Innovations and advances in cognitive behavioral therapy: Insights from experimental psychopathology

Abstract

At its core, the goal of experimental psychopathology is to understand what processes or mechanisms cause, maintain, or otherwise contribute to mental health problems (e.g., Zvolensky, Forsyth, & Johnson, 2013). There are countless examples of how this type of research has led to important improvements in treatment for people with psychological disorders. Perhaps most famously, Beck’s (1963) findings that people with depression consistently exhibit systematic thinking errors (i.e., cognitive distortions) and conscious negative automatic thoughts revolutionized how we help people with emotional disorders (see Beck, 2019, for a history of cognitive therapy for depression). Indeed, by spending a bit of time perusing treatment recommendations by the National Institute for Health and Care Excellence (NICE), it becomes clear quickly that cognitive behavioral therapy (CBT) is now—and has been for a while—a first-line evidence-based treatment for almost every psychological disorder. As such, it would be easy to conclude that “our work is done.” However, many people continue to suffer with mental health problems that either are not improved following CBT or relapse following treatment; many more are unable to access evidence-based care. Understanding what mechanisms still need to be targeted, for whom, under which conditions, and developing ways to increase access to these treatments is vital. Experimental psychopathology comprises a framework in which to make that happen. The goal of this Special Collection was thus to bring together experimental psychopathology research that continues to advance CBT for various psychological disorders. Authors were invited to submit manuscripts describing (1) original investigations of underlying mechanisms of psychopathology, (2) original investigations of new (or new variations of) CBT interventions, or (3) reviews/integrations of a body of published experimental psychopathology findings that have led to recent innovations or have the potential to lead to innovations in CBT. The result is an exciting special collection that runs the gamut of mental health problems, experimental psychopathology methods (experiments, case-study designs, and randomized controlled trials [RCTs]), includes both clinical and nonclinical participants, and features reviews of experimental psychopathology literature. Together, these articles suggest that we have learned much, and that we have much to learn about how to advance CBT and its accessibility for people with mental health problems. In their selective review, Gagné, Kelly-Turner, and Radomsky (2018) focused on the science–practice bridge (rather than the gap) to understand both how research has informed the treatment of obsessive– compulsive disorder (OCD) and how clinical experience can inspire experimental research. They provided a broad overview of etiological models of OCD, with a particular focus on diverse cognitive models such as the cognitive appraisal model and the seeking proxies for internal states model. Through examples of experiments across checking, obsessions, contamination fear, and “just-right” symptom presentations, they provided ideas for future research and future practice. Indeed, throughout the years, researchers have developed many clever studies that shed light on the diverse cognitive mechanisms that cause and maintain OCD (e.g., inducing thought– action fusion by telling an experimental group that if they think the word “apple,” a person in the next room will receive a shock; Rassin, Merckelbach, Muris, & Spaan, 1999) and thus provide potentially fruitful treatment targets. There are also important gaps in the experimental literature. Most notably, “just-right” experiences have been largely understudied; clinical suggestions for treating this particular Journal of Experimental Psychopathology July-September 2019: 1–5 a The Author(s) 2019 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/2043808719874966 journals.sagepub.com/home/jepp