Discontinuities and cognitive changes in an exposure-based cognitive therapy for depression

Hayes, Adele M.; Feldman, Greg C.; Beevers, Christopher G.; Laurenceau, Jean-Philippe; Cardaciotto, LeeAnn; Lewis-Smith, Jamie

doi:10.1037/0022-006x.75.3.409

Cited by 198Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and ApplicationsPsychological Treatments and Assessments

Discontinuities and cognitive changes in an exposure-based cognitive therapy for depression

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Hayes, Adele M., Feldman, Greg C., Beevers, Christopher G., Laurenceau, Jean-Philippe, Cardaciotto, LeeAnn, Lewis-Smith, Jamie·2007·Journal of Consulting and Clinical Psychology

DOI 10.1037/0022-006x.75.3.409PMC PMC6961653

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Abstract

Significant shifts or discontinuities in symptom course can mark points of transition and reveal important change processes. The authors investigated 2 patterns of change in depression-the rapid early response and a transient period of apparent worsening that the authors call a depression spike. Participants were 29 patients diagnosed with major depressive disorder who enrolled in an open trial of an exposure-based cognitive therapy. Hierarchical linear modeling revealed an overall cubic shape of symptom change and that both the rapid response and spike patterns predicted lower posttreatment depression. Patients wrote weekly narratives about their depression. Early narratives of rapid responders were coded as having more hope than those of nonrapid responders. The narratives of patients with a depression spike had more cognitive-emotional processing during this period of arousal than those without a spike. Findings are discussed in the context of cognitive-emotional processing theories in depression and anxiety disorders.

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Activation of negative cognition may result in a transient exacerbation of depressive symptoms, and this temporary deterioration is positively associated with treatment outcomes upon completion.
“Previous studies have suggested that activation of negative cognition may result in a transient exacerbation of depressive symptoms, and this temporary deterioration is positively associated with treatment outcomes upon completion (29).”
From A virtual reality-based self-guided training on identification of negative automatic thoughts in healthy adults: a mixed-methods feasibility study (2024) · cites this paper as [29]

