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A test of the feasibility of a visualization method to show the depth and duration of awareness during Method of Levels therapy

Published online by Cambridge University Press:  27 June 2019

Jakub Grzegrzolka Open the ORCID record for Jakub Grzegrzolka [Opens in a new window]  and
Warren Mansell
Jakub Grzegrzolka*
Affiliation:
Northpoint Wellbeing Limited, Leeds Bridge House, Hunslet Road Leeds LS10 1JN, UK Division of Psychology and Mental Health, School of Psychological Sciences, University of Manchester, Manchester, UK
Warren Mansell
Affiliation:
Division of Psychology and Mental Health, School of Psychological Sciences, University of Manchester, Manchester, UK
*
*Corresponding author. Email: Jakub.Grzegrzolka@manchester.ac.uk
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Abstract

Many psychological therapies help clients to direct and sustain their awareness onto specific aspects of their problems to promote change. Yet, no theory-driven measure exists that can code moment-by-moment changes in awareness during a therapy session. It is known that awareness plays a crucial role in the process of change, but little is known about the underlying core processes. Perceptual Control Theory (PCT) offers a scientific explanation of psychological distress as loss of control and describes the role of awareness in processes responsible for restoring control by resolving any internal conflict. The Depth and Duration of Awareness Coding Scheme (D-DACS) was previously developed to capture the person’s current focus of awareness and its duration on the areas that from a PCT point of view are desirable in order to facilitate effective psychological change. The current research applies D-DACS to code three publicly available Method of Levels (MOL) therapy sessions delivered by an expert therapist and presents a visual representation of the client’s presumed attention in these sessions. The results showed that an average of 61.65% of the client’s attention was focused on the D-DACS areas, which is higher than the previous studies involving novel therapists. The produced visual representation of the clients’ presumed attention helps to examine the utility of this new coding scheme and further examine the validity of the underlying theory. Such work might help in examining effectiveness of therapy in meeting the underlying theoretical foundations of change. However, limitations and areas for improvement are also evident.

Key learning aims

  1. (1) To provide a rationale for the use of observer-rated measures of within-session processes involved in therapeutic change.

  2. (2) To describe the desired focus of the client’s awareness in order to facilitate effective psychological change as described by Perceptual Control Theory.

  3. (3) To use an earlier validated scheme to code the depth and duration of awareness of three clients in best practice videos of Method of Levels psychotherapy.

  4. (4) To present and test the feasibility of a visual representation of moment-to-moment changes in a client’s awareness in a therapy session.

Keywords

common factorscontrolevidence-based practicepsychotherapy process
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 12 , 2019 , e34
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019 

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References

Further reading

Carey, TA, Mansell, W, Tai, SJ (2015). Principles-Based Counselling and Psychotherapy: A Method of Levels Approach. London, UK: Routledge.CrossRefGoogle Scholar
Higginson, S, Mansell, W (2018). The Development and Evaluation of the Depth and Duration of Awareness Coding Scheme (D-DACS). The Cognitive Behavioural Therapist, 11. doi: 10.1017/S1754470X1800020X CrossRefGoogle Scholar
Mansell, W, Carey, TA, Tai, SJ (2012). A Transdiagnostic Approach to CBT Using Method of Levels Therapy: Distinctive Features. London, UK: Taylor and Francis.CrossRefGoogle Scholar

