Cognitive and behavioral psychotherapy act differently on the brain. Each of them modifies cognitive mechanisms that the other is not capable of encompassing. This is clear from a study published this Wednesday in Science Advances, which lays the foundations for identifying the specific effects that each therapeutic strategy used by psychologists has on the human mind, one of the great pending challenges of the field.
“Psychotherapy treatments are usually provided in ‘packages’ made up of many different treatment components,” explains Agnes Norbury, one of the researchers at University College London (UCL) who carried out the study, to La Vanguardia. “We know that these treatments are relatively effective at the population level (for about 30-40% of patients), but we don't know as much about why they don't work or are less effective in particular cases,” she continues.
One hypothesis is that certain patients respond better to some therapeutic “packages” than others, depending on their cognitive mechanisms and the symptoms they present. In this case, “the treatment would be more effective if it somehow matched the needs of each individual,” explains Norbury. However, the complexity and multifactorial nature of therapeutic processes has not allowed, until now, to validate this idea.
The study carried out by the Norbury team, although still preliminary, indicates that achieving that much-sought match is possible. The work is preliminary, because the 800 volunteers who participated in the study were healthy people, and the interventions were carried out in a gamified environment. Both the problem to be solved and the therapeutic intervention were simpler than day-to-day situations.
However, despite the limited nature of the experiment, the UCL researchers have been able to observe how setting realistic goals before carrying out a task makes us perceive it as easier. Also, knowing that the way we interpret an event determines more how we feel than the event itself, makes us blame ourselves less for the negative events of our daily life.
But what is perhaps most important about his research is that it has revealed that both interventions are specific. That is to say, setting goals does not make us blame ourselves less for what happens to us in our daily lives; and how we interpret facts does not affect the sense of effort we judge a task will entail.
“This is a vital step toward the eventual goal of providing more targeted or personalized psychotherapeutic treatment,” the authors note in the article. If, on the other hand, each cognitive process were affected by different treatments at the same time, regulating their administration would become much more complicated, they reason.
One last detail that the experiment has revealed is that the effects of the psychological interventions were not homogeneous for all participants. Those who responded to an initial questionnaire with a general lack of interest (a symptom called anhedonia) especially benefited from setting attainable goals. On the other hand, the cognitive intervention (explaining that our feelings depend more on how we interpret situations than on the event itself) was not as useful to them.
“These findings must be interpreted with caution, given that they were not replicated in all samples,” the authors warn. But they suggest that behavioral treatments may be a more useful tool than cognitive treatments to treat patients with these characteristics.
UCL scientists have already carried out a second study “in patients with significant levels of low mood or depressive symptoms”, explains Norbury, and in a real therapeutic setting. The results, which the expert assures will be published “shortly,” will reveal to what extent these preliminary indications are applicable to the therapeutic framework as a whole.
