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.

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.