Post-event processing (PEP), the act of engaging in a detailed, self-focused, and negative analysis of a prior social situation, has been hypothesised to contribute to the maintenance of social phobia (Clark & Wells, 1995). In light of this proposal, the present study investigated whether deliberate engagement in PEP as opposed to distraction following a speech task elicits unhelpful effects on emotion, cognition, and behaviour in a subsequent speech task in high and low socially anxious participants. The PEP manipulation instructed participants to focus on the anxious thoughts, images, feelings, and somatic sensations relating to the first speech. Contrary to hypotheses, results demonstrated that engaging in PEP as opposed to distraction led to a number of constructive outcomes such as: increased willingness among low socially anxious participants to give the second speech, a reduction in negative performance appraisals and underestimation of performance among high socially anxious participants, and better self-perceived speech quality irrespective of social anxiety level. However, there were no effects of response condition on anxiety, performance appraisals, observable behaviour, and negative cognitions. The findings underscore the need for additional research identifying the precise contents, construals, and processing modes that distinguish between adaptive and maladaptive forms of PEP.

Anxiety and depression are common problems experienced by children and adolescents that, without an effective intervention, can lead to a series of negative consequences. The aim of this study was to evaluate the effectiveness the Spanish version of the FRIENDS for Life program (Barrett, 2008a, 2008b), a social and emotional skills program that uses cognitive-behavioural techniques for the prevention and early intervention of anxiety and depression. The program was implemented at the selective level of prevention with girls living at an orphanage in Mexico. Participants received the program for 10 consecutive weeks, and pretest and post-test measures were administered. Measures evaluated participants’ anxiety and depressive symptoms and risk status, proactive coping skills, levels of self-concept, self-esteem, and optimism. Social validity was also assessed. Results showed positive changes particularly in optimism and self-concept. Particular items and subscales of the measures also reported statistically significant changes, such as a decrease in worry, physiological symptoms of anxiety, and negative mood, and an increase in self-esteem at home and with peers. Participants evaluated the program as enjoyable and useful. Implications of the findings and further research are discussed.

Assessment and feedback of relationship strengths and challenges is a widely used brief approach to couple relationship education (CRE). It can be fully automated through the internet, with couples self-interpreting the feedback. This study assessed whether therapist guidance of couples to interpret the report and develop relationship goals enhanced the benefits of the feedback. Thirty-nine couples seeking CRE were randomly assigned to either self-interpretation of an internet-based relationship assessment report (RELATE), or therapist-guided interpretation of the same report (RELATE+). Participants were assessed on relationship satisfaction and psychological distress pre- and post-CRE, and at 6-month follow-up. RELATE and RELATE+ were not reliably different in outcome. Couples in both conditions sustained high relationship satisfaction and showed an overall decline in psychological distress. However, consumer satisfaction was substantially higher for the RELATE+ condition than the RELATE condition.

Self-administered therapies (SATs) have been promoted as a way to increase access to evidence-based mental health services. Recent meta-analyses and literature reviews suggest that SATs with clinical guidance are more effective than SATs with no contact for the treatment of anxiety and depression. However, little attention has been paid to the role of nonguidance contact, contact that does not involve the provision of assistance in the application of specific therapy techniques such as emails to encourage treatment adherence. The present article examines the impact of nonguidance contact on the outcomes of SATs for anxiety and depression. Electronic databases were searched to identify studies conducted over the past two decades by independent research teams that have tested cognitive-behavioural SATs over multiple trials. Findings suggest that the involvement or guidance of a therapist is not essential for SATs to produce significant benefits as long as nonguidance contact is provided. It is suggested that even very minimal levels of nonguidance contact increase SAT's outcomes by motivating treatment engagement and improving adherence. The benefit of SATs that can be accessed directly by large numbers of individuals and that do not require therapist involvement to ensure efficacy can potentially significantly increase the cost effectiveness and quality of mental health service delivery.

