The Synergistic Process of Improvement in Cognitive Behavioral Therapy for Major Depression

Malkomsen, Anders; Røssberg, Jan Ivar; Dammen, Toril; Wilberg, Theresa; Løvgren, André; Evensen, Julie

doi:10.3390/ijerph18052292

Cited by 5 publications

(5 citation statements)

References 36 publications

(58 reference statements)

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“…In two previous articles on the same patient material we found that both patients who had received CBT and PDT wanted tools to help them out of the depression [39,40]. By exploring the metaphor of tools more closely when it is used by the patient, the therapist may get a better understanding of what the patient actually needs.…”

Section: Tools: What Patients Need To Improvementioning

confidence: 97%

Digging down or scratching the surface: how patients use metaphors to describe their experiences of psychotherapy

et al. 2021

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Background In the present study, we wanted to explore which metaphors patients suffering from major depressive disorder (MDD) use to explain their experience of being in therapy and their improvement from depression. Methods Patients with MDD (N = 22) received either psychodynamic therapy (PDT) or cognitive behavioral therapy (CBT). They were interviewed with semi-structured qualitative interviews after ending therapy. The transcripts were analyzed using a method based on metaphor-led discourse analysis. Results Metaphors were organized into three different categories concerning the process of therapy, the therapeutic relationship and of improvement from depression. Most frequent were the metaphorical concepts of surface and depth, being open and closed, chemistry, tools, improvement as a journey from darkness to light and depression as a disease or opponent. Conclusions Patient metaphors concerning the therapeutic experience may provide clinicians and researchers valuable information about the process of therapy. Metaphors offer an opportunity for patients to communicate nuances about their therapeutic experience that are difficult to express in literal language. However, if not sufficiently explored and understood, metaphors may be misinterpreted and become a barrier for therapeutic change. Trial registration Clinical Trial gov. Identifier: NCT03022071. Date of registration: 16/01/2017.

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Section: Tools: What Patients Need To Improvementioning

confidence: 97%

Digging down or scratching the surface: how patients use metaphors to describe their experiences of psychotherapy

et al. 2021

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“…We used a reference list to analyze ME and categorize conceptual metaphors. Specifically, the list contains the following studies: (1) Literature on depression metaphors ( Hughes-Hammer et al, 1998 ; McMullen and Conway, 2002 ; Pritzker, 2003 , 2007 ; Schoeneman et al, 2004 ; Charteris-Black, 2012 ; Refaie, 2014 ; Kauschke et al, 2018 ; Leis et al, 2019 ; Yoon et al, 2019 ; Beck, 2020 ; Tong, 2020 ; Coll-Florit et al, 2021 ; Malkomsen et al, 2021 ; Munday et al, 2021 ; Taylor-Jackson and Moustafa, 2021 ) (2) List of metaphors ( Lakoff et al, 1991 ) (3) Oxford guide to metaphors in CBT ( Stott et al, 2010 ) …”

Section: Methodsmentioning

confidence: 99%

“…(1) Literature on depression metaphors ( Hughes-Hammer et al, 1998 ; McMullen and Conway, 2002 ; Pritzker, 2003 , 2007 ; Schoeneman et al, 2004 ; Charteris-Black, 2012 ; Refaie, 2014 ; Kauschke et al, 2018 ; Leis et al, 2019 ; Yoon et al, 2019 ; Beck, 2020 ; Tong, 2020 ; Coll-Florit et al, 2021 ; Malkomsen et al, 2021 ; Munday et al, 2021 ; Taylor-Jackson and Moustafa, 2021 )…”

Section: Methodsunclassified

Words for the hearts: a corpus study of metaphors in online depression communities

Shi,

Khoo

2023

Front. Psychol.

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Purpose/significanceHumans understand, think, and express themselves through metaphors. The current paper emphasizes the importance of identifying the metaphorical language used in online health communities (OHC) to understand how users frame and make sense of their experiences, which can boost the effectiveness of counseling and interventions for this population.Methods/processWe used a web crawler to obtain a corpus of an online depression community. We introduced a three-stage procedure for metaphor identification in a Chinese Corpus: (1) combine MIPVU to identify metaphorical expressions (ME) bottom-up and formulate preliminary working hypotheses; (2) collect more ME top-down in the corpus by performing semantic domain analysis on identified ME; and (3) analyze ME and categorize conceptual metaphors using a reference list. In this way, we have gained a greater understanding of how depression sufferers conceptualize their experience metaphorically in an under-represented language in the literature (Chinese) of a new genre (online health community).Results/conclusionMain conceptual metaphors for depression are classified into PERSONAL LIFE, INTERPERSONAL RELATIONSHIP, TIME, and CYBERCULTURE metaphors. Identifying depression metaphors in the Chinese corpus pinpoints the sociocultural environment people with depression are experiencing: lack of offline support, social stigmatization, and substitutability of offline support with online support. We confirm a number of depression metaphors found in other languages, providing a theoretical basis for researching, identifying, and treating depression in multilingual settings. Our study also identifies new metaphors with source-target connections based on embodied, sociocultural, and idiosyncratic levels. From these three levels, we analyze metaphor research’s theoretical and practical implications, finding ways to emphasize its inherent cross-disciplinarity meaningfully.

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“…We have previously shown that the improvement process is experienced after therapy as a gradual, non-linear and slow process involving many elements that interact synergistically (33). Patients seldom refer to just one particular element of therapyrather, "it's the whole package" that stimulates improvement.…”

Section: Identifying Synergistic and Cumulative Effectsmentioning

confidence: 99%

“…In fact, the differences in how improvement in CBT and PDT is experienced seem to have diminished in the years that have passed after therapy ended. We have previously interviewed patients who received CBT and PDT in the MOP project just a few weeks after therapy ended (33,42). After three years, patients who received CBT highlight fewer CBT specific elements than a few weeks after therapy.…”

Section: Diminishing Importance Of the Therapeutic Approachmentioning

confidence: 99%

“It takes time to see the whole picture”: patients’ views on improvement in cognitive behavioral therapy and psychodynamic therapy after three years

Malkomsen,

Røssberg,

Dammen

et al. 2024

Front. Psychiatry

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IntroductionThere is a lack of qualitative research that retrospectively explores how patients with major depressive disorder view their improvement in psychotherapy.MethodsFifteen patients who received short-term cognitive behavioral therapy and psychodynamic therapy were individually interviewed approximately three years after completing therapy.ResultsSome patients had altered their views on therapy, especially those who initially were uncertain of how helpful therapy had been. They said they did not realize the extent and importance of their improvement in therapy before some time had passed, which can be explained by the surprising cumulative effects of seemingly small changes.DiscussionThis should make retrospective qualitative research an important part of future psychotherapy research.

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The Synergistic Process of Improvement in Cognitive Behavioral Therapy for Major Depression

Cited by 5 publications

References 36 publications

Digging down or scratching the surface: how patients use metaphors to describe their experiences of psychotherapy

Digging down or scratching the surface: how patients use metaphors to describe their experiences of psychotherapy

Words for the hearts: a corpus study of metaphors in online depression communities

“It takes time to see the whole picture”: patients’ views on improvement in cognitive behavioral therapy and psychodynamic therapy after three years

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