References

Alsawy, S, Mansell, W, Carey, TA, McEvoy, P, Tai, SJ (2014). Science and practice of transdiagnostic CBT: a Perceptual Control Theory (PCT) approach. International Journal of Cognitive Therapy, 7, 334–359.CrossRefGoogle Scholar
Barlow, DH, Allen, LB, Choate, ML (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35, 205–230.CrossRefGoogle Scholar
Brack, PE, Bugental, JFT (2002). Existential/humanistic psychotherapy. In Kaslow, F.W. (ed), Comprehensive Handbook of Psychotherapy, pp. 255–277. Hoboken: John Wiley & Sons.Google Scholar
Bugental, JFT (1999). Psychotherapy Isn’t What You Think: Bringing the Psychotherapeutic Engagement into the Living Moment. Phoenix: Zeig, Tucker.Google Scholar
Carey, TA (2006). The Method of Levels: How to Do Psychotherapy without Getting in the Way. Hayward: Living Control Systems Publishing.Google Scholar
Carey, TA (2011). Exposure and reorganization: the what and how of effective psychotherapy. Clinical Psychology Review, 31, 236–248.CrossRefGoogle ScholarPubMed
Carey, TA, Mansell, W, Tai, SJ (2015). Principles-Based Counselling and Psychotherapy: A Method of Levels Approach. London, UK: Routledge.CrossRefGoogle Scholar
Carey, TA, Tai, SJ, Stiles, WB (2013). Effective and efficient: using patient-led appointment scheduling in routine mental health practice in remote Australia. Professional Psychology: Research and Practice, 44, 405–414.CrossRefGoogle Scholar
Craske, MG (2012). Transdiagnostic treatment for anxiety and depression. Depression & Anxiety, 29, 749–753.CrossRefGoogle ScholarPubMed
Doss, BD (2004). Changing the way we study change in psychotherapy. Clinical Psychology – Science and Practice, 11, 368–386.CrossRefGoogle Scholar
Fissler, M, Winnebeck, E, Schroeter, T, Gummersbach, M, Huntenburg, JM, Gaertner, M, Barnhofer, T (2016). An investigation of the effects of brief mindfulness training on self-reported interoceptive awareness, the ability to decenter, and their role in the reduction of depressive symptoms. Mindfulness, 7, 1170–1181.CrossRefGoogle Scholar
Geller, SM, Greenberg, LS (2012). Therapeutic Presence: A Mindful Approach to Effective Therapy. Washington, District of Columbia, USA: American Psychological Association.CrossRefGoogle Scholar
Hakamata, Y, Lissek, S, Bar-Haim, Y, Britton, JC, Foz, NA, Leibenluft, E, Pine, DS (2010). Attention bias modification treatment: a meta-analysis toward the establishment of novel treatment for anxiety. Biological Psychiatry, 68, 982–990.CrossRefGoogle ScholarPubMed
Harvey, A, Watkins, E, Mansell, W, Shafran, R (2004). Cognitive Behavioural Processes Across Psychological Disorders: A Transdiagnostic Approach to Research and Treatment. Oxford, UK: Oxford University Press CrossRefGoogle Scholar
Higginson, S, Mansell, W (2016). The Depth and Duration of Awareness Coding Scheme (D-DACS) Manual. doi: 10.13140/RG.2.1.2494.4725 CrossRefGoogle Scholar
Higginson, S, Mansell, W (2018). The Development and Evaluation of the Depth and Duration of Awareness Coding Scheme (D-DACS). The Cognitive Behavioural Therapist, 11, 1–21. doi: 10.1017/S1754470X1800020X Google Scholar
Higginson, S, Mansell, W, Wood, AM (2011). An integrative mechanistic account of psychological distress, therapeutic change and recovery: the perceptual control theory approach. Clinical Psychology Review, 31, 249–259.CrossRefGoogle ScholarPubMed
Kazdin, AE (2007). Mediators and mechanisms of change in psychotherapy research. Annual Review of Clinical Psychology, 3, 1–27.CrossRefGoogle ScholarPubMed
Leow, RP, Johnson, E, Zárate-Sández, G (2011). Getting a grip on the slippery construct of awareness: toward a finer-grained methodological perspective. In Sanz, C. and Leow, R.P. (eds), Implicit and Explicit Conditions, Processes and Knowledge in SLA and Bilingualism. Washington, DC, USA: Georgetown University Press Google Scholar
