Using Brief Cognitive Restructuring and Cognitive Defusion Techniques to Cope With Negative Thoughts
Open accessAbstract
Negative thoughts, experienced by 80% to 99% of the non-clinical population, have been linked to the development of psychopathology. The current study aimed to compare a cognitive restructuring and cognitive defusion technique for coping with a personally relevant negative thought. Over a 5-day period, participants used either a restructuring, defusion, or control strategy to manage a negative thought. Pre- and post-intervention participants reported (a) believability of the thought, (b) discomfort associated with the thought, (c) negativity associated with the thought, and (d) willingness to experience the thought. Daily online questionnaires assessing the total frequency of negative thought intrusions and their level of willingness to experience the negative thought were also used. Also, 10 positive and negative self-statements were rated on the same scales, and self-report measures of mood and psychological flexibility were completed. Findings indicated that defusion lowered believability, increased comfort and willingness to have the target thought, and increased positive affect significantly more than the control and cognitive restructuring. Within groups, cognitive restructuring also made significant gains in target thought discomfort, negativity, and “willingness to have” in the same direction as defusion but the no-instruction control did not. Negative thought frequency was reduced in the defusion group, maintained in the restructuring group, and increased in the no-instruction control group. Similar trends emerged from the secondary outcome measures, that is, the effects of the strategies on the positive and negative self-statements. The current findings support the efficacy of using defusion as a strategy for managing negative thoughts.
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Some studies have found defusion to be significantly more effective for managing negative thoughts as well as for reducing acting on food cravings.
“Some studies have found defusion to be significantly more effective for managing negative thoughts as well as for reducing acting on food cravings (Larsson et al., 2015; Moffitt et al., 2012).”
From Effects of Cognitive Restructuring and Defusion for Coping with Difficult Thoughts in a Predominantly White Female College Student Sample (2022) · cites this paper as Larsson et al., 2015
Even one process alone has been shown to improve depression.
“however even one process alone has been shown to improve depression (Larsson, Hooper, Osborne, Bennett, & McHugh, 2016).”
From A randomised controlled trial of brief web-based acceptance and commitment Therapy on the general mental health, depression, anxiety and stress of college Students (2022) · cites this paper as Larsson, Hooper, Osborne, Bennett, & McHugh, 2016
A 30-min web-based cognitive defusion program for negative self-referential thinking in adolescents resulted in large reductions in the believability of, and distress associated with, self-critical thoughts (d = 0.87-1.35), but neither this study nor similar ones recorded changes in trait cognitive fusion or decentering.
“This resulted in large reductions in the believability of, and distress associated with, self-critical thoughts (d = 0.87–1.35).”
From Decentering as a core component in the psychological treatment and prevention of youth anxiety and depression: a narrative review and insight report (2021) · cites this paper as [102]
Core techniques such as cognitive defusion can be highly effective for some individuals.
“while core techniques such as cognitive defusion can be highly effective for some individuals [19,21,27]”
From A Virtual Reality–Based Cognitive Defusion Application for Youth Depression and Anxiety: Mixed Methods Experimental Study. (2025) · cites this paper as [19]
Cognitive defusion, a core technique within ACT, aims to help individuals separate themselves or 'defuse' from distressing thoughts and emotions, often using experiential and conceptual techniques such as metaphors and visualization.
“cognitive defusion, a core technique within ACT [19-21], aims to help individuals separate themselves or “defuse” from distressing thoughts and emotions, often using experiential and conceptual techniques such as metaphors and visualization.”
From A Virtual Reality–Based Cognitive Defusion Application for Youth Depression and Anxiety: Mixed Methods Experimental Study. (2025) · cites this paper as [19]
Cognitive defusion and related third-wave CBT techniques typically encourage individuals to sit with uncomfortable thoughts and view them as separate to the self.
“Cognitive defusion and related third-wave CBT techniques typically encourage individuals to sit with uncomfortable thoughts and view them as separate to the self [19-21].”
From A Virtual Reality–Based Cognitive Defusion Application for Youth Depression and Anxiety: Mixed Methods Experimental Study. (2025) · cites this paper as [19]
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“Secondly, much previous defusion research utilizes an EA control condition (Masuda et al. 2010; Hooper et al. 2012; Hooper and McHugh 2013; Larsson et al. 2016).”
