Changing negative core beliefs with trial-based thought record

Background: Trial-based thought record (TBTR) is a technique used in trial-based cognitive therapy (TBCT), and simulates a court trial. It was designed to restructure unhelpful core beliefs (CBs) during psychotherapy. Objective: To confirm previous findings on the efficacy of TBTR in decreasing patients' adherence to self-critical and unhelpful CBs and corresponding emotions, as well as assessing the differential efficacy of the empty-chair approach relative to the static format of TBTR. Methods: Thirty-nine outpatients were submitted to a 50-minute, one-session, application of the TBTR technique in the empty-chair (n = 18) or conventional (n = 21) formats. Patients' adherence to unhelpful CBs and the intensity of corresponding emotions were assessed after each step of TBTR, and the results obtained in each format were compared. Results: Significant reductions in percent values both in the credit given to CBs and in the intensity of corresponding emotions were observed at the end of the session (p < .001), relative to baseline values. ANCOVA also showed a significant difference in favor of the empty-chair format for both belief credit and emotion intensity (p = .04). Discussion: TBTR may help patients reduce adherence to unhelpful CBs and corresponding emotions and the empty-chair format seems to be more efficacious than the conventional format.

Changing core beliefs with trial-based cognitive therapy may improve quality of life in social phobia: a randomized study

Objective: To determine whether there are differences in quality of life (QoL) improvement after treatment with the trial-based thought record (TBTR) versus conventional cognitive therapy (CCT) in patients with social anxiety disorder (SAD). Method: A randomized trial comparing TBTR with a set of CCT techniques, which included the standard 7-column dysfunctional thought record (DTR) and the positive data log (PDL) in patients with SAD, generalized type. Results: Repeated measures analysis of variance (ANOVA) revealed a significant time effect in the general health, vitality, social functioning, and mental health domains of the Short Form 36. It also indicated significant treatment effects on the bodily pain, social functioning, role-emotional, and mental health domains, with higher scores in the TBTR group. One-way analysis of covariance (ANCOVA), using pretreatment values as covariates, showed that TBTR was associated with significantly better QoL post-treatment (bodily pain, social functioning and role-emotional) and at follow-up (role-emotional). A significant treatment effect on the role-emotional domain at 12-month follow-up denoted a sustained effect of TBTR relative to CCT. Conclusion: This study provided preliminary evidence that TBTR is at least as effective as CCT in improving several domains of QoL in SAD, specifically when the standard 7-column DTR and the PDL are used. .

Trial-Based Thought Record (TBTR): preliminary data on a strategy to deal with core beliefs by combining sentence reversion and the use of analogy with a judicial process

OBJECTIVE: To propose the Trial-Based Thought Record, a modified, 7-column thought record addressing core beliefs by sentence reversion and the analogy to a trial. METHOD: Clients (n = 30) participated in a simulation of a trial and exhibited shifts in their adherence to core beliefs and in the intensity of corresponding emotions after each step (investigation, prosecutor’ s plea, defense attorney’ s plea, prosecutor’ s second plea, defense attorney’ s second plea, and jury verdict) during a session. RESULTS: Significant mean reductions existed between percent values after investigation (taken as baseline) and defense attorney’ s plea (p < 0.001), and after the jury’ s verdict, either in beliefs (p < 0.001) or in intensity of emotions (p < 0.001). Significant differences also emerged between the defense attorney’ s first and second pleas (p = 0.009) and between the defense attorney’ s second plea and jury’ s verdict concerning core beliefs (p = 0.005) and emotions (p = 0.02). CONCLUSION: Trial-Based Thought Record may at least temporarily help patients constructively reduce attachment to negative core beliefs and corresponding emotions.

OBJETIVO: Propor o Registro de Pensamentos com Base no Processo, versão modificada, com sete colunas, para lidar com as crenças nucleares por meio da combinação da reversão de sentenças e a analogia com um processo jurídico. MÉTODO: Os clientes (n = 30) participaram da simulação de um júri e exibiram mudanças na adesão às crenças nucleares e na intensidade das emoções correspondentes após cada passo durante uma sessão (investigação, alegação do promotor, alegação do advogado de defesa, réplica do promotor, tréplica do advogado de defesa e veredicto do júri). RESULTADOS: Reduções médias significantes foram observadas entre os valores percentuais após a investigação (tomada como valor basal), a alegação da defesa (p < 0,001) e o veredicto do júri, tanto das crenças (p < 0,001) quanto da intensidade das emoções (p < 0,001). Diferenças significantes foram também observadas entre as primeira e segunda alegações da defesa (p = 0,009) e entre a segunda alegação da defesa e o veredicto do júri no que diz respeito às crenças nucleares (p = 0,005) e às emoções (p = 0,02). CONCLUSÃO: O Registro de Pensamentos com Base no Processo pode, pelo menos temporariamente, ajudar os pacientes, de forma construtiva, a reduzirem a adesão às crenças nucleares negativas e emoções correspondentes.