Welcome to the July 2017 newsletter from Psychology Tools. There’s a focus on research this month with some fascinating data concerning imagery rescripting, the treatment of low self-esteem using COMET, psychological approaches to the treatment of gambling, and a paper considering motivational interviewing in a new light.
NEW ON PSYCHOLOGY TOOLS
PSYCHOLOGY TOOLS PRO
There has been an amazing response to the launch of Psychology Tools Pro and hundreds of you have signed up already. If you fancy having unlimited access to a professional library of therapy materials – and being able to share it all freely with your clients – then make your working life better now.
The final coat of polish is just being added to an audio package of PTSD grounding and stabilization resources. They will be available for free to Psychology Tools Pro members the moment they are finished so stay tuned.
Translations have kept pouring in this month – we’re up to 868 translated worksheets in 45 languages. If you have time do please consider translating Psychology Tools into your language. We still have nothing in Bengali or Hindi so it would be great to hear from anyone with expertise in those languages.
Well worth 7 minutes of your time is a video on the Big Think website. Biologist Robert Sapolsky discusses the (metaphor of the) triune brain and how our physiological state can drive our cognition – and vice versa. Very relevant for anyone practising CFT or body-based approaches to therapy.
- Robert Sapolsky discusses embodied cognition (or if you prefer a clickbaity title “how your brain is at the mercy of your reptilian impulses”)
Imagery rescripting (ImRs) is a fantastic technique for working with aversive memories. It is commonly used in the treatment of PTSD, but has also successfully been applied in the treatment of social anxiety disorder (source) as well as depression (source).
The first study is a new meta-analysis which demonstrates a large effect size of ImRs in the treatment of PTSD and social anxiety. This result is especially impressive in the light of relatively low number of sessions needed – an average of 4.5 per client.
Morina, N., Lancee, J., & Arntz, A. (2017). Imagery rescripting as a clinical intervention for aversive memories: A meta-analysis. Journal of behavior therapy and experimental psychiatry, 55, 6-15.
The second ImRs study is a randomized controlled trial comparing the effects of exposure and imagery rescripting in the treatment of non-fear emotions. Until now a common assumption has been that exposure is an effective treatment for presentations where the primary emotion is fear, but that non-fear emotions such as anger, disgust, or shame do not habituate in the same way, and thus do not respond well to exposure-based treatment. Contrary to previous assumptions, this study found that exposure was as effective as ImRs in the treatment of trauma, even for presentations where the primary emotion was not fear.
Langkaas, T. F., Hoffart, A., Øktedalen, T., Ulvenes, P. G., Hembree, E. A., & Smucker, M. (2017). Exposure and non-fear emotions: A randomized controlled study of exposure-based and rescripting-based imagery in PTSD treatment. Behaviour Research and Therapy.
Those who work with clients that struggle with gambling will find this recent review interesting. It discusses psychological treatments for problem gambling and includes suggestions for a unified CBT approach including exposure, cogntitive restructuring and mindfulness approaches.
Tolchard, B. (2016). Cognitive-behavior therapy for problem gambling: a critique of current treatments and proposed new unified approach. Journal of Mental Health, 1-8.
I love the COMET approach to the treatment of low self-esteem. If you haven’t heard of it before it’s a really positive treatment which involves aspects of memory training – essentially building up positive self-representations rather than breaking down negative ones. COMET has demonstrated efficacy in improving self-esteem in clients with depression (source) as well as those with personality disorders (source).
A new study has now compared the use of COMET and EMDR in the treatment of self-esteem in anxiety disorders. EMDR initially struck me as an odd choice for a control condition but it’s really there as a lovely test of the theory – is it more effective to de-activate negative representations (EMDR should be better), or to activate positive representations (COMET should be better)? The researchers used a crossover design so that clients got both treatments in a randomized order. Those who got COMET first demonstrated better outcomes.
Staring, A. B. P., van den Berg, D. P. G., Cath, D. C., Schoorl, M., Engelhard, I. M., & Korrelboom, C. W. (2016). Self-esteem treatment in anxiety: A randomized controlled crossover trial of Eye Movement Desensitization and Reprocessing (EMDR) versus Competitive Memory Training (COMET) in patients with anxiety disorders. Behaviour research and therapy, 82, 11-20.
EVOLUTIONARY IDEAS IN MOTIVATIONAL INTERVIEWING
Ideas about the evolution of our psychology increasingly informs modern theory – compassion focused therapy is a good example of this. This article explores evolutionary ideas in the context of motivational interviewing. One problem behavior change clinicians try to avoid is psychological reactance – the tendency to act contrary to the recommendations of others. This paper explores the adaptive consequences of psychological reactance in the context of social roles – it can be seen as an attempt to maintain dominance in a hierarchy. The paper discusses motivational interviewing ideas such as working alongside clients in the light of this theory.
de Almeida Neto, A. C. (2017). Understanding Motivational Interviewing: an Evolutionary Perspective. Evolutionary Psychological Science, 1-11.