Materials used to support cognitive behavioural therapy for depression: a survey of therapists’ clinical practice and views

ABSTRACT

Use of supporting materials in cognitive behavioural therapy (CBT) is widely advocated, and homework increases effectiveness. The study aimed to identify materials most frequently used by CBT therapists to support CBT for depression, and those perceived clinically most effective. Questionnaires were sent to 3665 accredited CBT therapists asking about their use of resources commonly described in CBT manuals, and their views on effectiveness. Of 3665 approached by post/email, 994 (27%) responded. Another 33 completed the questionnaire via the study website. 818/1027 (80%) of respondents were accredited practitioners who deliver one-to-one therapy. Symptom measures, lists of problems/goals, activity schedules, behavioural activation diaries/plans, and case formulation worksheets were used “frequently” or “very frequently” by over 85% of respondents. Sleep diaries and computerised CBT were used least. Most resources were used within and between sessions. Activity schedules, behavioural activation diaries/plans, case formulation worksheets, thought records, and resources to support the identification of conditional beliefs were regarded as most effective. Symptom measures, sleep diaries, and computerised/online materials were considered only moderately effective. Therapists use a wide range of materials to support individual CBT. For delivering CBT, technology-enabled approaches should incorporate a range of materials to enable therapists to tailor treatment effectively.     

Inconsistent child-rearing: A reply to rosenthal

Abstract

In a reply to our paper (Kohlmann, Schumacher, & Streit, 1988), Rosenthal (in a Letter to the Editors, this issue) primarily gives some comments on findings regarding the association of inconsistent child-rearing behavior and anxiety in the child. Results of our study were compared to results from a study by Rosenthal, Finkelstein, Ni, and Robertson (1959).     

PTSD Symptom Patterns Following Traumatic and Nontraumatic Events

This study extends research examining posttraumatic stress disorder symptoms following different types of potentially traumatic events. Specifically, the study examined and compared the symptom patterns observed in those who suffered a major accident, the unexpected death of a loved one, or sexual assault. Based on recent findings, this project also examines those who reported nontraumatic (but stressful) events, as well as comparing symptom patterns across gender. Findings suggest different types of traumas might be associated with differences in severity and patterns of symptoms for women (but not for men), suggesting symptom patterns manifest differently in men and women. Results also call into question the assumption that traumatic events demonstrate different symptom patterns than other types of events.     

The law of large numbers in children's diversity-based reasoning

Adults increase the certainty of their inductive inferences by observing more diverse instances. However, most young children fail to do so. The present study tested the hypothesis that children's sensitivity to instance diversity is determined by three variables: ability to discriminate among instances (Discrimination); an intuition that large numbers of instances increase the strength of conclusion (Monotonicity); ability to detect subcategories and evaluate numerical differences between the subcategories, or Extraction. A total of 219 Chinese children aged 6 to 11 were tested for sensitivity to diversity by means of Discrimination, Monotonicity, and Extraction. The results indicated that children at all ages were able to discriminate instances and attend to set size. However, only 9- and 11-year-olds demonstrated Extraction and sensitivity to diversity. Furthermore, among all children diversity scores increased linearly with the level of Extraction. These results suggest that the law of large numbers plays a role in children's diversity-based reasoning.     

On the failure of cognitive ability to predict myside and one-sided thinking biases

Two critical thinking skills—the tendency to avoid myside bias and to avoid one-sided thinking—were examined in three different experiments involving over 1200 participants and across two different paradigms. Robust indications of myside bias were observed in all three experiments. Participants gave higher evaluations to arguments that supported their opinions than those that refuted their prior positions. Likewise, substantial one-side bias was observed—participants were more likely to prefer a one-sided to a balanced argument. There was substantial variation in both types of bias, but we failed to find that participants of higher cognitive ability displayed less myside bias or less one-side bias. Although cognitive ability failed to associate with the magnitude of the myside bias, the strength and content of the prior opinion did predict the degree of myside bias shown. Our results indicate that cognitive ability—as defined by traditional psychometric indicators—turns out to be surprisingly independent of two of the most important critical thinking tendencies discussed in the literature.     

The grim reasoner: Analytical reasoning under mortality salience

The human species enjoys uniquely developed capacities for analytical reasoning and rational decision making, but these capacities come with a price: They make us aware of our inevitable physical death. Drawing on terror management theory and dual-process theories of cognition, we investigate the impact of mortality awareness on analytical reasoning. Two experiments show that experimentally induced thoughts of death impair analytical reasoning performance, just as cognitive load would. When made aware of their own mortality, reasoners allocate their executive resources to the suppression of this disturbing thought, therefore impairing their performance on syllogisms that require analytic thought. This finding has consequences for all aspects of rational thinking that draw on executive resources, and calls for an integrated approach to existential psychology and the psychology of rational thought.     

