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Helpful aspects of metacognitive therapy and cognitive behaviour therapy for depression: a qualitative study

Published online by Cambridge University Press:  21 September 2015

Nanna S. Straarup*
Affiliation:
Psykologerne Johansen, Kristoffersen & Pedersen, Copenhagen, Denmark
Stig Poulsen
Affiliation:
Department of Psychology, University of Copenhagen, Copenhagen, Denmark
*
*Author for correspondence: Dr N. S. Straarup, Psykologerne Johansen, Kristoffersen & Pedersen, Østbanegade 9, 1. th., DK-2100 Copenhagen Ø, Denmark (email: [email protected]).

Abstract

Six clients in cognitive behaviour therapy (CBT) or metacognitive therapy (MCT) were interviewed about their experiences of therapy with a focus on helpful elements. Clients in both CBT and MCT mentioned the positive and informal relationship with the therapist as helpful. However, while clients in both therapies emphasized insight into the causes of depression and modification of negative maintenance patterns as helpful, the understanding of depression and the remedies for the condition differed. Clients in CBT focused on previous negative experiences as the cause of present maintenance patterns and mentioned changing negative thought patterns as helpful. Clients in MCT stated that the realization that rumination was their key problem and that they could choose not to engage in negative thinking had been crucial. Furthermore, clients in CBT tended to describe increased personal strength and self-confidence as the main gain from therapy, whereas MCT clients mentioned improved ways of coping with thoughts or problems. The importance attributed by the clients to technical factors differs from previous qualitative studies conducted across various therapeutic approaches, which have typically concluded that common therapeutic factors are more important than specific factors. It does, however, correspond with conclusions from other qualitative studies focusing explicitly on CBT.

Type
Original Research
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

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References

Recommended follow-up reading

Barnes, M, Sherlock, S, Thomas, L, Kessler, D, Kuyken, W, Owen-Smith, A, Lewis, G, Wiles, N, Turner, K (2013). No pain, no gain: depressed clients’ experiences of cognitive behavioural therapy. British Journal of Clinical Psychology 52, 347364.Google Scholar
Hodgetts, A, Wright, J (2007). Researching clients’ experiences: a review of qualitative studies. Clinical Psychology and Psychotherapy 14, 157163.Google Scholar
Nilsson, T, Svensson, M, Sandell, R, Clinton, D (2007). Patients’ experience of change in cognitive-behavioral therapy and psychodynamic therapy: a qualitative comparative study. Psychotherapy Research 17, 553566.CrossRefGoogle Scholar
Timulak, L (2007). Identifying core categories of client-identified impact of helpful events in psychotherapy: a qualitative meta-analysis. Psychotherapy Research 17, 305314.CrossRefGoogle Scholar

