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Rumination-Focused Cognitive Behavioral Therapy (RFCBT)

Repetitive thinking is a critical transdiagnostic mechanism that is implicated in the onset and maintenance of depression and anxiety. We can conceptualize repetitive thinking about the future as ‘worry,’ and repetitive thinking about the past as ‘rumination.’ Repetitive thinking can be a maintenance factor in conditions including anxiety and depression. Rumination-focused cognitive behavioral therapy (RFCBT) as described by Watkins (2016) involves the components of:
  • a longitudinal case formulation which views rumination as a learned behavior;
  • the use of diaries to notice rumination and avoidance;
  • functional analysis to examine the context and function of rumination and avoidance;
  • behavioral experiments to examine the effect of different modes of thinking (why vs. how);
  • behavioral activation;
  • focus on the patient’s values;
  • relapse prevention.
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  • The how and why of rumination and worry – presentation by Professor Ed Watkins
  • Targeting rumination by changing processing style: Experiential and Imagery exercises – presentation by Professor Ed Watkins

Recommended Reading

  • Watkins, E. R. (2009). Depressive Rumination and Co-Morbidity: Evidence for Brooding as a Transdiagnostic Process. Journal of Rational-Emotive Cognitive Behaviour Therapy, 27, 160-175
  • Watkins, E. (2015). Psychological treatment of depressive rumination. Current Opinion in Psychology4, 32-36.
  • Watkins, E. R. (2016). Rumination-focused cognitive-behavioral therapy for depression. Guilford Publications.


  • Watkins, E. R. (2016). Rumination-focused cognitive-behavioral therapy for depression. New York: Guilford.