Thaís R. Delavechia, Michella L. Velasquez
Department of Neurosciences and Mental Health, Postgraduate Programs (Medicine and Health, and Interactions of Organs and Systems), Federal University of Bahia (UFBA), Salvador, BA, Brazil.
Érica P. Duran, Lina S. Matsumoto
Institute and Department of Psychiatry, University of São Paulo School of Medicine (IPq-HCFMUSP), São Paulo, SP, Brazil.
Irismar Reis de Oliveira
Department of Neurosciences and Mental Health, Postgraduate Programs (Medicine and Health, and Interactions of Organs and Systems), Federal University of Bahia (UFBA), Salvador, BA, Brazil.

Abstract:

Background: Trial-based thought record (TBTR) is a technique used in trial-based cognitive therapy (TBCT), and simulates a court trial. It was designed to restructure unhelpful core beliefs (CBs) during psychotherapy. Objective: To confirm previous findings on the efficacy of TBTR in decreasing patients’ adherence to self-critical and unhelpful CBs and corresponding emotions, as well as assessing the differential efficacy of the empty-chair approach relative to the static format of TBTR. Methods: Thirty-nine outpatients were submitted to a 50-minute, one-session, application of the TBTR technique in the empty-chair (n = 18) or conventional (n = 21) formats. Patients’ adherence to unhelpful CBs and the intensity of corresponding emotions were assessed after each step of TBTR, and the results obtained in each format were compared. Results: Significant reductions in percent values both in the credit given to CBs and in the intensity of corresponding emotions were observed at the end of the session (p < .001), relative to baseline values. ANCOVA also showed a significant difference in favor of the empty-chair format for both belief credit and emotion intensity (p .04). Discussion: TBTR may help patients reduce adherence to unhelpful CBs and corresponding emotions and the empty-chair format seems to be more efficacious than the conventional format.

Keywords:Cognitive therapy, core belief, Kafka, trial-based thought record, trial-based cognitive therapy.