Evidence-supported therapy for obsessive-compulsive disorder (OCD) is often difficult to access, especially in rural and remote areas. Videoconferencing is gaining momentum as a means of improving access. Metacognitive therapy (MCT) has already been found to be effective for OCD when delivered face-to-face. This preliminary study explored whether videoconference-based MCT can be effective for OCD. Three participants completed a brief course of MCT using videoconferencing. Participants experienced clinically significant reductions in OCD symptoms, depression, anxiety, and stress, some of which were maintained after a 6- to 8-week follow-up period. Results suggest that videoconferencing MCT can be effective for OCD. Implications for clinicians are discussed.

This research aimed to examine the effects of moving (videos) versus static (pictures) images on habituation and progression in a hierarchy during online symbolic exposure (OSE) for spider fear. Participants were 351 people with high spider fear who logged on to an OSE website (www.feardrop.com) for self-help purposes. The inclusion of moving images in the exposure hierarchy increased adherence rates relative to static images, particularly among those with lower relative to higher spider fear. Those who viewed moving images at Stage 2 showed higher Subjective Units of Distress Scale (SUDS) ratings overall, but a similar pattern of habituation relative to those who viewed static images. In addition, 71% of participants completed at least one stage of the OSE program, representing an improvement from 30% adherence in previous research that used an earlier version of the program. These findings support the development of tailored exposure hierarchies to maximise adherence and treatment benefit for individual participants.

Although the role of excessive efforts to exert mental control over one's unwanted intrusive thoughts has been successfully explained and documented in the cognitive-behavioural models of obsessive–compulsive disorder (OCD), individual's beliefs regarding the controllability of events, that is, locus of control (LOC), have been largely ignored in recent cognitive formulations of OCD. The present study aimed to examine the relationship between these two control-related cognitions by comparing their roles in obsessive–compulsive (OC) and depression symptoms. Measures of LOC, obsessive-related beliefs, depression, anxiety and OCD symptoms were administered to a sample of 530 Turkish university students. Results showed that while external LOC was positively associated with depression symptoms, the relation was different for OC symptoms. The interaction of LOC with a high desire for thought control was significantly associated with general OC symptoms, particularly with checking symptoms. The findings suggest that beliefs regarding the controllability of events are critical factors in OC symptomatology, but only when there is also a high desire of thought control.

Behavioural Activation (BA) therapy is a stand-alone evidence-based treatment for depression and also is being applied to anxiety with promising outcomes. Essentially, BA involves structured therapy aimed at increasing the amount of activity in a person's daily life, so that he or she comes into contact with sources of positive reinforcement for clinically healthy behaviours. Originally, contemporary BA was developed as a behaviour therapy treatment condition in a study that compared BA to Cognitive Behavioural Therapy (CBT). Over time, many variants of BA have appeared in the published literature, which included techniques that might be viewed as being incompatible with the original intended treatment model and more similar to generic forms of CBT. The purpose of this article is to provide researchers and practitioners with a description of what we consider to be the distinctive and essential elements of BA therapy.

Experiential avoidance (EA) has been connected to various behavioural indicators of psychological distress, implicated in the etiology and maintenance of psychological disorders, and is the target of prevalent psychological treatments. However, the reasons that individuals engage in dysfunctional EA are little understood. One hypothesis focuses on the preference for small, immediate rewards above larger, delayed rewards — in other words, impulsiveness. We examined the relationship of impulsiveness, measured both by self-report and behaviourally, to EA, while statistically controlling for possible confounding variables (i.e., intellectual functioning, gender, ethnicity), in a sample of normal undergraduate participants. Regression analyses suggest a significant relationship exists between EA and self-reported (but not behaviourally measured) impulsiveness. Exploratory analyses indicate nonplanning-type impulsiveness might be the best predictor of EA. Possible confounding variables did not account for a significant amount of variance within either model examined. Thus, support is provided for a theoretically proposed relationship within the Acceptance and Commitment Therapy model of psychopathology between EA and impulsiveness.