Cognitive styles and person–environment fit: Investigating the consequences of cognitive (mis)fit

There is currently considerable interest in the key elements of person–environment fit to understand vocational behaviour and to develop strategic human resource management practices. In the light of this interest, we wanted to investigate (1) whether people within similar functions have similar cognitive styles, and (2) what the consequences of cognitive (mis)fit are on three work attitudes, using two large-scale databases (N = 24,267 and N = 2,182). We identified a knowing-oriented cognitive climate in finance, information technology (IT), and research and development (R&D) functions; a planning-oriented cognitive climate in administrative and technical and production functions; and a creating-oriented cognitive climate in sales and marketing functions and general management. Furthermore, we found that the relationship between people's cognitive styles and work attitudes (i.e., job satisfaction, job search behaviour, and intention to leave) does not depend on the cognitive climate in which they work. However, we did find that people with a higher creating style on average score higher on intention to leave and job search behaviour in comparison with people who score lower on the creating style, irrespective of the cognitive climate they are working in. The cognitive climate also partially affects job satisfaction and intention to leave after controlling for cognitive styles. In summary, cognitive styles and cognitive climate seem to have separate influences on people's work attitudes. Our findings are relevant for selection and recruitment policies of organizations and in the context of training, job design, and workforce planning.     

When bystanders become bothersome: The negative consequences of bystander conflict and the moderating role of resilience

Bystander conflict is a situation in which employees are hindered in their work by parties not involved in the primary process. Public service employees and emergency care workers, such as ambulance employees and firefighters, often encounter this kind of conflict with potentially far-reaching detrimental effects for public or patient safety. Unfortunately, until now, bystander conflict has hardly received scientific attention. In this paper, we will present the results of an experiment (Study 1) and a simulation study (Study 2). Taken together, the results indicate that bystander conflict is negatively related to the affective, behavioural, and cognitive outcomes of individuals. Higher levels of bystander conflict were associated with more negative and less positive feelings (Studies 1, 2), unfavourable bystander appraisals (Studies 1, 2), and lower levels of performance (Study 2). Additionally, Study 2 revealed that bystander conflict was negatively and indirectly related to positive affect and performance through cognitive capacity. We investigated the moderating role of resilience, in order to provide insight into potential factors alleviating these negative associations. In both studies, resilience alleviated the negative associations of bystander conflict. Overall, the results of the two studies provide a first step towards a theory on bystander conflict.     

Methodological practices in cognitive style research: Insights and recommendations from the field of business and psychology

This study provides insights and recommendations concerning methodological practices of cognitive style research applied to the field of business and psychology. Based on a carefully designed selection process, 139 style-related articles published between 1986 and 2010 were content-analysed. In terms of research design, we found the field to be dominated by quantitative, cross-sectional, and single-source designs that relied heavily on self-reports, sample surveys, and student samples. While this might indicate a potential vulnerability in terms of internal and external validity, a strong emphasis on construct validity was also found, exemplified by high attention to reliability, and exploratory and confirmatory factor analyses. With regard to construct measurement, although more than 30 different instruments were used, the field was dominated by three of these. Regarding data analysis, traditional approaches have been mainly used and more advanced and novel approaches have not yet permeated through the cognitive style field. Implications and suggestions for future research are offered. This is the first review of methodological practices in cognitive style research and represents an important step in the advancement of the field.     

Attributions for Memory Performance in Adulthood: Age Differences and Mediation Effects

We examined age differences in attributions to internal (controllable and uncontrollable), external (uncontrollable), and unstable factors for performance on a free recall memory task in 149 young, middle-aged, and older adults. Attributions varied by age and by level of memory performance. Middle-aged and older adults rated internal, uncontrollable factors (ability and genes) as more influential for high performance than for low performance, and they were less likely than young adults to attribute low performance to these factors. Within age groups, only the older adults rated memory ability as more influential than strategy use, even though they were as likely as the other age groups to use a categorization strategy. Attributions to both internal controllable (strategy use) and uncontrollable (ability) factors as well as to health were associated with better memory performance. These attributions partially mediated the relationship between age and memory performance. Thus, attributions may provide some insight into sources of age differences in memory performance.