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Title: Cognitive predictors of outcomes in cognitive behavioural therapy
Author: King, Dorothy
ISNI:       0000 0004 8500 3568
Awarding Body: Royal Holloway, University of London
Current Institution: Royal Holloway, University of London
Date of Award: 2018
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This thesis focuses on mechanisms of change and predictors of outcome in cognitive behavioural therapies for depressive and anxiety disorders. Cognitive behavioural therapies encompass a range of approaches. Therapies falling under the cognitive-behavioural umbrella have become one of the most dominant modalities of psychotherapy (Gaudiano, 2008) with a well-established evidence base for a range of mental health difficulties (Butler, Chapman, Forman, & Beck, 2006; Carpenter et al., 2018; Hofmann, Asnaani, Vonk, Sawyer, & Fang, 2012; Piet & Hougaard, 2011). Cognitive behavioural therapies are routinely recommended in national guidelines for the treatment of various mental health disorders, including the National Institute for Health and Care Excellence (NICE) guidelines in the UK. A recent commission on the future of psychological treatments research highlights that psychological treatments have a key role in the treatment of mental health difficulties, however there is a need to improve their efficacy as current treatments do not work for everyone (Holmes et al., 2018). Two recommendations for advancing psychological treatments include furthering research into their mechanisms and developing personalised models of treatment to understand who should be treated, "for what and with what" (Holmes et al., 2018). This research has the potential to support the refinement of treatments to directly target the processes responsible for change, improve precision in matching treatments to individuals, guide case formulation and identify the factors that contribute to differential treatment responses (Holmes et al., 2018; Kazdin, 2007; Laurenceau, Hayes, & Feldman, 2007). This could enhance the effectiveness and efficiency of existing treatments and support the development of novel treatments. There are several categories potential mechanisms of therapy might fall into including psychological, therapeutic, biological and neuropsychological, therapist related, demographic, disorder specific and social factors. Research into the process of psychotherapy and treatment mechanisms typically focuses on three questions: the course of change (individual trajectories over the course of therapy), moderators of change (for whom and under what conditions does change occur) and mediators of change (how and why change is occurring; Laurenceau et al., 2007). The systematic review chapter of this thesis focuses on psychological mediators of change in cognitive behavioural therapies for generalised anxiety disorder (GAD). The empirical study examines cognitive predictors of outcome in CBT for depression and anxiety disorders, which aimed to develop current understanding of treatment moderators.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Cognitive Behavioural Therapy ; Mechanisms ; CBT ; Anxiety ; Depression ; Generalised Anxiety Disorder ; GAD