Cognitive Restructuring and Psychotherapy Outcome: A Meta-analytic Review

Overview

Journal Psychotherapy (Chic)

Specialties Pharmacology
Psychology

Date 2023 Mar 13

PMID 36913269

Authors

Iony D Ezawa

Steven D Hollon

Affiliations

Soon will be listed here.

Abstract

Cognitive restructuring (CR) is one method that is hypothesized to play a role in the process of change across many psychotherapies and for a variety of clinical presentations. In this article, we define and illustrate CR. We then present a meta-analysis of four studies (including a total of 353 clients) examining the effect of CR measured within session on psychotherapy outcomes. The overall CR-outcome association was = .35 (95% CI [.24, .44]; equivalent of = 0.85). While more research on CR and immediate psychotherapy outcomes is needed, there is accumulating encouraging evidence regarding the therapeutic effect of CR. We conclude by advancing implications for clinical training and therapeutic practices. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Citing Articles

Stress management through cognitive reconstruction and positive thinking in women with recurrent failed In Vitro Fertilization: a randomized controlled trial.

Masoumi S, Abdoli S, Kazemi F, Pilehvari S, Ahmadpanah M, Khodakarami B BMC Psychiatry. 2025; 25(1):119.

PMID: 39939888 PMC: 11823176. DOI: 10.1186/s12888-025-06533-9.

Family Functioning, Anxiety and Depression in Chinese Higher Vocational School Students: A Network Analysis.

Ye L, Chen S, Chen Q, Luo X Psychol Res Behav Manag. 2024; 17:4399-4412.

PMID: 39735859 PMC: 11682667. DOI: 10.2147/PRBM.S490712.

Reframe-IT+, an indicated preventive school-based intervention, reduces suicidal ideation among adolescents in vulnerable contexts in Chile.

Nunez D, Meza D, Andaur J, Robinson J, Gaete J BMC Psychol. 2024; 12(1):780.

PMID: 39719648 PMC: 11669232. DOI: 10.1186/s40359-024-02300-9.

Psychometric Validation of the Slovenian Version of the Children's Automatic Thoughts Scale (CATS).

Damjanac Z, Kurnik Mesaric K, Petric M, Hudoklin M, Kodric J Child Psychiatry Hum Dev. 2024; .

PMID: 39636368 DOI: 10.1007/s10578-024-01800-4.

Alexithymia, Inner Thinking Patterns, and Perceptions of Mental Health Therapy Strategies Among Autistic Adults.

Mazurek M, Pappagianopoulos J, Brunt S, Menezes M, Smith J, Howard M J Autism Dev Disord. 2024; .

PMID: 39549208 DOI: 10.1007/s10803-024-06643-5.

References

Resick P, Galovski T, Uhlmansiek M, Scher C, Clum G, Young-Xu Y . A randomized clinical trial to dismantle components of cognitive processing therapy for posttraumatic stress disorder in female victims of interpersonal violence. J Consult Clin Psychol. 2008; 76(2):243-258. PMC: 2967760. DOI: 10.1037/0022-006X.76.2.243. View

Gomez Penedo J, Coyne A, Constantino M, Krieger T, Hayes A, Grosse Holtforth M . Theory-specific patient change processes and mechanisms in different cognitive therapies for depression. J Consult Clin Psychol. 2020; 88(8):774-785. DOI: 10.1037/ccp0000502. View

Schmidt I, Pfeifer B, Strunk D . Putting the "cognitive" back in cognitive therapy: Sustained cognitive change as a mediator of in-session insights and depressive symptom improvement. J Consult Clin Psychol. 2019; 87(5):446-456. DOI: 10.1037/ccp0000392. View

Wang L, Maxwell S . On disaggregating between-person and within-person effects with longitudinal data using multilevel models. Psychol Methods. 2015; 20(1):63-83. DOI: 10.1037/met0000030. View

