Why Don't People Change? What Stops Them from Changing? An Integrative Commentary on the Special Issue on Resistance

This commentary discusses the four papers from the vantage point of a cognitive-developmental view. Psychotherapeutic change involving changes in core cognitive structures is seen as threatening an individual's personal sense of identity as well as security and safety needs. Core cognitive constructs are laid down early via the principle of covariation of events and form the basis of our tacit knowledge base. Subsequent changes in this tacit knowledge is difficult because the core cognitive constructs act like a mental filter to screen in confirming data and screen out disconfirming data. Ambiguous stimuli tend to be interpreted on the basis of preexisting cognitive constructs, even when the match between event and interpretation is not ideal. Several suggestions are given for increasing the probability of changes occurring in core cognitive constructs.     

自控摄入小剂量酒精影响熟练驾驶行为的实验研究

一个小样本受试者内设计实验,受试者在实验允许的酒精剂量范围内自由选择摄入量。实验安排饮酒前,酒后３０分钟、１１０分钟和１７０分钟四个测试阶段,分别检验受试者在模拟驾驶和实际驾驶两项任务中的认知行为。酒后３０分钟实际驾驶的技能与其他三个测试期相比存在有意义的差别显著性;模拟测试任务中酒后对红、黄两种信号灯的认知反应时之间呈现显著性差别,酒后１１０分钟对黄色信号灯的反应明显延迟。研究提示：受试对酒精感受性的估计是不可靠的,小剂量酒精也能对驾驶行为构成伤害。     

The Prediction of Negative Events Associated with Anxiety and Dietary Restraint: A Test of the Content Specificity Hypothesis

The prediction of future negative events was studied in a sample of undergraduate students varying on measures of anxiety and dietary restraint. Cognitive theories of psychopathology hypothesize that the emotional concerns of an individual determine which types of information are most often cognitively processed with a biased interpretation. This prediction has generally been called the content specificity hypothesis. Based upon this aspect of cognitive theory, we hypothesized that a high level of trait anxiety would be associated with higher ratings of the probability of future physically threatening events. In addition, it was hypothesized that a high level of dietary restraint would be associated with lower ratings of the probability of future occurrences of overeating. The results of the study supported these hypotheses. These prediction biases were found to be more pronounced in women, as compared to men. The findings were interpreted as supportive of the content specificity hypothesis.     

Cognitive Bias in Spider-Phobic Children: Comparison of a Pictorial and a Linguistic Spider Stroop

The relation between spider fear in children and cognitive processing bias toward threatening information was examined. It was investigated whether spider fear in children is related to a cognitive bias for threatening pictures and words. Pictorial and linguistic Stroop stimuli were administered to 28 spider phobic and 30 control children aged 8–12. Spider-phobic children showed a moderate bias for threatening words. Surprisingly, no bias was found for spider pictures, while the spider-phobic children judged the pictures as more aversive. Moreover, in a recent similar study in adults (Kindt & Brosschot, 1997), a strong relation between spider phobia and bias toward threat words and pictures was found. Several explanations are given to account for this divergence.     

Exploring Decision Making Around Therapist Self‐Disclosure in Cognitive Behavioural Therapy

Background

Therapist self‐disclosure (TSD) usage varies greatly among different psychotherapy orientations. Anecdotal evidence seems to suggest that there are reasons for its judicious use, and a small number of researchers have proposed guidelines for how TSD should be used to help therapists across psychotherapy models make decisions around disclosure. However, there is almost no literature specifically exploring how cognitive behaviour therapy (CBT) practitioners make decisions around employing TSD within the CBT framework.

Objective

This study aimed to explore how experienced CBT practitioners make decisions around TSD.

Method

In‐depth qualitative interviews were conducted with six clinical psychologists who were trained and experienced in CBT, and the interviews were analysed thematically.

Results

There were two overarching themes in terms of how they made decisions to self‐disclose: (A) the rules for TSD use, which included sub‐themes (a) it must have a clear purpose, (b) it must fit, (c) the therapist must maintain boundaries, and (d) the therapist must always reflect on his/her use of TSD; and (B) how they use TSD, which included subthemes of (a) using it as a tool for change and (b) using it to manage the therapeutic relationship.

Conclusion

Participants’ decisions on whether or not to self‐disclose were strongly influenced by the CBT model, and this process went beyond what is suggested in the transtheoretical literature. Understanding this process may lead to the development of CBT‐specific guidelines for making TSD‐related decisions.     

Cognitive Behavioral Therapy and the Treatment of Posttraumatic Stress Disorder: Where Counseling and Neuroscience Meet

There is increasing evidence to support the biological basis of mental disorders. Subsequently, understanding the neurobiological context from which mental distress arises can help counselors appropriately apply cognitive behavioral therapy and other well‐researched cognitive interventions. The purpose of this article is to describe the neurobiological context underlying the formation and treatment of posttraumatic stress disorders, a mental disorder frequently encountered by counselors, from a cognitive therapy framework.     

Enhanced Cognitive Behavior Therapy: A Single Treatment for All Eating Disorders

Eating disorders are serious mental illnesses affecting a significant proportion of women and a smaller number of men. Approximately half of those with an eating disorder (ED) will not meet the criteria for anorexia or bulimia nervosa, and will be diagnosed with an eating disorder not otherwise specified (EDNOS). Until recently, there were no recommended treatments for EDNOS. This article provides an overview of enhanced cognitive behavior therapy, a validated treatment for all forms of EDs.