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Stefan, S., Stroian, P., Fodor, L., Matu, S., Nechita, D., Boldea, I., Fechete, I., Mătiță, D., & Mustățea, M. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.06.005 · Cited by 8 · see citing works
Cojocaru, C.-M., Popa, C. O., Schenk, A., Jakab, Z., Suciu, B. A., Olah, P., Popoviciu, H., & Szasz, S. (2024) · Behavioral Sciences · doi:10.3390/bs14040327 · Cited by 7 · see citing works
“In contrast, cognitive defusion helps separating thoughts from facts and enables a more detached perspective on them, decreasing their potential to generate distress [50].”
BackgroundDeveloping a brief acceptance and commitment therapy model for industrial psychologists
Van Lill, X., & Van Lill, R. (2022) · SA Journal of Industrial Psychology · doi:10.4102/sajip.v48i0.1897 · Cited by 7 · see citing works
“• Enhance psychological flexibility by implementing the six processes of the hexaflex model (Barret & Stewart, 2020; Bond & Bunce, 2000; Finnes et al., 2019; Flaxman & Bond, 2010; Folke et al., 2012; Glassman et al., 2016; Hinton & Gaynor, 2010; Kroska et al., 2020; Larsson et al., 2015; Macías et al., 2019; Ruiz et a…”
BackgroundMethodLiu, Z., Li, M., Jia, Y., Zheng, L., & Chen, L. (2025) · BMC Cancer · doi:10.1186/s12885-025-13679-y · Cited by 7 · see citing works
Zhang, X., Zayed, A. M., Hamrin, J. R., Özgür, A. G., & Kuoppamäki, S. (2025) · Journal of Medical Internet Research · doi:10.2196/78829 · Cited by 7 · see citing works
“Through this process, users learned to question the accuracy of their negative thoughts and to replace them with balanced perspectives, a technique known as cognitive restructuring [20].”
Estructura factorial del Cuestionario de Fusión Cognitiva en universitarios de Lima
Asociación Peruana Contextual-Conductual de Psicología, P., Valencia, P. D., Falcón, C., & Asociación Peruana Contextual-Conductual de Psicología, P. (2019) · Interacciones Revista de Avances en Psicología · doi:10.24016/2019.v5n2.167 · Cited by 8 · see citing works
PTSD Symptoms, Daily Subjective Age, and Psychological Distress in Community-Dwelling Older Adults
Hoffman, Y. S. G., Shrira, A., & Bodner, E. (2021) · GeroPsych · doi:10.1024/1662-9647/a000256 · Cited by 7 · see citing works
O’Toole, M. S., & Michalak, J. (2024) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2024.101955 · Cited by 6 · see citing works
Coping Strategies Among Adolescents During the COVID-19 Pandemic: A Cross-Cultural Exploration
Mmari, K., Mafuta, E. M., Yu, C., Pinandari, A., Borges, A. L. V., Matilde Maddaleno, H., & Martinez-Baack, M. (2024) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2024.09.001 · Cited by 6 · see citing works
Age-Tastic! An Evaluation of an Evidence-Based Intervention for Older Adults
Pardasani, M. P., Berman, J., & Powell, M. E. (2018) · Healthcare · doi:10.3390/healthcare6040142 · Cited by 6 · see citing works
“Cognitive restructuring techniques “include challenging the truthfulness of a thought by looking at evidence for and against the thought, identifying thinking errors the thought exemplifies, and developing alternative thought that more realistically reflect their experience” [16] (p.”
