Transcript Integrating Psychodrama and Cognitive Therapy: An

Integrating Psychodrama and
Cognitive Therapy:
An Exploratory Study
by Michelle N. Boury
The present study evaluated the
effects of participating in a group
course which integrated
psychodramatic and cognitivebehavioral techniques on changes
in the number of core beliefs,
number of automatic thoughts,
mood and alleviating depression.
Cognitive Model
• Thoughts influence emotions and behaviors.
• Dysfunctional thoughts are frequently
associated with psychological distress.
• Such thoughts are provoked by core beliefs.
• Core beliefs are based in early childhood
and are the content of the cognitive
structures (schema) within the mind.
• Early Maladaptive Schemas (EMS).
Cognitive Triad
Future
Self
World
Intensity of Emotion
Psychodramatic Triad
Catharsis
Selection of patient
Warm-up
Sharing
Action
Closure
Cognitive Theory of Depression
• Depressed individuals negatively misinterpret
facts and experiences.
• The more negative thoughts the greater the
severity of other depressive symptoms.
• Depression is maintained by negative thoughts.
• To reduced depression there needs to be a
reduction in negative thoughts.
• Cognitive-Behavioral Therapy (CBT) evokes
change in thoughts and underlying beliefs.
Research on CognitiveBehavioral Therapy
• CBT has shown to be as effective as
pharmacology, psychoanalysis,
interpersonal and behavioral therapy.
• CBT has been effective in both individual
and group settings.
Present Study
• Purpose
– Examine the effects of completing the Thought
Record Form (TRF) with the integration of
psychodramatic and Cognitive-Behavioral
techniques.
– Examine the relationship among the variables
derived from the TRF and depression.
Present Study
• Beck’s Model
– When an individual is depressed there is an
increase in negative thought content about the
self, future, and world.
– Therapy should decrease depression because of
the awareness it brings to the negative thought
process.
Present Study
• The Psychodrama Course
– Cognitive techniques
– Psychodramatic techniques
– Group setting
Methods
• Participants
– 40 Undergraduate and graduate students.
– 24 females and 16 males.
– Enrolled in 1 of 5 group psychodrama courses
at West Chester University between the fall of
1997 and the fall of 1999.
– The course was 14 weeks long, meeting once a
week for 3 hours.
Instruments
• Thought Record Form
– Identifies negative thoughts evoked by a
particular situation.
• Beck Depression Inventory II
– Self-report measure of depression.
Thought Record Form Variables
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Number of distressing situations.
Number of negative moods identified.
Average initial mood rating.
Number of automatic thoughts.
Number of implied core beliefs.
Number of implied different types of core beliefs.
Number of balanced thoughts.
Number of moods reported after completion of
balanced thoughts.
• Average new mood rating.
Procedure
• BDI-II were computed weekly.
• Gradual introduction of the TRF.
• TRFs were completed as weekly homework
assignments.
Results
• Review of main purpose of this study
– To evaluate if the group class had any impact
on changes in number of core beliefs, automatic
thoughts, mood and BDI-II scores.
– To examine the correlation among various
measures derived from the TRFs and BDI-II
scores.
Effect of the Group Course
• More situations were mentioned in the first
three weeks of the course than the last three
weeks of the course.
Effect of the Group Course
• There was no difference in the following variables
from the first three weeks to the last three weeks
of the course:
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The number of automatic thoughts.
The number of core beliefs.
BDI-II scores.
The number of mood reported at the beginning of the
TRF.
– The average mood rating at the beginning of the TRF.
– The average mood rating after writing balanced
thoughts.
Effect of the Group Course
• More moods were reported in the beginning of the
TRF than in the end for both the first and last three
weeks of the course.
• The difference between the number of moods
reported from the beginning of the TRF and the
end was greater in the first three weeks of the
course.
• There were more moods reported at the end of the
TRF in the last three weeks than the first three
weeks.
Effect of the Group Course
• The average mood rating decreased from the
beginning of the TRF to the end, after writing the
balanced thoughts, in both the first three weeks
and last three weeks of the course.
• There was a greater reduction of mood rating from
the beginning to the end of the TRF in the first
three weeks than the last three weeks.
TRF Variables and BDI-II Scores
• The BDI-II correlated with the following
variables in the first three weeks:
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Number of moods in the beginning of the TRF.
Number of automatic thoughts.
Number of implied core beliefs.
Number of different implied core beliefs.
TRF Variables and BDI-II Scores
• The BDI-II correlated with the following
variables in the last three weeks:
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Number of situations.
Number of moods in the beginning of the TRF.
Number of automatic thoughts.
Number of implied core beliefs.
Number of new moods.
The average new mood rating.
Correlations Among the
TRF Variables
• The number of situations were positively
correlated with:
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Number of moods in the beginning of the TRF.
Number of automatic thoughts.
Number of core beliefs.
Number of different core beliefs.
Correlations Among the
TRF Variables
• The number of moods and balanced
thoughts were correlated with:
– Number of automatic thoughts.
– Number of implied core beliefs.
– Number of different core beliefs
Summary and Conclusion
• BDI-II scores did not differ from the first
three weeks to the last three weeks.
• Average mood ratings decreased as a result
of writing balanced thoughts.
• No reduction in negative moods as a result
of completing TRF weekly.
Summary and Conclusion
• Immediate positive effects of writing
balanced thoughts.
• These effects did not generalize to other
situations.
Suggestions
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Improved way of accessing mood.
Clinical population.
Longer term intervention.
Larger sample size.