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Living into the story: Agency and coherence in a longitudinal study of narrative identity development and mental health over the course of psychotherapy
Adler, J. M. (2012) · Journal of Personality and Social Psychology · doi:10.1037/a0025289 · Cited by 588 · see citing works
The bright side of being blue: depression as an adaptation for analyzing complex problems.
Andrews, P. W., & Thomson, J. A. (2009) · Psychological Review · doi:10.1037/a0016242 · Cited by 549 · see citing works
Change is not always linear: The study of nonlinear and discontinuous patterns of change in psychotherapy
Hayes, A. M., Laurenceau, J., Feldman, G. C., Strauss, J. L., & Cardaciotto, L. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.01.008 · Cited by 514 · see citing works
Self-citation
Exploring the roles of approach and avoidance in depression: An integrative model
Trew, J. L. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2011.07.007 · Cited by 316 · see citing works
Beyond linear mediation: Toward a dynamic network approach to study treatment processes
Hofmann, S. G., Curtiss, J. E., & Hayes, S. C. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101824 · Cited by 232 · see citing works
Changes in mindfulness and emotion regulation in an exposure-based cognitive therapy for depression
Kumar, S., Feldman, G., & Hayes, A. (2008) · Cognitive Therapy and Research · doi:10.1007/s10608-008-9190-1 · Cited by 206 · see citing works
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Implicit cognition and depression: A meta-analysis
Phillips, W. J., Hine, D. W., & Thorsteinsson, E. B. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.05.002 · Cited by 182 · see citing works
The ups and downs of psychotherapy: Sudden gains and sudden losses identified with session reports
Lutz, W., Ehrlich, T., Rubel, J. A., Hallwachs, N., Röttger, M.-A., Jorasz, C., Mocanu, S., Vocks, S., Schulte, D., & Tschitsaz, A. (2012) · Psychotherapy Research · doi:10.1080/10503307.2012.693837 · Cited by 189 · see citing works
Negative effects of internet interventions: a qualitative content analysis of patients' experiences with treatments delivered online
Rozental, A., Boettcher, J., Andersson, G., Schmidt, B., & Carlbring, P. (2015) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2015.1008033 · Cited by 189 · see citing works
United we stand: emphasizing commonalities across cognitive-behavioral therapies.
Mennin, D. S., Ellard, K. K., Fresco, D. M., & Gross, J. J. (2013) · Behavior Therapy · doi:10.1016/j.beth.2013.02.004 · Cited by 172 · see citing works
“Other approaches have combined traditional (“tCBTs”) and recent (“rCBTs”) approaches either in additive (Interpersonal Emotional Processing, Newman et al., 2011; MBCT; Segal et al., 2002) or integrative designs (STAIR-PE; Cloitre, Koenen, Cohen, & Han, 2002; Acceptance-Based Behavioral Therapy; ABBT; Roemer & Orsillo,…”
Patterns of early change and their relationship to outcome and follow-up among patients with major depressive disorders
Lutz, W., Stulz, N., & Köck, K. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.01.019 · Cited by 186 · see citing works
A complex systems approach to the study of change in psychotherapy
Hayes, A. M., & Andrews, L. A. (2020) · BMC Medicine · doi:10.1186/s12916-020-01662-2 · Cited by 149 · see citing works
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Emotion Regulation Therapy: A Mechanism-Targeted Treatment for Disorders of Distress
Renna, M. E., Quintero, J. M., Fresco, D. M., & Mennin, D. S. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.00098 · Cited by 152 · see citing works
Randomized controlled trial of expressive writing for psychological and physical health: the moderating role of emotional expressivity
Niles, A. N., Haltom, K. E. B., Mulvenna, C. M., Lieberman, M. D., & Stanton, A. L. (2013) · Anxiety Stress & Coping · doi:10.1080/10615806.2013.802308 · Cited by 145 · see citing works
“Asking why” from a distance: Its cognitive and emotional consequences for people with major depressive disorder
Kross, E., Gard, D., Deldin, P., Clifton, J., & Ayduk, O. (2012) · Journal of Abnormal Psychology · doi:10.1037/a0028808 · Cited by 140 · see citing works
The identification of critical fluctuations and phase transitions in short term and coarse-grained time series—a method for the real-time monitoring of human change processes
Schiepek, G. K., & Strunk, G. (2010) · Biological Cybernetics · doi:10.1007/s00422-009-0362-1 · Cited by 143 · see citing works
Dynamic emotional processing in experiential therapy: Two steps forward, one step back.
Pascual‐Leone, A. (2009) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0014488 · Cited by 141 · see citing works
Self-Esteem, Self-Efficacy, and Resources in Adults With ADHD
Newark, P. E., Elsässer, M., & Stieglitz, R. (2012) · Journal of Attention Disorders · doi:10.1177/1087054712459561 · Cited by 144 · see citing works
Working with patients’ strengths: A microprocess approach
Flückiger, C., Caspar, F., Holtforth, M. G., & Willutzki, U. (2009) · Psychotherapy Research · doi:10.1080/10503300902755300 · Cited by 132 · see citing works
