Trial-based psychotherapy and the efficacy of trial-based thought record in changing unhelpful core beliefs and reducing self-criticism

Oliveira, Irismar Reis de; Hemmany, Curt; Powell, Vania Bitencourt; Bonfim, Thaís D.; Duran, Érica Panzani; Novais, Nilma; Velasquez, Michella Lopes; Sarno, Elaine Di; Alves, Gledson L.; Cesnik, Joici A.

doi:10.1017/s1092852912000399

Cited by 22 publications

(34 citation statements)

References 11 publications

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“…Subsequently, the intensity of patients' dysfunctional CBs and corresponding emotions after the first use of the TBTR was assessed in a larger sample (n = 166) 8 , confirming the previous findings.…”

Section: Introductionsupporting

confidence: 80%

Changing negative core beliefs with trial-based thought record

Delavechia¹,

Velasquez²,

Duran

et al. 2016

Arch. Clin. Psychiatry (São Paulo)

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Background: Trial-based thought record (TBTR) is a technique used in trial-based cognitive therapy (TBCT), and simulates a court trial. It was designed to restructure unhelpful core beliefs (CBs) during psychotherapy. Objective: To confirm previous findings on the efficacy of TBTR in decreasing patients' adherence to self-critical and unhelpful CBs and corresponding emotions, as well as assessing the differential efficacy of the empty-chair approach relative to the static format of TBTR. Methods: Thirty-nine outpatients were submitted to a 50-minute, one-session, application of the TBTR technique in the emptychair (n = 18) or conventional (n = 21) formats. Patients' adherence to unhelpful CBs and the intensity of corresponding emotions were assessed after each step of TBTR, and the results obtained in each format were compared. Results: Significant reductions in percent values both in the credit given to CBs and in the intensity of corresponding emotions were observed at the end of the session (p < .001), relative to baseline values. ANCOVA also showed a significant difference in favor of the empty-chair format for both belief credit and emotion intensity (p = .04). Discussion: TBTR may help patients reduce adherence to unhelpful CBs and corresponding emotions and the empty-chair format seems to be more efficacious than the conventional format.

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Section: Introductionsupporting

confidence: 80%

Changing negative core beliefs with trial-based thought record

Delavechia¹,

Velasquez²,

Duran

et al. 2016

Arch. Clin. Psychiatry (São Paulo)

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“…It is also noteworthy that participants positively compared CFT chair‐work to their prior cognitive treatment, contrasting the chair‐work's “feel‐it” moments to the rational focus of verbal or written work. As identified by participants, it could be argued that CFT chair‐work acts to link “head”‐based propositional meaning with “heart”‐based implicational processing (Teasdale & Barnard, ), giving support to prior findings that chair‐work is more effective at meaning and emotion change than verbal interventions on the same subject (de Oliveira et al, ). The emotional, embodied and multi‐sensory nature of CFT chair‐work might therefore be conceptualised as reducing “rational‐emotional dissociation” (Stott, ) whilst increasing “depth of experiencing” (a factor associated with improved clinical outcomes in experiential practice, for example, Pascual‐Leone & Yeryomenko, ).…”

Section: Discussionsupporting

confidence: 56%

“…Whilst much of the outcome research on chair‐work is preliminary (see Pugh, , for review), technique comparison studies have been notable in demonstrating how chair‐work had a greater impact in reducing mental health problems such as depression, anxiety and self‐criticism when compared to “relationship conditions” alone (Stiegler, Molde, & Schanche, ). Chair‐work has also been shown to outperform written cognitive interventions, in key clinical areas, when addressing the same material (de Oliveira et al, ). Stand‐alone studies of chair‐work have shown particular benefit in targeting and reducing self‐criticism and associated emotional distress (Shahar et al, ).…”

Section: Introductionmentioning

confidence: 99%

“A definite feel‐it moment”: Embodiment, externalisation and emotion during chair‐work in compassion‐focused therapy

