TY - JOUR
T1 - A Theoretically Based Experimental Manipulation of the Processing of Sudden Gains
T2 - Considering Reasons, Meaning, and Opportunities to Leverage the Gain
AU - Shalom, Jonathan G.
AU - Strauss, Asher Y.
AU - Huppert, Jonathan D.
AU - Andersson, Gerhard
AU - Aderka, Idan M.
N1 - Publisher Copyright:
© 2024 American Psychological Association
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
KW - internet interventions
KW - processes of change
KW - rapid change
KW - social anxiety disorder
KW - sudden gains
UR - http://www.scopus.com/inward/record.url?scp=85214522693&partnerID=8YFLogxK
U2 - 10.1037/ccp0000941
DO - 10.1037/ccp0000941
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
AN - SCOPUS:85214522693
SN - 0022-006X
JO - Journal of Consulting and Clinical Psychology
JF - Journal of Consulting and Clinical Psychology
ER -