Network destabilization and transition in depression: New methods for studying the dynamics of therapeutic change
Hayes, A. M., Yasinski, C. W., Barnes, J. B., & Bockting, C. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.06.007 · Cited by 132 · see citing works
Self-citation
Real-Time Monitoring of Psychotherapeutic Processes: Concept and Compliance
Schiepek, G. K., Aichhorn, W., Gruber, M., Strunk, G., Bachler, E., & Aas, B. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.00604 · Cited by 124 · see citing works
Primum Non Nocere: An Evolutionary Analysis of Whether Antidepressants Do More Harm than Good
Andrews, P. W., Thomson, J. A., Amstadter, A., & Neale, M. C. (2012) · Frontiers in Psychology · doi:10.3389/fpsyg.2012.00117 · Cited by 120 · see citing works
Symptom exacerbations in trauma-focused treatments: Associations with treatment outcome and non-completion
Larsen, S. E., Stirman, S. W., Smith, B. N., & Resick, P. A. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.12.009 · Cited by 114 · see citing works
Examining hope as a transdiagnostic mechanism of change across anxiety disorders and CBT treatment protocols
Gallagher, M. W., Long, L. J., Richardson, A., D’Souza, J., Boswell, J. F., Farchione, T. J., & Barlow, D. H. (2020) · Behavior Therapy · doi:10.1016/j.beth.2019.06.001 · Cited by 108 · see citing works
Effects of expressive writing on depressive symptoms-A meta-analysis
Reinhold, M., Bürkner, P., & Holling, H. (2018) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12224 · Cited by 94 · see citing works
Written emotional disclosure: A controlled study of the benefits of expressive writing homework in outpatient psychotherapy
Graf, M. C., Gaudiano, B. A., & Geller, P. A. (2008) · Psychotherapy Research · doi:10.1080/10503300701691664 · Cited by 90 · see citing works
Change in emotional processing during a dialectical behavior therapy-based skills group for major depressive disorder
Feldman, G., Harley, R., Kerrigan, M., Jacobo, M., & Fava, M. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.01.005 · Cited by 79 · see citing works
Self-citation
Specific and general therapeutic mechanisms in cognitive behavioral treatment of chronic pain
Burns, J. W., Nielson, W. R., Jensen, M. P., Heapy, A., Czlapinski, R., & Kerns, R. D. (2015) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0037208 · Cited by 77 · see citing works
Exposure and reorganization: The what and how of effective psychotherapy
Carey, T. A. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.04.004 · Cited by 112 · see citing works
Destabilization in self-ratings of the psychotherapeutic process is associated with better treatment outcome in patients with mood disorders
Olthof, M., Hasselman, F., Strunk, G., Aas, B., Schiepek, G. K., & Lichtwarck‐Aschoff, A. (2019) · Psychotherapy Research · doi:10.1080/10503307.2019.1633484 · Cited by 78 · see citing works
Early development of mechanisms of change as a predictor of subsequent change and treatment outcome: The case of working alliance.
Zilcha‐Mano, S., & Errázuriz, P. (2017) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000192 · Cited by 78 · see citing works
Sudden gains in cognitive–behavior therapy for treatment-resistant depression: Processes of change.
Abel, A., Hayes, A. M., Henley, W., & Kuyken, W. (2016) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000101 · Cited by 76 · see citing works
Self-citation
A controlled single case study with repeated fMRI measurements during the treatment of a patient with obsessive-compulsive disorder: Testing the nonlinear dynamics approach to psychotherapy
Schiepek, G. K., Tominschek, I., Karch, S., Lutz, J., Mulert, C., Meindl, T., & Pogarell, O. M. (2008) · The World Journal of Biological Psychiatry · doi:10.1080/15622970802311829 · Cited by 73 · see citing works
A characteristic destabilization profile in parent-child interactions associated with treatment efficacy for aggressive children.
Lichtwarck‐Aschoff, A., Hasselman, F., Cox, R. F. A., Pepler, D. J., & Granic, I. (2012) · PubMed · Cited by 69 · see citing works
Cognitive-Behavioral Therapy: Nature and Relation to Non-Cognitive Behavioral Therapy
Lorenzo‐Luaces, L., Keefe, J. R., & DeRubeis, R. J. (2016) · Behavior Therapy · doi:10.1016/j.beth.2016.02.012 · Cited by 66 · see citing works
Complexity and Nonlinear Dynamics in Psychotherapy
Schiepek, G. K. (2009) · European Review · doi:10.1017/s1062798709000763 · Cited by 65 · see citing works
Effects of psychotherapy training and intervention use on session outcome.
Boswell, J. F., Castonguay, L. G., & Wasserman, R. H. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0020088 · Cited by 62 · see citing works
No pain, no gain: Depressed clients' experiences of cognitive behavioural therapy
Barnes, M., Sherlock, S., Thomas, L., Kessler, D. S., Kuyken, W., Owen‐Smith, A., Lewis, G., Wiles, N., & Turner, K. M. (2013) · British Journal of Clinical Psychology · doi:10.1111/bjc.12021 · Cited by 63 · see citing works
Change mechanisms in psychotherapy: Both improved insight and improved affective awareness are necessary.