References

APA (2000). Diagnostic and Statistical Manual of Mental disorders, 4th edn, text revision. Washington, DC: American Psychiatric Association.Google Scholar
Barnes, M, Sherlock, S, Thomas, L, Kessler, D, Kuyken, W, Owen-Smith, A, Lewis, G, Wiles, N, Turner, K (2013). No pain, no gain: depressed clients’ experiences of cognitive behavioural therapy. British Journal of Clinical Psychology 52, 347364.CrossRefGoogle ScholarPubMed
Beck, AT, Steer, RA, Brown, GK (1996). Manual for the Beck Depression Inventory–II. San Antonio, TX: Psychological Corporation.Google Scholar
Berg, C, Raminani, S, Greer, J, Harwood, M, Safren, S (2008). Participants’ perspectives on cognitive-behavioral therapy for adherence in HIV. Psychotherapy Research 18, 271280.CrossRefGoogle ScholarPubMed
Butler, AC, Chapman, JE, Forman, EM, Beck, AT (2006). The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clinical Psychology Review 26, 1731.Google Scholar
Callesen, P (2010). Meta-cognitive therapy (MCT) versus cognitive behaviour therapy (CBT) for depression: a randomised clinical trial. Current Controlled Trials. doi:10.1186/ISRCTN82799488.Google Scholar
Clark, D, Beck, A, Alford, B (1999). Scientific Foundations of Cognitive Theory and Therapy of Depression. John Wiley & Sons.Google Scholar
Clarke, H, Rees, A, Hardy, GE (2004). The big idea: client's perspectives of change processes in cognitive therapy. Psychology and Psychotherapy: Theory, Research and Practice 77, 6789.Google Scholar
Crowe, M, Whitehead, L, Carlyle, D, McIntosh, V, Jordan, J, Joyce, P, Carter, J (2012). The process of change in psychotherapy for depression: helping clients to reformulate the problem. Journal of Psychiatric and Mental Health Nursing 19, 681689.CrossRefGoogle ScholarPubMed
Elliott, R (2008). Research on client experiences of therapy: introduction to the special selection. Psychotherapy Research 18, 239242.CrossRefGoogle Scholar
Elliott, R, James, E (1989). Varieties of client experience in psychotherapy: an analysis of the literature. Clinical Psychology Review 9, 443467.CrossRefGoogle Scholar
Fennell, M (1989). Depression. In: Cognitive Behaviour Therapy for Psychiatric Problems: A Practical Guide (ed. Hawton, K., Salkovskis, P. M., Kirk, J. & Clark, D. M.), pp. 169234. Oxford: Oxford University Press.Google Scholar
First, MB, Gibbon, M, Spitzer, RL, Williams, JBW, Benjamin, LS (1997). Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). Washington, D.C.: American Psychiatric Press.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition (SCID-I/NP). New York: Biometrics Research, New York State Psychiatric Institute.Google Scholar
Fitzpatrick, M, Janzen, J, Chamodraka, M, Park, J (2006). Client critical incidents in the process of early alliance development: a positive emotion-exploration spiral. Psychotherapy Research 16, 486498.Google Scholar
Hodgetts, A, Wright, J (2007). Researching clients’ experiences: a review of qualitative studies. Clinical Psychology and Psychotherapy 14, 157163.CrossRefGoogle Scholar
Lambert, MJ (2011). Psychotherapy research and its achievements. In: History of Psychotherapy: Continuity and Change, 2nd edn (ed. Norcross, J. C., Vandenbos, G. R. & Freedheim, D. K.), pp. 299332. Washington, DC: American Psychological Association.Google Scholar
Langdridge, D (2007). Phenomenological Psychology: Theory, Research and Method. Harlow: Pearson Education Limited.Google Scholar
Levitt, H, Butler, M, Hill, T (2006). What clients find helpful in psychotherapy: developing principles for facilitating moment to moment change. Journal of Counselling Psychology 53, 314324.Google Scholar
Longmore, RJ, Worrell, M (2007). Do we need to challenge thoughts in cognitive behavior therapy? Clinical Psychology Review 27, 173187.CrossRefGoogle ScholarPubMed
McGowan, JF, Lavender, T, Garety, A (2005). Factors in outcome of cognitive-behavioral therapy for psychosis: users’ and clinicians’ view. Psychology and Psychotherapy: Therapy, Research and Practice 78, 513529.CrossRefGoogle Scholar
Messari, S, Hallam, R (2003). CBT for psychosis: a qualitative analysis of clients’ experiences. British Journal of Clinical Psychology 42, 171188.Google Scholar
Nilsson, T, Svensson, M, Sandell, R, Clinton, D (2007). Patients’ experience of change in cognitive-behavioral therapy and psychodynamic therapy: a qualitative comparative study. Psychotherapy Research 17, 553566.CrossRefGoogle Scholar
Papageorgiou, C (2009). Cognitive behaviour therapy, depressive rumination and metacognition. In: Cognitive Behaviour Therapy: A Guide for the Practising Clinician, Volume 2 (ed. Simos, G.), pp. 1833. New York, NY: Routledge.Google Scholar
Papageorgiou, C, Wells, A (2004). Depressive Rumination: Nature, Theory and Treatment. John Wiley & Sons.Google Scholar
Paulson, BL, Trutscott, D, Stuart, J (1999). Client's perceptions of helpful experiences in counseling. Journal of Counseling Psychology 46, 317324.CrossRefGoogle Scholar
Poulsen, S (2004). De-privatization: client experience of short-term dynamic group psychotherapy. Group 28, 3150.Google Scholar
Poulsen, S, Lunn, S, Sandros, C (2010). Client experience of psychodynamic psychotherapy for bulimia nervosa: an interview study. Psychotherapy Theory, Research, Practice, Training 47, 469483.Google Scholar
Roth, A, Fonagy, P (2005). What Works for Whom? A Critical Review of Psychotherapy Research. New York: Guilford Press.Google Scholar
Smith, J, Flowers, P, Larkin, M (2009). Interpretative Phenomenological Analysis: Theory, Method and Research. London: Sage.Google Scholar
Timulak, L (2007). Identifying core categories of client-identified impact of helpful events in psychotherapy: a qualitative meta-analysis. Psychotherapy Research 17, 305314.Google Scholar
Wampold, BE (2010). The Basics of Psychotherapy: An Introduction to Therapy and Practice. Washington, DC: American Psychological Association.Google Scholar
Wells, A (2000). Emotional Disorders and Metacognition: Innovative Cognitive Therapy. John Wiley & Sons.Google Scholar
Wells, A (2005). Detached mindfulness in cognitive therapy: A metacognitive analysis and ten techniques. Journal of Rational-Emotive & Cognitive-Behaviour Therapy 23, 337355.Google Scholar
Wells, A (2009). Metacognitive Therapy for Anxiety and Depression. New York: The Guilford Press.Google Scholar
Wells, A, Papageorgiou, C (2004). Metacognitive therapy for depressive rumination. In: Depressive Rumination: Nature, Theory and Treatment (ed. Papageorgiou, C. & Wells, A.), pp. 259275. John Wiley & Sons Ltd.Google Scholar
Westra, HA, Aviram, A, Barnes, M, Angus, L (2010). Therapy was not what I expected: a preliminary qualitative analysis of concordance between client expectations and experience of cognitive-behavioural therapy. Psychotherapy Research 20, 436446.CrossRefGoogle Scholar
Willig, C (2004). Introducing Qualitative Research in Psychology: Adventures in Theory and Method. New York, NY: Open University Press.Google Scholar
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