BackgroundThe impact of Age-Tastic! On health literacy about depression among older adults: a pilot study
Berman, J., Pardasani, M. P., & Powell, M. E. (2020) · Educational Gerontology · doi:10.1080/03601277.2020.1714832 · Cited by 6 · see citing works
Levin, M. E., Krafft, J., An, W., Ong, C. W., & Twohig, M. P. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.02.002 · Cited by 6 · see citing works
“Consistent with theoretical predications and previous literature (e.g., Deacon et al., 2011; Larsson et al., 2016), participants assigned to use a cognitive defusion app”
BackgroundResultMacLellan, A., Fairchild, G., & Button, K. (2025) · Cognitive Therapy and Research · doi:10.1007/s10608-025-10636-8 · Cited by 4 · see citing works
Kabrel, M., Tulver, K., & Aru, J. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05522-8 · Cited by 7 · see citing works
“This change can be facilitated by exploring and establishing new, more effective connections using various techniques, for example, “cognitive restructuring” in Cognitive-Behavioral Therapy (CBT) [77].”
MethodWollach, C.-A. H., Cardaciotto, L., Levin, M. E., & Armstrong, S. L. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2020.03.007 · Cited by 5 · see citing works
Elbarazi, A. (2025) · Journal of Public Health Research · doi:10.1177/22799036251347030 · Cited by 4 · see citing works
“66 (9) Promoting positive emotions through activities that encourage joy, gratitude or relaxation.”
USING BRIEF COGNITIVE RESTRUCTURING AND COGNITIVE DEFUSION TECHNIQUES TO COPE WITH NEGATIVE THOUGHTS
Marasigan, P. R. (2019) · Social Values and Society · doi:10.26480/svs.04.2019.11.14 · Cited by 5 · see citing works
Bell, I. H., Li, C., Thompson, A., Ellinghaus, C., O’Sullivan, S., Reynolds, K. A., Wadley, G., Liu, Y., Bendall, S., Gleeson, J., et al. (2025) · JMIR Mental Health · doi:10.2196/70160 · Cited by 3 · see citing works
“Cognitive defusion and related third-wave CBT techniques typically encourage individuals to sit with uncomfortable thoughts and view them as separate to the self [19-21].”
Chan, C. H., & Ho, H. C. Y. (2025) · Cognitive Therapy and Research · doi:10.1007/s10608-025-10610-4 · Cited by 3 · see citing works
Wahyuni, S. I., Munthe, R. A., & Fadilla, S. E. (2024) · Psikis Jurnal Psikologi Islami · doi:10.19109/psikis.v10i2.22610 · Cited by 3 · see citing works
Fiori, V., Lombardo, C., Baglioni, C., & Ballesio, A. (2026) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2026.102339 · Cited by 3 · see citing works
The Drexel Defusion Scale: Reliability and Validity of the Turkish Version
Aydın, G., & Güneri, O. Y. (2021) · Sakarya University Journal of Education · doi:10.19126/suje.770582 · Cited by 4 · see citing works
Tunç, E., Orak, O. S., & Avci, İ. A. (2025) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/02793695-20250314-02 · Cited by 3 · see citing works
The Development of a Japanese Version of the State Cognitive Fusion Questionnaire
Kang, R. N., Tanaka, Y., Sato, T., Maeda, S., & Shimada, H. (2023) · Japanese Psychological Research · doi:10.1111/jpr.12453 · Cited by 3 · see citing works
Cognitive Defusion as a Verbal Exercise: An Experimental Approach
de Uralde-Selva, M. D. L. A. L., & Aguayo, L. V. (2021) · Psicothema · doi:10.7334/psicothema2020.103 · Cited by 3 · see citing works
Conley, C. S., Nowakowski, L. M., Hareli, M., & Gonzales, C. H. (2025) · Social and Emotional Learning Research Practice and Policy · doi:10.1016/j.sel.2025.100107 · Cited by 4 · see citing works
Browning, M. E., Guzick, A. G., McCarty, R. J., Cooke, D. L., Toledano, S., Olsen, B. T., Barthle-Herrera, M. A., Bailey, B. A., Guastello, A. D., Lazaroe, L. M., et al. (2022) · Bulletin of the Menninger Clinic · doi:10.1521/bumc.2022.86.2.133 · Cited by 2 · see citing works
Comparing cognitive coping components: An investigation of treatment outcomes and processes
Wall, A. D., & Lee, E. B. (2025) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2025.100893 · Cited by 1 · see citing works
Web-based multimodal learning system to develop social communication skills
Tanaka, H., & Lisitsyna, A. (2025) · Journal on Multimodal User Interfaces · doi:10.1007/s12193-025-00460-5 · Cited by 1 · see citing works
“In addition to SST, we incorporate cognitive restructuring principles from CBT [45].”