Lutz, W, Hill, CE (2009). Quantitative and qualitative methods for psychotherapy research: introduction to special section. Psychotherapy Research, 19, 369–373. doi: 10.1080/10503300902948053 CrossRefGoogle ScholarPubMed
Mansell, W (2005). Control theory and psychopathology: an integrative approach. Psychology and Psychotherapy: Theory, Research and Practice, 78, 141–178.CrossRefGoogle Scholar
Mansell, W (2008). The seven C’s of CBT: a consideration of the future challenges for cognitive behaviour therapy. Behavioural and Cognitive Psychotherapy, 36, 641–649.CrossRefGoogle Scholar
Mansell, W (2009). Perceptual Control Theory as an integrative framework and Method of Levels as a cognitive therapy: what are the pros and cons? The Cognitive Behaviour Therapist, 2, 178–196.CrossRefGoogle Scholar
Mansell, W (2011). Core processes of psychopathology and recovery: ‘Does the Dodo bird effect have wings?’. Clinical Psychology Review, 31, 189–192.CrossRefGoogle Scholar
Mansell, W, Carey, TA, Tai, SJ (2012). A Transdiagnostic Approach to CBT Using Method of Levels Therapy: Distinctive Features. London, UK: Taylor and Francis.CrossRefGoogle Scholar
Mansell, W, Harvey, A, Watkins, ER, Shafran, R (2009). Conceptual foundations of the transdiagnostic approach. Journal of Cognitive Psychotherapy, 23, 6–19.CrossRefGoogle Scholar
McHugh, RK, Murray, HW, Barlow, DH (2009). Balancing fidelity and adaptation in the dissemination of empirically-supported treatments: the promise of transdiagnostic interventions. Behaviour Research and Therapy, 47, 946–953.CrossRefGoogle ScholarPubMed
McManus, F, Shafran, R, Cooper, Z (2010). What does a transdiagnostic approach have to offer the treatment of anxiety disorders? British Journal of Clinical Psychology, 49, 491–505.CrossRefGoogle ScholarPubMed
Mehling, WE, Wrubel, J, Daubenmier, JJ, Price, CJ, Kerr, CE, Silow, T, Stewart, AL (2011). Body awareness: a phenomenological inquiry into the common ground of mind-body therapies. Philosophy, Ethics, and Humanities in Medicine, 6, 1.CrossRefGoogle ScholarPubMed
Merikle, PM (1984). Toward a definition of awareness. Bulletin of the Psychonomic Society, 22, 449–450.CrossRefGoogle Scholar
Moore, A, Malinowski, P (2009). Meditation, mindfulness and cognitive flexibility. Consciousness and Cognition, 18, 176–186.CrossRefGoogle ScholarPubMed
Moorey, J, Guthrie, E (2003). Persons and experience: essential aspects of psychodynamic interpersonal therapy. Psychodynamic Practice, 9, 547–564.CrossRefGoogle Scholar
Nock, MK (2007). Conceptual and design essentials for evaluating mechanisms of change. Alcoholism-Clinical and Experimental Research, 31, 4–12S.CrossRefGoogle ScholarPubMed
Norton, PJ, Paulus, DJ (2016). Toward a unified treatment for emotional disorders: update on the science and practice. Behavior Therapy, 47, 854–868.CrossRefGoogle Scholar
Powers, WT (1973). Behaviour: The Control of Perception. New Canaan: Benchmark Publications.Google Scholar
Stern, DN (2004). The Present Moment in Psychotherapy and Everyday Life. New York, USA: W.W. Norton.Google Scholar
Taylor, S, Clark, DA (2009). Transdiagnostic cognitive-behavioral treatments for mood and anxiety disorders: introduction to the special issue. Journal of Cognitive Psychotherapy, 23, 3.CrossRefGoogle Scholar
Wells, A. (2007). The attention training technique: theory, effects, and a metacognitive hypothesis on auditory hallucinations. Cognitive and Behavioral Practice, 14, 134–138.CrossRefGoogle Scholar
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