Bell

Montague

Elander

et al. 2019

Couns and Psychother Res

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Chair‐work is an experiential method used within compassion‐focused therapy (CFT) to apply compassion to various aspects of the self. This is the first study of CFT chair‐work and is focused on clients' lived experiences of a chair‐work intervention for self‐criticism. Twelve participants with depression were interviewed following the chair‐work intervention and the resulting data were examined using interpretative phenomenological analysis. Three superordinate themes were identified: “embodiment and enactment,” “externalising the self in physical form” and “emotional intensity.” The findings suggest the importance of accessing and expressing various emotions connected with self‐criticism, whilst highlighting the potential for client distress and avoidance during the intervention. The role of embodying, enacting and physically situating aspects of the self in different chairs is also suggested to be an important mechanism of change in CFT chair‐work. The findings are discussed in terms of clinical implications, emphasising how core CFT concepts and practices are facilitated by the chair‐work process.

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“…37 Still regarding the comparison between TBCT or cognitive interventions and BA, in addition to the study by Jacobson et al, 34 another trial has suggested that both psychotherapies have similar efficacy rates. 75 However, TBCT is a transdiagnostic approach, 41,43,46 while BA has been shown to be effective in treating only depression to date. Thus, TBCT might be the choice for patients presenting with comorbid conditions.…”

Section: Discussionmentioning

confidence: 99%

“…40 Therefore, TBCT promotes cognitive restructuring at the 3 levels of cognitive conceptualization (automatic thoughts, underlying assumptions and core beliefs) with techniques that mimic a legal process in which the patients are led to assume the roles of defendant, prosecutor, defense attorney and juror, by seeking evidence for and against their CBs conceptualized as self-accusations. 41,42 TBCT has been shown to be effective in social phobia, 43,44 and also to promote modification of CBs in patients presenting with a variety of psychiatric diagnoses. 43,45,46 It is therefore important to evaluate its efficacy in reducing depressive symptoms relative to BA, a first-line treatment for MDD.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of trial-based cognitive therapy, behavioral activation and treatment as usual in the treatment of major depressive disorder: preliminary findings from a randomized clinical trial

et al. 2019

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Introduction. Major depressive disorder (MDD) is a prevalent, debilitating and disabling disorder, and its prevalence is increasing. Antidepressants (AD), cognitive-behavioral therapy (CBT) and behavioral activation (BA) are the main treatments for MDD. Trial-based cognitive therapy (TBCT) addresses and restructures dysfunctional negative core beliefs (CBs) and is a novel and promising approach. Objective. The aim of this study was to compare the efficacy of TBCT, BA and treatment as usual (TAU) in the treatment of MDD. Methods. A total of 76 patients with MDD were randomized into 1 of 3 groups and evaluated at baseline, after 6 weeks and at week 12 (final evaluation). The primary outcome was changing in HAM-D scores, and the secondary outcomes included scores on the BDI, CD-Quest, Sheehan Disability Scale (SDS) and WHOQOL. Results. Both TBCT and BA (which also included AD) were different from TAU (which included antidepressants alone) in reducing the HAM-D and BDI scores and other measures. TBCT and BA were different from TAU in the reduction of disability in SDS and WHOQOL physical domain scores. Besides limited by a small sample size, the dropout rate in the TAU arm was higher, and only 10 patients completed the 3 evaluations. Conclusion. This trial provides evidence that TBCT and BA combined with antidepressants were more efficacious than the TAU (drug alone) in reducing the severity of depressive symptoms and disability, showing that this combination can be useful for clinical practice.

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Trial-based psychotherapy and the efficacy of trial-based thought record in changing unhelpful core beliefs and reducing self-criticism

Abstract: TBTR may help patients reduce attachment to negative CBs and corresponding emotions. Outcomes were significantly favorable regardless of the format use and therapists' level of exposure to TBTR.

Cited by 22 publications

References 11 publications

Changing negative core beliefs with trial-based thought record

Changing negative core beliefs with trial-based thought record

“A definite feel‐it moment”: Embodiment, externalisation and emotion during chair‐work in compassion‐focused therapy

Efficacy of trial-based cognitive therapy, behavioral activation and treatment as usual in the treatment of major depressive disorder: preliminary findings from a randomized clinical trial

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