No pain, no gain: Depressed clients' experiences of cognitive behavioural therapy

Abstract

Highlighting the possible barriers to adherence in CBT can help clinicians to better prepare clients in making an informed choice about therapy. Exploring these issues during therapy may also help with engagement. Despite the challenges, clients can still benefit from CBT by learning strategies that enable them to effectively deal with their depression.

Do mental health patients learn what their cognitive-behaviour therapists think they do? A short report on qualitative interviews comparing perspectives

“…In line with other research, patients valued therapy as an opportunity to learn new and diverse cognitive-behavioural skills (Barnes et al, 2013; French et al, 2017), which seems to be an important mediator of symptom change (Hundt et al, 2013). Patient and therapist perceptions strongly relate to general mechanisms of psychotherapeutic change, like resource activation or mastery (Gassmann & Grawe, 2006).…”

“…Accordingly, we focused not only on depression (Barnes et al, 2013; French et al, 2017; Hundt et al, 2013) but included different diagnoses, which also implied heterogeneity. Study limitations refer to the small accidental sample size, reactivity due to an awareness of being interviewed, self-assessment bias (Walfish, McAlister, O’Donnell, & Lambert, 2012), patient selection by therapists (which is why it remains unclear whether prototypical or especially cooperative patients were included), of therapies mainly in the early stages, and the restriction to a university treatment setting.…”

“…This is also the case for emotion regulation and acceptance, whereas both are described as part of the so-called “third wave” interventions. Further studies should focus on facilitators of change regarding current daily behaviours and on enablers of long-term change (Barnes et al, 2013; Hundt et al, 2013). Alongside focusing on the benefits of CBT, patients should also be given balanced information about potential obstacles, like emotional problems arising during homework tasks, in order to manage expectations, prepare patients for coping with difficulties, and thus reduce treatment discontinuation (Barnes et al, 2013).…”

“…Further studies should focus on facilitators of change regarding current daily behaviours and on enablers of long-term change (Barnes et al, 2013; Hundt et al, 2013). Alongside focusing on the benefits of CBT, patients should also be given balanced information about potential obstacles, like emotional problems arising during homework tasks, in order to manage expectations, prepare patients for coping with difficulties, and thus reduce treatment discontinuation (Barnes et al, 2013). Most importantly, patients who valued the learning experiences during CBT are more likely to use newly acquired skills, even in the long run (French et al, 2017).…”

A Feasibility Study: Emotional Freedom Techniques for Depression in Australian Adults

“…CBT is thought to be effective for the treatment of a variety of conditions, including mood, anxiety, personality, eating, substance abuse, tic and psychotic disorders. However, research has found that the skill of the therapist is directly related to the outcomes of CBT (Strunk et al, 2010) and at times clients reportthey have felt under pressure to give particular answers when receiving CBT, or that the therapy was not flexible enough to match client needs (Barnes et al, 2013). While meta-analyses find CBT more effective than psychodynamic therapy and equal to other therapies in treating anxiety and depression (Cuijpers et al, 2008;Tolin, 2010), psychodynamic therapy may provide better long-term outcomes (Shedler, 2010).…”