Jonathan G Shalom, Asher Y Strauss, Jonathan D Huppert, Gerhard Andersson, Idan M Aderka
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Specifically, we randomized individuals who experienced a sudden gain (<i>n</i> = 52) to either receive (n = 26) or not receive (<i>n</i> = 26) processing of the gain.</p><p><strong>Results: </strong>We found that processed sudden gains were significantly less likely to be reversed compared to unprocessed sudden gains. We also found that individuals with processed sudden gains had lower symptom levels at posttreatment/follow-up compared to individuals with unprocessed sudden gains (<i>M</i><sub>difference</sub> = 15.65, <i>SE</i> = 5.87, <i>p</i> = .023, Cohen's <i>d</i> = 0.84; <i>M</i><sub>difference</sub> = 16.68, <i>SE</i> = 6.36<i>, p</i> = .026, Cohen's <i>d</i> = 1.05; respectively). In addition, individuals with unprocessed sudden gains did not have significantly different symptom levels at posttreatment/follow-up compared to individuals who did not experience a sudden gain during treatment.</p><p><strong>Conclusions: </strong>Our findings suggest that in internet-delivered cognitive behavior therapy for social anxiety disorder, the processing of sudden gains (rather than the gains themselves) leads to upward spirals of improvement that affect long-term outcomes. Replication of these findings in additional studies is needed, and, if replicated, such findings could provide the basis for adding processing of sudden gains to existing therapeutic protocols. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":"93 2","pages":"120-130"},"PeriodicalIF":4.5000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A theoretically based experimental manipulation of the processing of sudden gains: Considering reasons, meaning, and opportunities to leverage the gain.\",\"authors\":\"Jonathan G Shalom, Asher Y Strauss, Jonathan D Huppert, Gerhard Andersson, Idan M Aderka\",\"doi\":\"10.1037/ccp0000941\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Sudden gains in psychotherapy have been found to predict outcome, but the conditions under which this occurs remain understudied. In the present study, we experimentally examined the effects of processing sudden gains on treatment outcome.</p><p><strong>Method: </strong>As part of a large randomized controlled trial of internet-delivered cognitive behavior therapy for social anxiety disorder (<i>n</i> = 182), we experimentally manipulated therapists' responses to sudden gains. Specifically, we randomized individuals who experienced a sudden gain (<i>n</i> = 52) to either receive (n = 26) or not receive (<i>n</i> = 26) processing of the gain.</p><p><strong>Results: </strong>We found that processed sudden gains were significantly less likely to be reversed compared to unprocessed sudden gains. We also found that individuals with processed sudden gains had lower symptom levels at posttreatment/follow-up compared to individuals with unprocessed sudden gains (<i>M</i><sub>difference</sub> = 15.65, <i>SE</i> = 5.87, <i>p</i> = .023, Cohen's <i>d</i> = 0.84; <i>M</i><sub>difference</sub> = 16.68, <i>SE</i> = 6.36<i>, p</i> = .026, Cohen's <i>d</i> = 1.05; respectively). In addition, individuals with unprocessed sudden gains did not have significantly different symptom levels at posttreatment/follow-up compared to individuals who did not experience a sudden gain during treatment.</p><p><strong>Conclusions: </strong>Our findings suggest that in internet-delivered cognitive behavior therapy for social anxiety disorder, the processing of sudden gains (rather than the gains themselves) leads to upward spirals of improvement that affect long-term outcomes. Replication of these findings in additional studies is needed, and, if replicated, such findings could provide the basis for adding processing of sudden gains to existing therapeutic protocols. 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引用次数: 0
摘要
目的：已经发现心理治疗的突然获益可以预测结果，但这种情况发生的条件仍未得到充分研究。在本研究中，我们通过实验检验了处理突发性增益对治疗结果的影响。方法：作为网络认知行为治疗社交焦虑障碍的大型随机对照试验的一部分（n = 182），我们通过实验操纵治疗师对突然收益的反应。具体来说，我们将经历突然增益的个体（n = 52）随机分配给接受（n = 26）或不接受（n = 26）增益处理的个体。结果：我们发现，与未处理的突然增益相比，处理过的突然增益明显不太可能逆转。我们还发现，与未处理突然增益的个体相比，处理突然增益的个体在治疗后/随访时的症状水平较低(Mdifference = 15.65, SE = 5.87, p = 0.023, Cohen’s d = 0.84；Mdifference = 16.68, SE = 6.36, p = 0.026, Cohen’s d = 1.05；分别)。此外，在治疗后/随访中，与在治疗期间没有经历突然增加的个体相比，未经处理的突然增加的个体没有显著不同的症状水平。结论：我们的研究结果表明，在针对社交焦虑障碍的网络认知行为治疗中，对突然收益的处理（而不是收益本身）导致了影响长期结果的改善的上升螺旋。需要在其他研究中重复这些发现，如果重复，这些发现可以为在现有治疗方案中增加处理突然收益提供基础。（PsycInfo Database Record (c) 2025 APA，版权所有）。
A theoretically based experimental manipulation of the processing of sudden gains: Considering reasons, meaning, and opportunities to leverage the gain.
Objective: Sudden gains in psychotherapy have been found to predict outcome, but the conditions under which this occurs remain understudied. In the present study, we experimentally examined the effects of processing sudden gains on treatment outcome.
Method: As part of a large randomized controlled trial of internet-delivered cognitive behavior therapy for social anxiety disorder (n = 182), we experimentally manipulated therapists' responses to sudden gains. Specifically, we randomized individuals who experienced a sudden gain (n = 52) to either receive (n = 26) or not receive (n = 26) processing of the gain.
Results: We found that processed sudden gains were significantly less likely to be reversed compared to unprocessed sudden gains. We also found that individuals with processed sudden gains had lower symptom levels at posttreatment/follow-up compared to individuals with unprocessed sudden gains (Mdifference = 15.65, SE = 5.87, p = .023, Cohen's d = 0.84; Mdifference = 16.68, SE = 6.36, p = .026, Cohen's d = 1.05; respectively). In addition, individuals with unprocessed sudden gains did not have significantly different symptom levels at posttreatment/follow-up compared to individuals who did not experience a sudden gain during treatment.
Conclusions: Our findings suggest that in internet-delivered cognitive behavior therapy for social anxiety disorder, the processing of sudden gains (rather than the gains themselves) leads to upward spirals of improvement that affect long-term outcomes. Replication of these findings in additional studies is needed, and, if replicated, such findings could provide the basis for adding processing of sudden gains to existing therapeutic protocols. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
期刊介绍：
The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.
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