Symposium 111 - Sharing and Leveraging the Lessons of CBT: Understanding How CBT Works and Using that Understanding to Inform Interventions

Chair(s)

• 

  Daniel Strunk, Ph.D. (he/him/his)

  Professor of Psychology
  The Ohio State University
  Columbus, Ohio

Discussant(s)

• 

  Matthew Southward, Ph.D. (he/him/his)

  Research Assistant Professor
  University of Kentucky
  Lexington, Kentucky

Presenter(s)

• LL

  Lorenzo Lorenzo-Luaces, PhD (he/him/his)

  Assistant Professor
  Indiana University, Bloomington
  Bloomington, Indiana
• RD

  Robinson De Jesus-Romero, M.S. (he/him/his)

  Graduate Student
  Indiana University
  Bloomington, Indiana
• SM

  Samuel Murphy, Clinical Psychology Ph.D. Candidate

  MA
  Ohio State University
  Columbus, Ohio
• 

  Daniel Strunk, Ph.D. (he/him/his)

  Professor of Psychology
  The Ohio State University
  Columbus, Ohio
• BB

  Brooklynn Bailey, M.S. (she/her/hers)

  Clinical Psychology, Ph.D. Candidate
  The Ohio State University
  Columbus, Ohio

We focus on two important problems in the cognitive behavioral therapy (CBT) literature. First, CBT is difficult to scale to address mental health problems at a societal level. Second, questions about how CBT works and how understanding this might be useful have persisted for some time.

Highlighting efforts to understand how cognitive behavioral interventions achieve their effects, one speaker will present evidence that improvements in cognitive reappraisal, but not reductions in expressive suppression appear to account for the week-to-week improvements in a transdiagnostic guided self-help intervention. Another speaker will present evidence highlighting the role of cognitive change and CBT skills as drivers of therapeutic gains in two cognitive behavioral therapies. Both presentations highlight the use of sophisticated analytic approaches to study potential causal relationships with repeated measures data. Using random-intercept cross-lagged panel models, the researchers can examine within and between person relationships. These models also allow for appropriate modeling of autoregressive effects and the simultaneous modeling of reciprocal relationships. Thus, evidence from these studies is among the highest quality naturalistic evidence available to address the role of these variables in the process of change in cognitive behavioral interventions.

Understanding how CBT achieves its effects can also inform intervention development. Presenters will highlight a variety of different approaches to sharing the lessons of CBT in different kinds of cognitive behavioral interventions. A speaker will share results from a clinical trial comparing a guided and unguided transdiagnostic self-help intervention for internalizing symptoms. Results reveal improvements across both conditions as well as specific additional benefit for guided CBT. Another speaker will report on a test of a group internet-intervention for the friends and family of those with mental health challenges living in rural areas. Results suggest the intervention was well-received and yielded a number of positive benefits. Finally, a speaker will present results from a trial of Skill-Enhanced CBT (CBT-SE), which was designed to promote CBT skills use extensively. CBT-SE outperformed CBT on promoting skill use between sessions. Although there were no differences overall in symptom reduction, CBT-SE outperformed CBT in the more severely depression portion of the sample.

Taken together, the presentations serve to highlight how cognitive behavioral interventions achieve their effects. The inter-weaving of presentations on outcome and process will facilitate showing how findings can inform one another. The projects highlight how cognitive behavioral interventions can be delivered in different contexts, all leveraging the active ingredients of CBT in different ways. The discussant, an expert in research on cognitive behavioral treatments and CBT skills, will synthesize the findings, comment on their applicability to clinical practice, and discuss important directions for future research.