Developing a theoretical understanding of therapy techniques: An illustrative analogue study
Freeman D., Garety PA., McGuire P., Kuipers E.
Objectives. In psychological interventions, clients are often asked to review unhelpful beliefs. Surprisingly, there is no theoretical understanding of how beliefs are reviewed in therapy. Moreover, by understanding a therapeutic technique, potential interactions with symptom processes can be considered. An analogue study assessing the feasibility of researching therapy techniques is described, in which links between symptoms, reasoning style, and an experimental version of the cognitive therapy technique of belief evaluation are examined. Design. Individuals without psychiatric illness (N = 30) completed (i) dimensional measures of depression, anxiety, and delusions, (ii) a measure of confirmatory reasoning (Wason's 2-4-6 task) both before and after instruction in disconfirmatory reasoning, and (iii) a belief evaluation task. Results. Compared with individuals with a confirmatory reasoning style, individuals with a disconfirmatory reasoning style in Wason's task were less hasty in their data gathering, considered a greater number of hypotheses during the task, had higher intellectual functioning, and had lower levels of depressive symptoms. Conversely, the individuals with the strongest confirmatory reasoning had higher levels of depression and preoccupation with delusional ideation. Successful adoption of disconfirmatory reasoning was associated with less hasty decision-making and lower levels of preoccupation and distress by delusional ideation. Individuals with a disconfirmatory reasoning style reported more evidence both for and against their beliefs in the belief evaluation task. Conclusion. The preliminary evidence, from this small non-clinical group, indicates that evaluating beliefs may partially involve the use of confirmatory and disconfirmatory reasoning processes. Disconfirmatory reasoning, associated with less hasty data gathering and consideration of alternatives, may lead to better belief evaluation. In the context of clinical research indicating that individuals with delusions are hasty in their data gathering and have difficulty considering alternatives, a potential implication of the findings is that individuals with delusions may find belief evaluation in therapy particularly difficult. The current study has clear limitations, but a research focus on specific techniques of therapy does appear feasible and show promise. © 2005 The British Psychological Society.