Høglend, P. A., & Hagtvet, K. A. (2019) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000381 · Cited by 61 · see citing works
Cognitive inefficiency in depressive undergraduates: Stroop processing and ERPs
Krompinger, J. W., & Simons, R. F. (2010) · Biological Psychology · doi:10.1016/j.biopsycho.2010.12.004 · Cited by 59 · see citing works
TRAJECTORIES OF CHANGE IN ATTACHMENT AND BIOBEHAVIORAL CATCH‐UP AMONG HIGH‐RISK MOTHERS: A RANDOMIZED CLINICAL TRIAL
Yarger, H. A., Hoye, J. R., & Dozier, M. (2016) · Infant Mental Health Journal · doi:10.1002/imhj.21585 · Cited by 56 · see citing works
Pattern destabilization and emotional processing in cognitive therapy for personality disorders
Hayes, A. M., & Yasinski, C. W. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.00107 · Cited by 56 · see citing works
Self-citation
Nomothetic and idiographic symptom change trajectories in acute-phase cognitive therapy for recurrent depression.
Vittengl, J. R., Clark, L. A., Thase, M. E., & Jarrett, R. B. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0032879 · Cited by 56 · see citing works
Identifying Functional Mechanisms in Psychotherapy: A Scoping Systematic Review
Carey, T. A., Griffiths, R., Dixon, J. E., & Hines, S. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00291 · Cited by 53 · see citing works
“Furthermore, the reorganization model can account for the nonlinear and unpredictable nature of the change process (38).”
Background
The Potential Role of Learning Capacity in Cognitive Behavior Therapy for Depression: A Systematic Review of the Evidence and Future Directions for Improving Therapeutic Learning
Bruijniks, S. J. E., DeRubeis, R. J., Hollon, S. D., & Huibers, M. J. H. (2019) · Clinical Psychological Science · doi:10.1177/2167702619830391 · Cited by 54 · see citing works
Processes of change in cognitive behavioral therapy for treatment-resistant depression: psychological flexibility, rumination, avoidance, and emotional processing
Yasinski, C. W., Hayes, A. M., Ready, C. B., Abel, A., Görg, N., & Kuyken, W. (2019) · Psychotherapy Research · doi:10.1080/10503307.2019.1699972 · Cited by 59 · see citing works
Self-citation
The therapeutic process in psychological treatments for eating disorders: A systematic review
Brauhardt, A., de Zwaan, M., & Hilbert, A. (2014) · International Journal of Eating Disorders · doi:10.1002/eat.22287 · Cited by 51 · see citing works
Common genetic, clinical, demographic and psychosocial predictors of response to pharmacotherapy in mood and anxiety disorders
Serretti, A., Chiesa, A., Calati, R., Perna, G., Bellodi, L., & Ronchi, D. D. (2008) · International Clinical Psychopharmacology · doi:10.1097/yic.0b013e32831db2d7 · Cited by 48 · see citing works
Religiously oriented mindfulness‐based cognitive therapy
Hathaway, W., & Tan, E. (2009) · Journal of Clinical Psychology · doi:10.1002/jclp.20569 · Cited by 47 · see citing works
Mediated moderation in combined cognitive behavioral therapy versus component treatments for generalized anxiety disorder.
Newman, M. G., & Fisher, A. J. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0031690 · Cited by 45 · see citing works
“…the role of CBT to promote more flexible and evidence-based thinking, reduced bodily tension, and reduced automatic emotional and physiological responses to nondangerous external triggers, leading to greater adaptability to the natural environment (e.g., Hayes et al., 2007; Hayes & Strauss, 1998).”
Background
Defining early positive response to psychotherapy: An empirical comparison between clinically significant change criteria and growth mixture modeling.
Rubel, J., Lutz, W., Kopta, S., Köck, K., Minami, T., Zimmermann, D., & Saunders, S. (2015) · Psychological Assessment · doi:10.1037/pas0000060 · Cited by 46 · see citing works
Breaking the vise of hopelessness: Targeting its components, antecedents, and context
Marchetti, I., Alloy, L., & Koster, E. (2019) · International Journal of Cognitive Therapy · doi:10.1007/s41811-023-00165-1 · Cited by 49 · see citing works
Nonlinear Dynamics: Theoretical Perspectives and Application to Suicidology
Schiepek, G. K., Fartacek, C., Sturm, J., Kralovec, K., Fartacek, R. R., & Plöderl, M. (2011) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.2011.00062.x · Cited by 45 · see citing works
Sudden gains versus gradual gains in a psychotherapy training clinic
Greenfield, M. F., Gunthert, K. C., & Haaga, D. A. F. (2010) · Journal of Clinical Psychology · doi:10.1002/jclp.20748 · Cited by 43 · see citing works
Complex individual pathways or standard tracks? A data‐based discussion on the trajectories of change in psychotherapy
Schiepek, G. K., Gelo, O. C. G., Viol, K., Kratzer, L., Orsucci, F. F., de Felice, G., Stöger‐Schmidinger, B., Sammet, I., Aichhorn, W., & Schöller, H. J. (2020) · Counselling and Psychotherapy Research · doi:10.1002/capr.12300 · Cited by 43 · see citing works
A randomized-controlled trial of cognitive–behavioral therapy for depression with integrated techniques from emotion-focused and exposure therapies
Holtforth, M. G., Krieger, T., Zimmermann, J., Altenstein, D., Doerig, N., Meisch, L., & Hayes, A. M. (2017) · Psychotherapy Research · doi:10.1080/10503307.2017.1397796 · Cited by 41 · see citing works
