Client memory and learning of treatment contents: An experimental study of intervention strategies and relationship to outcome in a brief treatment for procrastination

Measuring Memory for Treatment Using Patient Conceptualizations of Clinical Vignettes: A Pilot Psychometric Study in the Context of Cognitive Therapy for Depression

Background

Patient memory for psychological treatment contents is a promising transdiagnostic mechanism of change, but there is little consensus concerning its measurement. We conducted a pilot psychometric investigation of the Conceptualization Task, a novel measure of patient memory for treatment.

Methods

Data were from a trial comparing cognitive therapy-as-usual to cognitive therapy plus the Memory Support Intervention (MSI) for adults with depression (N = 171). For the Conceptualization Task, patients read clinical vignettes and provided written responses to assess three facets of conceptualization: identifying contributing factors to psychopathology, making intervention recommendations, and providing a rationale for recommendations. Higher scores were given to responses reflecting accurate memory for the theoretical model and change strategies used in treatment.

Results

The Conceptualization Task showed excellent inter-rater reliability and sensitivity to change during treatment, but only fair test–retest reliability and insufficient internal consistency. Findings supported discriminant validity with measures of education, IQ, and general memory functioning, but not convergent validity with existing measures of patient memory for treatment. Criterion validity analyses showed that some aspects of the Conceptualization Task were associated with therapist use of memory support strategies from the MSI and treatment outcome. However, findings were mixed, effect sizes were small, and some results did not remain statistically significant after correcting for multiple comparisons.

Conclusions

Further refinement and testing is needed before the Conceptualization Task may be used to assess the patient memory for treatment contents.

Knowledge gain and usage of knowledge learned during internet-based CBT treatment for adolescent depression - a qualitative study

BACKGROUND

The role of explicit learning of treatment content in internet-based cognitive-behavioural treatment (ICBT) is an emerging field of research. The objective of this study was to explore clients experiences of their ICBT treatment for depression with a focus on knowledge gain and usage of knowledge learned during treatment.

METHODS

A strategic sample of ten adolescents, aged between 15 and 19 years, who had received ICBT for major depression within a clinical controlled trial were recruited for the study. Semi-structured interviews were conducted 6 months following trial completion. Data were transcribed and analysed using thematic analysis. The participants had a general adherence rate of 6-8 opened modules out of 8 possible.

RESULTS

Two main themes were identified; "Active agents of CBT" and "Passive agents of CBT", with each theme consisting of three and two sub-themes. Active agents of CBT reflect a tendency to specifically remember and actively apply specific CBT principles in present life situations. Passive agents of CBT reflect a tendency to remember CBT treatment principles vaguely and express a passive or reactive usage of learned therapy content.

CONCLUSION

The findings suggest that young clients can remember and apply CBT principles 6 months after their treatment. However, while experiencing benefits of treatment, clients recall and application of treatment strategies vary. The study emphasizes the importance of exploring client recall of CBT components and how valuable it is to explicitly remember contents of a treatment in order to improve and maintain improvement. Further studies on the role of knowledge and memory of ICBT for adolescent populations are warranted.