Patient constructive learning behavior in cognitive therapy: A pathway for improving patient memory for treatment?☆
Section snippets
Study overview
Data for the current study were drawn from a pilot randomized controlled trial (NCT01790919) comparing cognitive therapy-as-usual (CT-as-usual) to cognitive therapy integrated with the Memory Support Intervention (CT + Memory Support) for adults with Major Depressive Disorder (N = 48). Patients in both conditions received 14 weekly, 50-min, individual sessions with a therapist holding a master's or doctoral degree in psychology. All sessions were video recorded. Therapists in both conditions
Aim 1: describe the frequency of patient constructive learning behavior in the context of therapist use of constructive memory support strategies
Among the 468 instances of therapist use of constructive memory support strategies, patient constructive learning behavior was observed in 177 (37.82%). Across all sessions (N = 154), the average number of patient constructive learning behaviors was 1.15 per session (SD = 1.48).
Aim 2: examine the effect of therapist invitation to respond and therapist scaffolding on the likelihood of patient constructive learning behavior
Among the 468 instances of therapist use of constructive memory support, 273 instances (58.33%) involved the therapist inviting a response from the patient, and 131 instances (28.00%) involved the therapist using
Discussion
This study sought to inform future iterations of the Memory Support Intervention (Harvey et al., 2014) by applying novel theories from cognitive psychology to identify effective intervention components, potential mechanisms of action, and methods to optimally engage mechanisms of action. Specifically, the construct of constructive educational activities (Chi & Wylie, 2014) was used to distinguish constructive memory support strategies from non-constructive memory support strategies, and to
Conclusion
In summary, based on a small, pilot sample, this study provides initial evidence that patient constructive learning behaviors may represent an important pathway to enhanced patient memory for treatment. These constructive learning behaviors can be elicited by strategies comprising the Memory Support Intervention, and may be more likely to occur if therapists are trained to invite patients to express ideas, inferences, and connections about treatment contents and provide scaffolding to patients
Acknowledgements
We thank Cara Woodworth and Sydney Garcia for assistance with data coding.
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Optimizing outcomes, mechanisms, and recall of Cognitive Therapy for depression: Dose of constructive memory support strategies
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2022, Behaviour Research and TherapyCitation Excerpt :Each of these were evident after the treatment had ended. It remains to be seen if future research that factors in the type of memory supports [e.g., constructive memory support (Sarfan, Zieve, Gumport, et al., 2022; Zieve et al., 2019)] or that focuses on patient groups who may derive particular benefit from memory support (e.g., those with poorer memory for treatment) yield more encouraging outcomes. It is also possible that between session memory support is an effective adjunct to within session memory support (Dolsen et al., 2021) may.
The Development and Validation of the Memory Support Treatment Provider Checklist
2021, Behavior TherapyCitation Excerpt :Internal consistency was on the low end of acceptable, which is likely due to the few items on the scale, as the number of items on a scale contributes this value (Tavakol & Dennick, 2011). CFA results supported the two-factor model based on Zieve, Dong, Weaver, et al. (2019) over the one-factor model based on Lee et al. (2015). While this finding is inconsistent with the single factor solution of the MSRS (Lee et al., 2015), it is consistent with Zieve et al.’s proposal that there are two clusters of memory support strategies that are more (Application, Categorization, Cue-based Reminder, Evaluation) or less (Attention Recruitment, Practice Remembering, Praise Recall, Repetition) likely to elicit constructive learning behavior, or behavior that requires the learner to draw conclusions or inferences beyond the material that was initially presented (Chi & Wylie, 2014).
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This research was supported by National Institute of Mental Health Grants R34 MH094535.