The role of cognitive biases in short‐term psychodynamic psychotherapy. (13th September 2017)

• Record Type: Journal Article
• Authors: Kramer, Ueli; Ortega, Diana; Ambresin, Gilles; Despland, Jean‐Nicolas; de Roten, Yves
• Is Part Of: Psychology and psychotherapy. Volume 91:Part 2(2018)
• Page Start: 143
• Page End: 156
• Publication Date: 2017-09-13
• Subjects: cognitive biases -- process -- process‐outcome -- short‐term dynamic psychotherapy; Clinical psychology -- Periodicals; Psychotherapy -- Periodicals; Mental illness -- Psychological aspects -- Periodicals; 616.89
• DOI: 10.1111/papt.12152
• Languages: English
• ISSNs: 1476-0835

Abstract

Abstract : The concept of biased thinking – or cognitive biases – is relevant to psychotherapy research and clinical conceptualization, beyond cognitive theories. The present naturalistic study aimed to examine the changes in biased thinking over the course of a short‐term dynamic psychotherapy (STDP) and to discover potential links between these changes and symptomatic improvement. This study focuses on 32 self‐referred patients consulting for Adjustment Disorder according to DSM‐IV‐TR. The therapists were experienced psychodynamically oriented psychiatrists and psychotherapists. Coding of cognitive biases (using the Cognitive Errors Rating Scale; CERS) was made by external raters based on transcripts of interviews of psychotherapy; the reliability of these ratings on a randomly chosen 24% of all sessions was established. Based on the Symptom Check List SCL‐90‐R given before and after, the Reliable Change Index (RCI) was used. The assessment of cognitive errors was done at three time points: early (session 4–7), mid‐treatment (session 12–17), and close to the end (after session 20) of the treatment. The results showed that the total frequency of cognitive biases was stable over time ( p = .20), which was true both for positive and for negative cognitive biases. In exploring the three main subscales of the CERS, we found a decrease in selective abstraction ( p = .02) and an increase in personalization ( p = .05). A significant link between RCI scores (outcome) and frequency of positive cognitive biases was found, suggesting that biases towards the positive might have a protective function in psychotherapy. Practitioner points: Therapists may be attentive to changes in biased thinking across short‐term dynamic psychotherapy for adjustment disorder. Therapists may foster the emergence of positive cognitive biases at mid‐treatment for adjustment disorder.