Studies researching psychotherapeutic interventions for treatment-resistant depression (TRD) are quite new to the field. The Cognitive Behavioural Analysis System of Psychotherapy (CBASP) is the only model developed specifically to treat the chronically depressed patient. While empirical evidence indicates that CBASP is an effective treatment for chronic depression, little is known about its adaptation to a group modality. Treating these patients in a group approach would have the added benefits of being cost-effective and providing in vivo previously avoided interpersonal situations for practising social skills and role-plays. This single arm study asks whether CBASP adapted to a group modality can be effective. All patients received 12 CBASP group therapy sessions with two to four individual preparatory sessions before the group. Our results suggest that CBASP group treatment demonstrated positive effects on patient outcomes. Specifically, patients showed significant decreases in symptoms of depression and the use of emotion-oriented coping, as well as increases in overall social adjustment and interpersonal self-efficacy when compared to pretreatment levels. However, patients did not achieve normative levels in these areas by the end of treatment. These pilot results are encouraging and support further study of the effectiveness of CBASP group treatment with a control group.

This study aims to investigate whether gender differences in the prevalence of depressive symptoms, with girls reporting more depressive symptoms than boys, are related to gender differences in cognitive schema vulnerability. A cross-sectional study investigating adolescents from both clinical (N = 110) and non-clinical samples (N = 118) was conducted, using the Young Schema Questionnaire — Short Form (YSQ-SF) as a measure of cognitive schema vulnerability. Results show that adolescent girls tend to score higher on several maladaptive cognitive schemas, and that these schemas tend to be more highly correlated with depressive symptoms compared to adolescent boys. Further, cognitive schema vulnerability mediated the relationship between life-stress and depressive symptoms in girls but not in boys.

The aim of the study was to survey a group of clinicians who identify themselves as experienced in treating social anxiety disorder using cognitive behavioural treatment (CBT) with regard to the characteristics of clients which they think, based on their experience, are predictive of poor or good CBT outcome. Fifty-four practising clinicians responded to an email inviting participation in a research study of clinicians’ opinions about client characteristics that may be important in CBT outcome for social anxiety. Participants completed open-ended questions about, and made ratings of the importance of, client characteristics that they believed impact upon the outcome of CBT for social anxiety disorder. Motivation for seeking treatment, comorbidity, and intellect or reasoning ability were nominated most frequently by clinicians as having an effect on CBT outcome. Acceptance of the CBT rationale/model, ability to take responsibility for change, motivation/reason for seeking treatment, and ability to develop an alliance were all rated by participants as being important in contributing to CBT outcome. The results provide direction for future empirical research on client characteristics as predictors of CBT outcome.

The present study explored whether particular discrepancies among an individual's self-beliefs, as described by Higgins’ (1987) Self-Discrepancy Theory, were differentially related to the two broad situational domains of social anxiety: performance and social interaction anxiety. Fifteen people (4 males) with a primary diagnosis of GSP from Macquarie University's Emotional Health Clinic, and 25 undergraduate psychology students from Macquarie University (8 males) with mean chronological ages of 31.7 and 20.6 years respectively, participated in the study. As predicted, the study found that the ‘actual/other:ought/other’ self-discrepancy was uniquely related to performance anxiety, the ‘actual/own:ought/other’ self-discrepancy was uniquely associated with social interaction anxiety, and the ‘actual/own:ideal/own’ self-discrepancy was uniquely associated with depression. The results are discussed in terms of their unique contribution to Self-Discrepancy Theory research, the current empirical debate regarding the existence of subtypes within social phobia, and their implications for the cognitive models and treatment of social anxiety.

