Cognitive therapy (CT) is a widely used treatment approach for many psychological issues. One of the measures of progress in this type of therapy is the assessment of sudden gains (SG). Sudden gains occur when a client has seen a 25% drop in symptom severity and the gains remain constant when compared to pre-gain therapy sessions. Research has shown that SGs are highly predictive of post-therapy outcomes and can lead to greater symptom reduction and better overall long-term prognosis. This has been especially evident in research on social anxiety (SAD). However, to date, few studies have compared CT to other treatment methods with respect to SGs. To this end, Christiane Bohn of the Department of Clinical Psychology and Psychotherapy at Goethe-University Frankfurt in Germany recently led a study examining whether CT would provide more SGs than interpersonal therapy (IPT).
Bohn recruited 67 participants with SAD and enrolled them in 16 sessions of CT or IPT. The participants were evaluated for symptom severity at every session in order to measure SGs. The study revealed that nearly one quarter of the participants had a SG during the 16 weeks of treatment, which led to decreases in symptom severity post-treatment. In fact, the SG participants had much lower levels of SAD after their gains and at follow-up than those with no gains. However, Bohn did not find differences in treatment modality on SGs. Specifically, the participants in CT and IPT all experienced similar timing of SGs, similar frequency and strength of SGs. Also, cognitive shifts in either condition did not lead to SGs, but the SGs achieved in both treatment approaches did cause cognitive transformations. Bohn noted too that secondary symptoms, such as those of depression, were not affected by SGs for either group of participants.
The only significant difference that Bohn found was in long-term outcomes. The participants in the CT group were able to sustain their SGs and reductions in anxiety for longer periods than those in the IPT group. “These findings suggest that differences between treatment modalities may lie not in the generation of SG, but rather in their ability to capitalize on SG and create subsequent improvements,” said Bohn. Further research should expand these results and determine which method of treatment may be most beneficial for individuals with SAD and those with secondary symptoms as well.
Bohn, C., Aderka, I. M., Schreiber, F., Stangier, U., and Hofmann, S. G. (2012). Sudden gains in cognitive therapy and interpersonal therapy for social anxiety disorder. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0031198
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