Attitudes and applications of chairwork amongst CBT therapists: a preliminary survey

Chairwork refers to a collection of experiential interventions which utilise chairs, their positioning, movement, and dialogue to facilitate therapeutic change. Chair-based methods are used in several models of psychotherapy, including cognitive behavioural therapy (CBT). However, little is known about cognitive behavioural therapists’ use and attitudes towards chairwork. A mixed methods survey was conducted of 102 therapists who provided CBT. Overall, training in chairwork was weak amongst CBT therapists (35%). Quantitative results indicated that most therapists perceived chairwork to be clinically effective and consistent with the cognitive behavioural model, but did not feel competent using these methods. Perceived competence was highest amongst therapists who had been trained in chairwork and practised it frequently, but was unrelated to CBT accreditation or clinical experience. Qualitative feedback identified a number of factors that encouraged the use of chairwork (e.g. overcoming limitations associated with verbal restructuring methods), as well as inhibitors (e.g. therapist anxiety and limited access to training). These preliminary findings highlight a need for further research relating to cognitive behavioural chairwork and suggest that increased training in experiential interventions could go some way towards improving outcomes in CBT. Key learning aims As a result of reading this paper, readers should: (1) Understand cognitive behavioural therapists’ attitudes towards chairwork. (2) Appreciate therapists’ anxiety and avoidance in relation to chairwork. (3) Identify the key factors that facilitate or inhibit the use of cognitive behavioural chairwork.

Schema Therapy for Chronic Depression Associated with Childhood Trauma: A Case Study

Chronic depression lasting longer than 2 years is often undertreated. Research suggests that maladaptive cognitive schemas mediate the association between childhood trauma and later depression. Schema Therapy (ST) is an integrative treatment approach that targets maladaptive cognitive schemas through cognitive, behavioral, interpersonal, and experiential interventions. ST has been studied in patients with chronic depression with good results. The purpose of this case study is to detail how an ST treatment was used to treat chronic depression in a woman, “Amy,” with a childhood trauma history. Amy presented with a persistent depressive disorder that had lasted over 40 years. An ST approach was chosen in light of the chronicity of Amy’s symptoms and her childhood trauma history. Standardized measures including the Beck Depression Inventory were used to assess progress throughout treatment. We provide a comprehensive summary of the 22-session ST case conceptualization and treatment, through which Amy’s depressive symptoms evidenced a 73 percent reduction. Amy qualitatively reported reduced depressive rumination and avoidance behaviors as well as increased frequency of positive mood.

Prevalence and predictors of US medical graduates’ federal F32, mentored-K, and R01 awards: a national cohort study

The size and diversity of the physician-scientist workforce are issues of national concern. In this retrospective, national cohort study of US medical school matriculants who graduated in 1997–2004, we describe the prevalence and predictors of federal F32, mentored-K, and R01 awards among physicians. In multivariable logistic regression models, we identified demographic, educational, and professional development variables independently associated with each award through August 2014, reporting adjusted odds ratios and 95% confidence intervals (AOR (95% CI)). Among 117,119 graduates with complete data (97.7% of 119,906 graduates in 1997–2004), 509 (0.4%) received F32, 1740 (1.5%) received mentored-K, and 597 (0.5%) received R01 awards. Adjusting for all variables except US Medical Licensing Examination Step 1 scores, black (vs white) graduates were less likely to receive F32 (0.48 (0.28–0.82)), mentored-K (0.56 (0.43–0.72)), and R01 (0.48 (0.28–0.82)) awards; Hispanic graduates were less likely to receive mentored-K awards (0.68 (0.52–0.88)), and women less likely to receive F32 (0.81 (0.67–0.98)) and R01 (0.59 (0.49–0.71)) awards. After adding Step 1 scores, these race/ethnicity effects were not significant, but women (0.62 (0.51–0.75)) were still less likely to receive R01 awards. Graduates reporting both (vs neither) medical school research elective and authorship were more likely to receive F32 (1.89 (1.45–2.48)), mentored-K (2.48 (2.13–2.88)), and R01 (2.00 (1.54–2.60)) awards. Prior F32 (2.17 (1.46–3.21)) and mentored-K (28.08 (22.94–34.38)) awardees more likely received R01 awards. Findings highlight the need for research-experiential interventions along the medical education continuum to promote greater participation and diversity of US medical graduates in the federally funded, biomedical research workforce.

The Use of Recursive Frame Analysis on an Emotionally Focused Couples Therapy Session

Emotionally Focused Couples Therapy (EFT) is an evidence0based therapy model. It has been viewed as an empirical approach to couple therapy, and it has lasting treatment effects (Johnson, 2004; Greenman & Johnson, 2013). However, Greenman and Johnson (2013) also argued that there is still a lack of research concerning the EFT process. This study focuses on connections between theory and practice by analyzing the EFT process. Recursive Frame Analysis (RFA), a tool developed by Chenail and Keeney to map therapeutic conversation (Chenail, 1993; Chenail, 1995; Keeney, 1987), is used here as a research method to examine Sue Johnson’s use of EFT interventions and techniques to delivering EFT theory in the educational DVD titled, “Emotionally Focused Therapy in Action” (Johnson, 2011). Specifically, this study analyzes the conversational movement within and between the EFT stages and steps, to examine interventions and techniques related to interactional patterns, emotions, and attachment. It is a descriptive research. An analysis of the DVD session illustrates Johnson’s skills in using systemic interventions, experiential interventions, and attachment interventions and techniques linking EFT theories to practice. The skills of how and when to use specific interventions and techniques, as informed by a language perspective, can be very beneficial for therapists’ better understanding of the transitions and flows between EFT theories and practice. In addition, the researcher found that RFA as a research methodology is well-suited to analyzing an EFT session.