction of depressive symptoms in CBT.
  • IMs focusing on contrasts between old and new patterns, and on the process of change, are most predictive of symptom amelioration.
  • Therapists can integrate techniques encouraging exploration of contrasts and change processes into CBT to potentially enhance symptom improvement.