Self-citation
Validation of the Integrative Hope Scale in people with psychosis
Schrank, B., Woppmann, A., Hay, A. G., Sibitz, I., Zehetmayer, S., & Lauber, C. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2011.12.052 · Cited by 41 · see citing works
Fostering Cognitive-Emotional Processing in the Treatment of Depression: A Preliminary Investigation in Exposure-Based Cognitive Therapy
Holtforth, M. G., Hayes, A. M., Sutter, M., Wilm, K., Schmied, E., Laurenceau, J., & Caspar, F. (2012) · Psychotherapy and Psychosomatics · doi:10.1159/000336813 · Cited by 41 · see citing works
Self-citation
PATTERNS OF CHANGE IN RESPONSE TO PROLONGED EXPOSURE: IMPLICATIONS FOR TREATMENT OUTCOME
Clapp, J. D., Kemp, J. J., Cox, K. S., & Tuerk, P. W. (2016) · Depression and Anxiety · doi:10.1002/da.22534 · Cited by 40 · see citing works
Depression sudden gains and transient depression spikes during treatment for PTSD.
Keller, S. M., Feeny, N. C., & Zoellner, L. A. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0035286 · Cited by 40 · see citing works
Early patterns of symptom change signal remission with interpersonal psychotherapy for depressed adolescents
Gunlicks‐Stoessel, M., & Mufson, L. H. (2011) · Depression and Anxiety · doi:10.1002/da.20849 · Cited by 40 · see citing works
Avoidance motivation in psychological problems and psychotherapy
Holtforth, M. G. (2008) · Psychotherapy Research · doi:10.1080/10503300701765849 · Cited by 40 · see citing works
Predicting symptoms of depression from social anhedonia and emotion regulation
Atherton, B. D., Nevels, R. M., & Moore, M. T. (2015) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0000000000000262 · Cited by 39 · see citing works
What happens in session does not stay in session: Changes within exposures predict subsequent improvement and dropout
Norton, P. J., Hayes‐Skelton, S. A., & Klenck, S. C. (2011) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2011.02.006 · Cited by 39 · see citing works
Trauma-focused treatments for depression. A systematic review and meta-analysis
Dominguez, S. K., Matthijssen, S. J. M. A., & Lee, C. W. (2021) · PLoS ONE · doi:10.1371/journal.pone.0254778 · Cited by 40 · see citing works
Negative affective spillover from daily events predicts early response to cognitive therapy for depression.
Cohen, L. H., Gunthert, K. C., Butler, A. C., Parrish, B. P., Wenze, S. J., & Beck, J. S. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0014131 · Cited by 38 · see citing works
The Use of Relational‐Cultural Theory in Counseling Clients Who Have Traumatic Stress Disorders
Kress, V. E. W., Haiyasoso, M., Zoldan, C. A., Headley, J. A., & Trepal, H. (2018) · Journal of Counseling & Development · doi:10.1002/jcad.12182 · Cited by 41 · see citing works
Predictors of Depression Treatment Response in an Intensive CBT Partial Hospital
Beard, C., Stein, A. T., Hearon, B. A., Lee, J., Hsu, K. J., & Björgvinsson, Þ. (2016) · Journal of Clinical Psychology · doi:10.1002/jclp.22269 · Cited by 36 · see citing works
The form and function of depressive rumination
Bartošková, M., Ševčíková, M., Durisko, Z., Maslej, M. M., Barbic, S., Preiss, M., & Andrews, P. W. (2018) · Evolution and Human Behavior · doi:10.1016/j.evolhumbehav.2018.01.005 · Cited by 34 · see citing works
Sudden Gains Can Occur in Psychotherapy Even When the Pattern of Change Is Gradual
Thomas, C., & Persons, J. (2013) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12029 · Cited by 33 · see citing works
Facilitating emotional processing in depression: the application of exposure principles
Hayes, A. M. (2015) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2015.03.032 · Cited by 35 · see citing works
Self-citation
A Positive Role of Negative Mood on Creativity: The Opportunity in the Crisis of the COVID-19 Epidemic
Du, Y., Yang, Y., Wang, X., Xie, C., Liu, C., Hu, W., & Li, Y. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.600837 · Cited by 35 · see citing works
Shape of change in cognitive behavioral therapy for youth anxiety: Symptom trajectory and predictors of change.
Chu, B. C., Skriner, L. C., & Zandberg, L. J. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0033390 · Cited by 33 · see citing works
Does Feeling Bad, Lead to Feeling Good? Arousal Patterns during Expressive Writing
Pascual‐Leone, A., Yeryomenko, N., Morrison, O.-P., Arnold, R., & Kramer, U. (2016) · Review of General Psychology · doi:10.1037/gpr0000083 · Cited by 32 · see citing works
Intervention strategies and clinical process in transdiagnostic cognitive–behavioral therapy.
Boswell, J. F. (2013) · Psychotherapy · doi:10.1037/a0032157 · Cited by 33 · see citing works
Ambivalence over emotional expression in major depression
Brockmeyer, T., Holtforth, M. G., Krieger, T., Altenstein, D., Doerig, N., Friederich, H., & Bents, H. (2013) · Personality and Individual Differences · doi:10.1016/j.paid.2012.12.002 · Cited by 32 · see citing works
Constructive and Unproductive Processing of Traumatic Experiences in Trauma-Focused Cognitive-Behavioral Therapy for Youth
