Blog Posts Tagged "Cognitive Behavioural Therapy (CBT).".

I’m going to explain the results of a study and how you can use the same technique at home or with your therapist. It’s about a technique that was used to increase fruit and vegetable consumption but it’s easy to see how you could use this technique for other behavior change goals.

The Results of the Study

To cut to the chase, here’s what the results of the study showed. Participants ate on average 22.11 servings of fruits and vegetables per week before they were introduced to the CBT technique After the CBT intervention (1 session), the researchers followed them up for 24 months to assess the results.

They reassessed participants’ fruit and vegetable consumption 5 times in addition to the baseline measure before the intervention. These followp assessments of fruit and veg intake occurred immediately after the intervention, and 1, 2, 4, and 24 months after the intervention. Fruit and veg consumption at the followups was 27.78, 26.68, 26.44, 29.12, and 28.26 servings per week, an increase of 26%, 21%, 20%, 32%, and 28% compared to baseline levels. A control group that only received information about the benefits of eating fruits and vegies didn’t achieve the same sustained benefits (they improved initially but it didn’t last).

Here’s How They Did it

Participants participated in 1 session with a researcher in small groups.

Part 1: They got some information.

This consisted of a four-page health education leaflet that encouraged eating a healthy diet and gave the guideline to eat five servings of fruits and vegetables per day, detailed the advantages of a healthy diet in the short term and long term (e.g., better well-being, better weight control, lower risk for chronic diseases) and underlined the feasibility of eating a healthy diet (e.g., “Fruits and vegetable sticks are ideal snack food”);

They also did a knowledge self-check, had a discussion where participants compared their own answers with the correct answers provided by the researcher, and were encouraged to discuss all questions they had concerning a healthy lifestyle.

Part 2: They did the following, in order (the order is important).

They wrote down

“(a) their most important wish regarding their diet that should be both challenging and feasible (e.g., “eating more fruits and vegetables”);

(b) the most positive outcome of realizing their wish (e.g., “greater wellbeing”) and events and experiences they associated with this
positive outcome;

(c) the most critical obstacle (e.g., “no fruits at work”) together with events and experiences they associated
with this obstacle; and

(d) formed three implementation intentions with the following questions:

(1) “When and where does the obstacle occur, and what can I do to overcome or circumvent the obstacle?”;

(2) “When and where is an opportunity to prevent the obstacle from occurring, and what can I do to
prevent it from occurring?”; and

(3) “When and where is a good opportunity for me to act in a goal-directed way, and what would the goal-directed action be?” ”

The above is called “Mental Contrasting with Implementation Intentions.” They practiced the technique 4 times during their initial session with the researcher (focusing on 2 dietary goals for the next 24 hours and 2 dietary goals for the next couple of weeks). They were asked to practice the technique in written form each day in the week after the study and to practice it mentally throughout the day. They also practiced again during each of the followup periods.

If you’re interested in trying this yourself, your best bet is probably to read the full text of the study, which is available free online. Yay! Health Psychology.

Applying This To Other Areas

It’s easy to see how this technique could be applied to goals other than increasing fruit and vegetables. For example, if your goal was to use defusion techniques to respond to your anxiety.

I’ve previously written about how this same CBT technique can be used to increase exercise.

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I am writing 30 Days of Daily Tips (Weekdays) for Reducing Rumination on my Facebook page.

I’ve included the stream on this page for those who prefer to view it on my site rather than on Facebook.

I’m currently up to Day 5 – I started a little late this month due to being on vacation the end of Jan/beginning of Feb.

If you’re reading this in email you may need to click the post title to view the full post.

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Here’s an idea for a behavioral experiement for people who ruminate (passively & repeatedly think about the causes or consequences of problems without moving to active problem solving. Often involves self-criticism).

Prep: If you have a smart phone, you might find this easiest to do using your phone to record (you could use a basic notetaking app or your calendar app, or whatever suits you).

Or, you could just use a piece of paper/notebook.

Record: each time you notice yourself ruminating (as it happens)

You might do this by noticing
- when you are lost in thought,
- thinking about the past or the future, or
- when you are feeling negative emotions.

Any of these can act as triggers for you to ask yourself “Am I ruminating right now?” Or “Was I just ruminating?”

Record approx how many minutes you were ruminating for.

At the end of each day, record: any incidents of rumination that led to useful problem solving i.e., you took a specific action.

At the end of the week: Calculate your ratio

e.g.,

15 incidents of rumination, taking up approximately 10 hours, 3 incidents of it leading to problem solving = efficiency rating of 20% (3 incidents of problem solving out of 15 incidents of rumination) or 3 hr 20 mins of rumination to 1 problem solving action.

4 topics ruminated about, only 1 topic problem solved.

(Note that even the act of doing the recording is likely to lead to you doing more problem solving so your problem solving number might be higher).

Make an advance prediction:

Before you start, make a prediction of how much time you spend ruminating and your efficiency percentage. The goal of the exercise is to test how realistic your thoughts are about your rumination and perhaps give yourself some objective, personalized evidence that your rumination is not very useful for problem solving and how much time is available for thinking about something else.

Behavioral experiments have been shown to be highly effective in changing both thoughts and behavior.

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