Yin, X., Zhou, X., Zhang, Z., Li, C., Wei, T., Liu, X., Dong, S., & 柴林丽 (2026) · Basic and Applied Social Psychology · doi:10.1080/01973533.2026.2679770 · Cited by 1 · see citing works
Yaşar, A. B., & Gündüz, A. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1748511 · Cited by 1 · see citing works
“…particularly cognitive defusion, offer a complementary approach: rather than modifying metacognitive beliefs directly, defusion techniques alter the individual ’ s relationship to thought, reducing the “ stickiness ” of rumi-native content without requiring direct engagement with it (31, 32).”
Stroian, P., David, D. O., Hora, A., Erenler, B., Tuominen, E. W., Vlachantonis, K., & Žagar, T. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100839 · Cited by 1 · see citing works
A 19-Year-Old with Intrusive Loops of Music in His Mind
Rafin, Z. Y. (2016) · Psychiatric Annals · doi:10.3928/00485713-20161020-01 · Cited by 1 · see citing works
The Use of Gamification in Social Phobia
Simões-Silva, V., Maravalhas, V., Cunha, A. R., Soares, M. I., & Marques, A. J. (2020) · Advances in medical technologies and clinical practice book series · doi:10.4018/978-1-7998-7472-0.ch009 · Cited by 1 · see citing works
Using Family Resources as a Coping Strategy to Manage Stress During the COVID-19 Pandemic
الصويلح, م. (2021) · مجلة بحوث التربية النوعية · doi:10.21608/mbse.2021.87986.1036 · Cited by 1 · see citing works
The Stories We Tell: Why Cognitive Distortions Matter for Leaders
Fernandez, K. C., Clerkin, C., & Ruderman, M. (2020) · doi:10.35613/ccl.2021.2045 · Cited by 1 · see citing works
Desfusão cognitva na Terapia de Aceitação e Compromisso (ACT): o processo de mudança clínica
Assaz, D. A. (2020) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.47.2020.tde-24122021-113814 · Cited by 2 · see citing works
Kabrel, M., Tulver, K., & Aru, J. (2023) · doi:10.31234/osf.io/e8g9f · Cited by 1 · see citing works
Cojocaru, C. M., Popa, C. O., Schenk, A., Jakab, Z., Suciu, B. A., Olah, P., Popoviciu, H. V., & Szasz, S. (2023) · Preprints.org · doi:10.20944/preprints202312.1957.v1
Cochrane, M. (2018) · UVic’s Research and Learning Repository (University of Victoria)
Kovac, R. (2019) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.47.2019.tde-15012019-153511
Efeitos de uma Metáfora na Transformação de Funções de Estímulos
Kovac, R., Perez, W. F., & Meyer, S. B. (2019) · Revista Brasileira de Terapia Comportamental e Cognitiva · doi:10.31505/rbtcc.v21i2.1154 · Cited by 1 · see citing works
The Use of Gamification in Social Phobia
Simões-Silva, V., Maravalhas, V., Cunha, A. R., Soares, M. I., & Marques, A. J. (2022) · IGI Global eBooks · doi:10.4018/978-1-6684-7589-8.ch060
(2023) · Jordan Journal of Educational Sciences · doi:10.47015/19.2.4
Investigating Determinants of Client Psychotherapy Preference: An Analog Study
Lyons, G. A., Zettle, R. D., & Petts, R. A. (2024) · Journal of Cognitive Psychotherapy · doi:10.1891/jcp-2022-0041
COGNITIVE THERAPY UNTUK MENGURANGI PEMIKIRAN NEGATIF
Mahardika, A. P. R. (2023) · JURNAL PSIMAWA · doi:10.36761/jp.v6i2.3558
“Restrukturisasi efektif dalam menurunkan pemikiran negatif (Larsson et al., 2016; Olatunji et al., 2010).”