Sasso K, Strunk D, Braun J, DeRubeis R, Brotman M . A re-examination of process-outcome relations in cognitive therapy for depression: Disaggregating within-patient and between-patient effects. Psychother Res. 2015; 26(4):387-98. PMC: 4608846. DOI: 10.1080/10503307.2015.1026423. View

Hamilton M . A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960; 23:56-62. PMC: 495331. DOI: 10.1136/jnnp.23.1.56. View

Abramowitz J, Taylor S, McKay D . Potentials and limitations of cognitive treatments for obsessive-compulsive disorder. Cogn Behav Ther. 2005; 34(3):140-7. DOI: 10.1080/16506070510041202. View

Ponniah K, Hollon S . Empirically supported psychological treatments for adult acute stress disorder and posttraumatic stress disorder: a review. Depress Anxiety. 2009; 26(12):1086-109. DOI: 10.1002/da.20635. View

Strunk D, DeRubeis R, Chiu A, Alvarez J . Patients' competence in and performance of cognitive therapy skills: relation to the reduction of relapse risk following treatment for depression. J Consult Clin Psychol. 2007; 75(4):523-30. DOI: 10.1037/0022-006X.75.4.523. View

10.

Fluckiger C, Caspar F, Grosse Holtforth M, Willutzki U . Working with patients' strengths: a microprocess approach. Psychother Res. 2009; 19(2):213-23. DOI: 10.1080/10503300902755300. View

11.

Ougrin D . Efficacy of exposure versus cognitive therapy in anxiety disorders: systematic review and meta-analysis. BMC Psychiatry. 2011; 11:200. PMC: 3347982. DOI: 10.1186/1471-244X-11-200. View

12.

Strunk D, Brotman M, DeRubeis R . The process of change in cognitive therapy for depression: predictors of early inter-session symptom gains. Behav Res Ther. 2010; 48(7):599-606. PMC: 2878902. DOI: 10.1016/j.brat.2010.03.011. View

13.

Peterson R, Brown S . On the use of beta coefficients in meta-analysis. J Appl Psychol. 2005; 90(1):175-81. DOI: 10.1037/0021-9010.90.1.175. View

14.

Topp C, Ostergaard S, Sondergaard S, Bech P . The WHO-5 Well-Being Index: a systematic review of the literature. Psychother Psychosom. 2015; 84(3):167-76. DOI: 10.1159/000376585. View

15.

Lorenzo-Luaces L, German R, DeRubeis R . It's complicated: The relation between cognitive change procedures, cognitive change, and symptom change in cognitive therapy for depression. Clin Psychol Rev. 2015; 41:3-15. PMC: 10080251. DOI: 10.1016/j.cpr.2014.12.003. View

16.

Longmore R, Worrell M . Do we need to challenge thoughts in cognitive behavior therapy?. Clin Psychol Rev. 2006; 27(2):173-87. DOI: 10.1016/j.cpr.2006.08.001. View

17.

Mohlman J . Executive skills in older adults with GAD: relations with clinical variables and CBT outcome. J Anxiety Disord. 2013; 27(1):131-9. DOI: 10.1016/j.janxdis.2012.12.001. View

18.

Ezawa I, Bartels G, Pfeifer B, Strunk D . Pay no attention to the man behind the curtain: The overlooked issue of rater selection in psychotherapy observer ratings. Psychother Res. 2020; 31(4):548-556. DOI: 10.1080/10503307.2020.1780510. View

19.

Deacon B, Abramowitz J . Cognitive and behavioral treatments for anxiety disorders: a review of meta-analytic findings. J Clin Psychol. 2004; 60(4):429-41. DOI: 10.1002/jclp.10255. View

20.

Curran P, Bauer D . The disaggregation of within-person and between-person effects in longitudinal models of change. Annu Rev Psychol. 2009; 62:583-619. PMC: 3059070. DOI: 10.1146/annurev.psych.093008.100356. View