Hayes, A. M., Yasinski, C. W., Grasso, D. J., Ready, C. B., Alpert, E., McCauley, T. G., Webb, C. P. M., & Deblinger, E. (2016) · Behavior Therapy · doi:10.1016/j.beth.2016.06.004 · Cited by 31 · see citing works
Self-citation
Expressive writing in psychotherapy: A tool to promote and track therapeutic change.
Cummings, J. A., Hayes, A. M., Saint, D. S., & Park, J. (2014) · Professional Psychology Research and Practice · doi:10.1037/a0037682 · Cited by 31 · see citing works
Self-citation
Detecting Sudden Gains during Treatment of Major Depressive Disorder: Cautions from a Monte Carlo Analysis
Vittengl, J. R., Clark, L. A., Thase, M. E., & Jarrett, R. B. (2014) · Current Psychiatry Reviews · doi:10.2174/1573400510666140929195441 · Cited by 30 · see citing works
Changes in affective and cognitive distortion symptoms of depression are reciprocally related during cognitive behavior therapy.
Persons, J., Marker, C., & Bailey, E. (2023) · Behaviour Research and Therapy · doi:10.1016/j.brat.2023.104338 · Cited by 22 · see citing works
Measuring the Bright Side of Being Blue: A New Tool for Assessing Analytical Rumination in Depression
Barbic, S. P., Durisko, Z., & Andrews, P. W. (2014) · PLoS ONE · doi:10.1371/journal.pone.0112077 · Cited by 29 · see citing works
Moderation of the Alliance-Outcome Association by Prior Depressive Episodes: Differential Effects in Cognitive-Behavioral Therapy and Short-Term Psychodynamic Supportive Psychotherapy
Lorenzo‐Luaces, L., Driessen, E., DeRubeis, R. J., Van, H. L., Keefe, J. R., Hendriksen, M., & Dekker, J. (2016) · Behavior Therapy · doi:10.1016/j.beth.2016.11.011 · Cited by 29 · see citing works
Strategies for resolving challenging psychedelic experiences: insights from a mixed-methods study
Wood, M. J., McAlpine, R. G., & Kamboj, S. K. (2024) · Scientific Reports · doi:10.1038/s41598-024-79931-w · Cited by 29 · see citing works
Felicidad y esperanza subjetiva
Sarıçam, H. (2015) · Universitas Psychologica · doi:10.11144/javeriana.upsy14-1.shah · Cited by 32 · see citing works
Contextualizing the negative effects of psychotherapy
Rosendahl, J., Klatte, R., Frenzl, D., Castonguay, L., Vybíral, Z., & Strauss, B. (2025) · Nature Reviews Psychology · doi:10.1038/s44159-025-00472-8 · Cited by 9 · see citing works
Sudden gains in two trauma-focused treatments for posttraumatic stress disorder
Sloan, D., Thompson-Hollands, J., Hayes, A. M., Lee, D. J., Alpert, E., & Marx, B. P. (2021) · The Behavior Therapist · doi:10.1016/j.beth.2021.08.003 · Cited by 21 · see citing works
Self-citation
Instability and discontinuous change in the experience of therapeutic interaction: An extended single-case study of psychodynamic therapy processes
Gumz, A., Kästner, D., Geyer, M. A., Wutzler, U., Villmann, T., & Brähler, E. (2010) · Psychotherapy Research · doi:10.1080/10503300903551021 · Cited by 27 · see citing works
Hope in psychiatry
Schrank, B., Hayward, M., Stanghellini, G., & Davidson, L. (2011) · Advances in Psychiatric Treatment · doi:10.1192/apt.bp.109.007286 · Cited by 27 · see citing works
Defined symptom-change trajectories during acute-phase cognitive therapy for depression predict better longitudinal outcomes
Vittengl, J. R., Clark, L. A., Thase, M. E., & Jarrett, R. B. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2016.08.008 · Cited by 25 · see citing works
The bumpy road of trauma‐focused treatment: Posttraumatic stress disorder symptom exacerbation in people with psychosis
Burger, S. R., Hardy, A., van der Linden, T., van Zelst, C., de Bont, P. A. J. M., van der Vleugel, B. M., Staring, A. B. P., de Roos, C., de Jongh, A., Marcelis, M. C., et al. (2023) · Journal of Traumatic Stress · doi:10.1002/jts.22907 · Cited by 27 · see citing works
Processes of change in cognitive–behavioural treatment of obsessive–compulsive disorder: Current status and some future directions
Polman, A., Bouman, T. K., van Hout, W. J. P. J., de Jong, P. J., & den Boer, J. A. (2009) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.638 · Cited by 25 · see citing works
Convergent Validation of Methods for the Identification of Psychotherapeutic Phase Transitions in Time Series of Empirical and Model Systems
Schiepek, G. K., Schöller, H. J., de Felice, G., Steffensen, S. V., Bloch, M. S., Fartacek, C., Aichhorn, W., & Viol, K. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.01970 · Cited by 24 · see citing works
Internalizing and Externalizing Symptoms Moderate Treatment Response to School-Based Trauma and Grief Component Therapy for Adolescents
Herres, J. L., Williamson, A. A., Kobak, R., Layne, C. M., Kaplow, J. B., Saltzman, W. R., & Pynoos, R. S. (2016) · School Mental Health · doi:10.1007/s12310-016-9204-1 · Cited by 23 · see citing works
Change in Defense Mechanisms and Coping Patterns During the Course of 2-Year–Long Psychotherapy and Psychoanalysis for Recurrent Depression
Kramer, U., de Roten, Y., Perry, J. C., & Despland, J. (2013) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e3182982982 · Cited by 23 · see citing works
Theory-specific patient change processes and mechanisms in different cognitive therapies for depression.
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Self-citation