Oker, K. (2023) · Eötvös Loránd Tudományegyetem · doi:10.15476/elte.2023.049
Mostafavi, N. (2024) · International Journal of Psychological Studies · doi:10.5539/ijps.v16n2p8
“Common cognitive restructuring techniques include challenging the validity of a belief by assessing the evidence for and against it, identifying the fallacies in the thought, and developing counterarguments that better capture their experience (Larsson et al., 2016).”
BackgroundDankyi, L. A., & Appiah-Sakyi, G. (2024) · Sprin Journal of Arts Humanities and Social Sciences · doi:10.55559/sjahss.v3i3.240
“Counsellors can assist individuals in recognizing and altering their negative thought patterns by using the cognitive restructuring technique (Larsson et al., 2016; Schmidt, 1976).”
MethodCognitive Defusion and Its Application Research
黄, 楚. (2024) · Advances in Psychology · doi:10.12677/ap.2024.144198
Generalized anxiety disorder and its treatment
Adamcová, K., Stopková, P., Jablonská, M., Jakeš, D., Darmová, B., & Fajnerová, I. (2025) · Psychiatrie pro praxi · doi:10.36290/psy.2025.014
Ong, C. W., & Lee, E. B. (2025) · Oxford University Press eBooks · doi:10.1093/oso/9780197696378.005.0001
What Is Process-Based Therapy?
Ong, C. W., & Lee, E. B. (2025) · Oxford University Press eBooks · doi:10.1093/oso/9780197696378.003.0002
Ong, C. W., & Lee, E. B. (2025) · Oxford University Press eBooks · doi:10.1093/oso/9780197696378.003.0009
Ong, C. W., & Lee, E. B. (2025) · Oxford University Press eBooks · doi:10.1093/oso/9780197696378.002.0006
Ong, C. W., & Lee, E. B. (2025) · Oxford University Press eBooks · doi:10.1093/oso/9780197696378.003.0006
Ong, C. W., & Lee, E. B. (2025) · Oxford University Press eBooks · doi:10.1093/oso/9780197696378.003.0007
Ong, C. W., & Lee, E. B. (2025) · Oxford University Press eBooks · doi:10.1093/oso/9780197696378.002.0004
Ong, C. W., & Lee, E. B. (2025) · Oxford University Press eBooks · doi:10.1093/oso/9780197696378.003.0004
Ong, C. W., & Lee, E. B. (2025) · Oxford University Press eBooks · doi:10.1093/oso/9780197696378.003.0008
Ong, C. W., & Lee, E. B. (2025) · Oxford University Press eBooks · doi:10.1093/oso/9780197696378.002.0007
- Authors
- Larsson, A., Hooper, N., Osborne, L. A., Bennett, P., & McHugh, L.
- Affiliations
- Karolinska Institutet (SE)
- University of the West of England (GB)
- Abertawe Bro Morgannwg University Health Board, UK
- Swansea University (GB)
- University College Dublin (IE)
- Corresponding author
- Larsson, Andreas
- Venue
- Behavior Modification
- Publisher
- SAGE Publications
- Published
- 2015-12-18
- Volume
- 40
- Issue
- 3
- Pages
- 452-482
- ISSN
- 0145-4455 (ISSN-L)
- 1552-4167
- OpenAlex
- W2240594527
- Cited by
- 120
- References
- 47
- Citations by year
- 2026: 15 · 2025: 30 · 2024: 16 · 2023: 9 · 2022: 8 · 2021: 13 · 2020: 9 · 2019: 7 · 2018: 10 · 2017: 1 · 2016: 2
- FWCI
- 5.37
- Type
- journal article
- Language
- en
- Open access
- green
- eprints.uwe.ac.uk
- Locations
- Behavior Modification (publishedVersion)
- PubMed (publishedVersion)
- UWE Research Repository (UWE Bristol) (submittedVersion, cc-by)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- Funders
- Health and Care Research Wales (SCS/09/08)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- cognitive restructuring, cognitive defusion, negative thinking, coping strategies, psychological flexibility, self-statements, positive affect, acceptance and commitment therapy
- MeSH terms
- Pessimism, Adaptation, Psychological, Adult, Aged, Mental Disorders, Cognition, Emotions, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Surveys and Questionnaires, Self Concept, Thinking, Cognitive Behavioral Therapy
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