Competencies in Cognitive and Behavioral Interventions

Nezu, Christine Maguth; Ricelli, Sarah; Nezu, Arthur M.

doi:10.1093/oxfordhb/9780199733255.013.24

The Oxford Handbook of Cognitive and Behavioral Therapies 2015

DOI: 10.1093/oxfordhb/9780199733255.013.24

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Competencies in Cognitive and Behavioral Interventions

Christine Maguth Nezu

Sarah Ricelli

Arthur M. Nezu

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2020

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“…Addressing this gap, we can use theory and basic psychopathology research to map CBT and EBCT onto Doss’s four steps. For CBT, the primary therapy change processes are cognitive-behavioral techniques that are mostly derived from learning/conditioning and information-processing theories (Nezu, Ricelli, & Nezu, 2016). Such techniques aim at engaging the patient in cognitive restructuring, which is thought to ultimately reduce the patients’ suffering (Newman, 2016).…”

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Theory-specific patient change processes and mechanisms in different cognitive therapies for depression.

Coyne

Constantino

Krieger

et al. 2020

Journal of Consulting and Clinical Psychology

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This study aimed to identify differential patient change processes and mechanisms associated with long-term outcome in exposure-based cognitive therapy (EBCT) and cognitive-behavioral therapy (CBT) for depression. Method: We drew on a randomized controlled trial in which 149 patients were randomly assigned to either EBCT or CBT, with the treatments showing comparable efficacy at 12-month follow-up (grosse Holtforth et al., 2019). Based on Doss's ( 2004) 4-step model of psychotherapy change and using sequential multilevel structural equation models, we tested putative theory-based change processes and mechanisms for both treatments. Specifically, we examined emotional processing and cognitive restructuring during treatment as hypothesized change processes of EBCT and CBT, respectively. Furthermore, as potential change mechanisms during follow-up, we examined theory-relevant mechanisms for each treatment, preselected via multilevel models. Results: Although the full serial mediational pathways were not supported, EBCT fostered greater during-treatment increases in emotional processing and higher self-efficacy during follow-up than CBT, both of which associated with better long-term depression outcome. Unexpectedly, cognitive restructuring change did not differ between EBCT and CBT. Across both CBT and EBCT, greater during-treatment increases in cognitive restructuring related to lower cognitive-behavioral avoidance and greater self-efficacy across follow-up, which associated with lower long-term depression. Conclusions: Results suggest that therapists might improve long-term depression outcome by fostering both emotional processing (via emotionfocused techniques as included in EBCT) and cognitive restructuring (by using general CBT techniques included in both treatments), which operate either directly or through varied treatment-common mechanisms (e.g., greater self-efficacy and reduced cognitive-behavioral avoidance). What is the public health significance of this article?Therapists could capitalize on both enhancing emotional processing (via emotion-focused techniques integrated within cognitive-behavioral therapy) and cognitive restructuring (via overall cognitivebehavioral therapy techniques) during therapy for depression. Assimilating emotion-focused techniques into cognitive-behavioral therapy (CBT) facilitates greater emotional processing during treatment and greater self-efficacy during follow-up, both of which associated with better long-term outcome. Additionally, greater in-session cognitive restructuring in either standard CBT or exposurebased CBT leads to greater self-efficacy and lower cognitive-behavioral avoidance during follow-up, which are both associated with better long-term outcome after therapy for depression.

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mentioning

confidence: 99%

Theory-specific patient change processes and mechanisms in different cognitive therapies for depression.

Coyne

Constantino

Krieger

et al. 2020

Journal of Consulting and Clinical Psychology

View full text Add to dashboard Cite

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Competencies in Cognitive and Behavioral Interventions

Cited by 1 publication

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Theory-specific patient change processes and mechanisms in different cognitive therapies for depression.

Theory-specific patient change processes and mechanisms in different cognitive therapies for depression.

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