Levin, M. E., Krafft, J., An, W., Ong, C. W., & Twohig, M. P. (2021). Preliminary findings on processes of change and moderators for cognitive defusion and restructuring delivered through mobile apps. Journal of Contextual Behavioral Science, 20, 13-19. https://doi.org/10.1016/j.jcbs.2021.02.002
A process-based therapy approach emphasizes examining how and for whom specific therapeutic components linked to specific processes of change function. This preliminary study explored the processes of change for cognitive defusion and restructuring with daily ratings of self-criticism from a larger component trial as well as self-compassion as a moderator of these daily effects. A sample of 51 adults high in self-criticism (M age = 22.69, 78% female, 88% non-Hispanic White) were randomized to a cognitive defusion or restructuring mobile app for two weeks and completed daily assessments. Both conditions improved over time on daily frequency, defused noticing, challenging, and believability of self-critical thoughts as well as valued actions, with larger improvements in the defusion condition only for thought frequency and defused noticing. Global self-compassion moderated several effects such that only participants lower in self-compassion improved over time on daily self-criticism processes in the restructuring condition, while effects over time in the defusion condition generally did not vary by level of self-compassion. Improvements in daily frequency, defused noticing, and challenging self-critical thoughts as well as valued action each predicted global improvements in self-criticism at post-intervention across conditions. Overall, these preliminary results suggest cognitive defusion and restructuring may have some similar effects on self-criticism related processes of change, particularly for those low in self-compassion. However, defusion may produce larger effects on some targeted processes, especially among those with higher self-compassion.
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