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Understanding the Specificity of Well-Being Therapy

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My research group was very pleased with the results obtained with our approach to recurrent depression [11, 14]. In discussing the data with Chiara Rafanelli, who had performed all psychological evaluations blind to the treatment assignments, an important issue came up. What was the specific role of WBT? In our previous study that did not involve WBT [6, 9, 10], the results had been less positive, but this did not necessarily mean that WBT was responsible for them.

Chiara Rafanelli and I thus decided to perform another controlled investigation. The object of our study this time was a very common form of anxiety, GAD. We had come to the conclusion that probably the sequential combination of CBT and WBT was our best bet in an acute disorder, but was this combination going to be better than just performing CBT? Twenty patients with GAD were randomly assigned to 8 sessions of CBT or the sequential administration of CBT followed by another 4 sessions of WBT [19]. Both treatments were associated with a significant reduction of anxiety. However, significant advantages of the CBT/WBT sequential combination over CBT were observed, both in terms of symptom reduction and psychological well-being improvement as measured by CID [2], PWB [1], and SQ [3]. These results suggested the feasibility and clinical advantages of adding WBT to the treatment of GAD. A possible explanation of these findings is that self-monitoring of episodes of well-being may lead to a more comprehensive identification of automatic thoughts than that entailed by the customary monitoring of episodes of distress in cognitive therapy [20], and therefore may result in more effective cognitive restructuring. These results also lend support to our hypothesis that WBT provides something that CBT alone does not possess.

Well-Being Therapy

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