This study examined whether starting with the behavioural component of cognitive behavioural therapy (CBT) decreases the drop-out rate in outpatients with comorbid anxiety and depression. Retrospective data were collected on 60 patients with anxiety and depression. Mean values of different psychosocial assessment scales during screening, mid-session and discharge session were compared between the patients receiving and not receiving any type of behavioural interventions and among the patients receiving different types of behavioural interventions. A significant relationship was found (p < .05) between behavioural interventions and retention in therapy. Patients who did not receive any sort of behavioural intervention showed a greater rate of drop-out than those who received behavioural interventions. In the group of patients receiving different types of behavioural interventions, there was significant improvement in mental health scores between the screening and discharge sessions in those who received exposure therapy. The study findings will be helpful to retain patients with comorbid anxiety and depression in an outpatient therapy setting. If patient retention is increased, CBT can be more effectively delivered and thereby achieve better health outcomes for patients, more effective use of therapy service resources, and decrease the socioeconomic burden of anxiety and depression on the community.

This study investigated if clinical perfectionism leads to resetting standards higher following both success and failure. A sample of 206 participants (74% female) completed an online experiment consisting of three sets of a nonverbal reasoning task and were asked before each set to select how many of the trials they aimed to get correct. Each set was followed by feedback regarding performance. Half of the participants received ‘difficult’ items for set 2, to allow investigation of failure effects. There was a significant relationship between clinical perfectionism and the standards that were set for the first set; however, there was no relationship with standard setting following success or failure. Instead, previous actual success or failure was the best predictor of goal setting. Consequently, clinical perfectionism was associated with setting higher standards in general, but not resetting standards higher following success or failure. Findings suggest that while clinical perfectionism plays a role in standard setting prior to performance, following performance actual success or failure becomes the best indicator. The implications of these findings for the cognitive behavioural model of clinical perfectionism are discussed.

This study explores the impact of a cognitive behavioural lifestyle program, the Choose Health Program, on psychosocial wellbeing in overweight and obese adolescents. The sample comprised 29 male and 34 female adolescents aged 11.5 to 18.9 years (M = 14.3, SD = 1.9) and classified as overweight (n = 15) or obese (n = 48). Participants were randomly allocated to treatment or wait-list control conditions; participants allocated the wait-list condition were offered treatment after 6 months. Adolescents and parents completed self-report measures of psychopathology, psychosocial and family functioning. Treatment did not have detrimental effects on the psychosocial factors assessed. It resulted in significant improvements in weight control behaviour, impulse regulation, social support from family and parent–adolescent problem communication (p < .05). Similar results were obtained with completer and intention-to-treat analyses. Treatment acceptability was high, with all respondents indicating that they made progress. Combined, results indicate that treatment did not have detrimental effects on psychopathology, psychosocial functioning, or family functioning. Treatment resulted in significant improvements in impulse regulation, social support from family and parent–adolescent communication. Thus, parents and professionals can be assured that a comprehensive, multifaceted, parent-supported, cognitive behavioural intervention for overweight and obese adolescents does not cause psychological harm.

Clients undergo change as a function of engaging in a therapeutic experience. To date, little research into the residual effects of therapy have been completed using client-centred therapy. Some therapies provide didactic experiences to gain and practise skills and understandings so they can be recalled after the conclusion of therapy. Other therapies preclude such interventions and instead emphasise the insights of the client and the transformative therapeutic alliance to facilitate change. This research is an investigation of the possibility that client-centred therapy provides clients with experiences to allow insight into, and understanding of processes to optimally facilitate change through therapy. The aims of the research were to establish: whether factors known to enhance change in therapy increased for clients from the beginning to the end of therapy; whether the clinical group (n = 28; intervention) scores differed from a nonclinical group at both time points (n = 22; control); and establish whether gender differences were present. Analyses showed that nonclinical respondents’ scores at Times 1 and 2 were consistently higher on all factors compared with clinical respondents. The findings indicated that scores did not vary significantly between Time 1 and 2 for either the clinical or the nonclinical groups of respondents. The state/trait-like characteristics of the factors are discussed in reference to their application in therapeutic and applied settings.