Authors: Hayes, A. M., Feldman, G. C., Beevers, C. G., Laurenceau, J.-P., Cardaciotto, L., & Lewis-Smith, J.
Affiliations: University of Delaware (US)
Simmons University (US)
The University of Texas at Austin (US)
University of Miami (US)
ORCID: Hayes, Adele M.
Feldman, Greg C.
Beevers, Christopher G.
Laurenceau, Jean-Philippe
Venue: Journal of Consulting and Clinical Psychology
Publisher: American Psychological Association (APA)
Published: 2007-06
Volume: 75
Issue: 3
Pages: 409-421
ISSN: 0022-006X (ISSN-L)
1939-2117
DOI: 10.1037/0022-006x.75.3.409
PMC: PMC6961653
OpenAlex: W2118653600
Cited by: 198
References: 108
Citations by year: 2026: 3 · 2025: 8 · 2024: 17 · 2023: 9 · 2022: 6 · 2021: 9 · 2020: 11 · 2019: 9 · 2018: 6 · 2017: 8 · 2016: 13 · 2015: 11 · 2014: 15 · 2013: 15 · 2012: 12
FWCI: 13.65
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Journal of Consulting and Clinical Psychology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (R21-MH62662)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
Keywords: major depressive disorder, hope, patient narratives
MeSH terms: Adolescent, Adult, Affect, Cognition Disorders, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Severity of Illness Index, Cognitive Behavioral Therapy, Treatment Outcome

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Discontinuities and cognitive changes in an exposure-based cognitive therapy for depression

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