It's complicated: The relation between cognitive change procedures, cognitive change, and symptom change in cognitive therapy for depression

The effects of cognitive behavior therapy for adult depression on dysfunctional thinking: A meta-analysis

“…However, it is also possible that certain therapeutic contexts, like those focusing explicitly on changing dysfunctional thoughts, are more likely to engender cognitive change (Lorenzo-Luaces et al, 2015). In this case, we might expect to see differences between CBT and other therapies on these outcomes.…”

“…Garratt, Ingram, Rand, & Sawalani (2007) argued that the contrast against pharmacotherapy is particularly relevant because claims had yet to be made about pharmacotherapy also acting through the mediation of changing dysfunctional thoughts. Nonetheless, recently some of these claims have begun to be made (Lorenzo-Luaces et al, 2015). One of the main arguments comes from interpreting behavioral and neuroimaging data showing that in both healthy and depressed individuals, antidepressant medication can have effects on emotional processing even before it has effects on mood (Harmer, Goodwin, & Cowen, 2009).…”

“…Most studies have shown that CBT for depression does have an effect on dysfunctional thinking, but until now no meta-analysis has been done to examine magnitude of these effects and furthermore whether they are unique or specific to CBT. The last point is essential, given the fundamental opposition between researchers claiming that cognitive change, regardless of how it is achieved, is fundamental to symptom change (Beck & Dozois, 2011;David & Montgomery, 2011;Lorenzo-Luaces et al, 2015) and those arguing that cognitive change is non-essential for symptom change and most likely another consequence accompanying successful treatment, due to the action of other causal factors (Longmore & Worrell, 2007;Kazdin, 2007;Garratt, Ingram, Rand, & Sawalani, 2007;Wampold, 2001). It is not possible to examine causality directly using the available evidence primarily because the designs of most individual studies were such that that the outcomes and the presumed mechanisms of change could not truly and reliably be parsed (e.g., measured at the same time point, confounding variables were not accounted for).…”

Dynamic relationships of therapist alliance and group cohesion in transdiagnostic group CBT for anxiety disorders.

“…The magnitude of the cohesion-symptom relations in the present study was also remarkably consistent with the broader psychotherapy literature. Specifically, the effect size estimates in meta-analytic aggregations have generally found cohesion-outcome relations of r = 0.25, and found cohesion to have stronger relations with outcome than other process factors in group therapy (i.e., Burlingame et al, 2011; see also Ardito & Rabellino, 2011; Lorenzo-Luaces, German, & DeRubeis, in press). …”

Introduction to the Special Issue on Processes of Cognitive Behavioral Therapy: Does “Necessary, But Not Sufficient” Still Capture It?

“…The various treatments within the broad family of CBTs , each emphasize somewhat different processes Hofmann 2017, 2018;Klepac et al 2012), and there are suggestions of processes that can occur in the absence of cognition (Mennin et al 2013, and see review in;Lorenzo-Luaces et al 2015). The past two decades have witnessed some further advances, whereby core dimensions in psychopathology have been linked to treatment processes that are broadly relevant to the typical case presentation in the consultation office; where either full or partial DSM criteria for multiple disorders are met.…”