Rumination focused cognitive-behavioral therapy for managing rumination in job-seeking young adults with depression: A single-case study

Annisa Nur Harwiningtyas, Universitas Negeri Yogyakarta
Kwartarini Wahyu Yuniarti, Universitas Gadjah Mada

Abstract


Unemployed individuals are highly susceptible to depressive disorders that impact their cognitive dynamics. Rumination, commonly observed in individuals with depressive disorders, reinforces depressive affect. Addressing rumination is crucial for cognitive management, ultimately alleviating depressive symptoms. This single-case study investigates the effectiveness of rumination-focused cognitive-behavioral therapy (RFCBT) on a 24-year-old unemployed female. Assessments involved interviews, observations, the PHQ-9, and EPPS, followed by 10 intervention sessions, including 8 therapy sessions. Post-intervention results, measured using the Reliability Change Indicator (RCI) on pre-and post-treatment PHQ-9 scores, demonstrated a significant score reduction of 17 points (89.47%). Descriptive data from semi-structured interviews corroborated these findings.


Keywords


single-case study, cognitive-behavioral therapy, rumination-focused, unemployment

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References


Abeditehrani, H., Dijk, C., Neyshabouri, M. D., & Arntz, A. (2021). Beneficial Effects of Role Reversal in Comparison to role-playing on negative cognitions about Other’s Judgments for Social Anxiety Disorder. Journal of Behavior Therapy and Experimental Psychiatry, 70. https://doi.org/10.1016/j.jbtep.2020.101599

Achdut, N., & Refaeli, T. (2020). Unemployment and psychological distress among young people during the covid‐19 pandemic: Psychological resources and risk factors. International Journal of Environmental Research and Public Health, 17(19), 1–21. https://doi.org/10.3390/ijerph17197163

Arena, A. F., Mobbs, S., Sanatkar, S., Williams, D., Collins, D., Harris, M., Harvey, S. B., & Deady, M. (2023). Mental health and unemployment: A systematic review and meta-analysis of interventions to improve depression and anxiety outcomes. In Journal of Affective Disorders (Vol. 335, pp. 450–472). Elsevier B.V. https://doi.org/10.1016/j.jad.2023.05.027

Beck, J. S. (2021). Cognitive Behavior Therapy: Basics and Beyond (3rd ed.).

Bennett-Levy, J. (2003). Mechanisms of change in cognitive therapy: The case of automatic thought records and behavioural experiments. Behavioural and Cognitive Psychotherapy, 31(3), 261–277. https://doi.org/10.1017/S1352465803003035

Bennett-Levy, J., Butler, G., Fennell, M., Hackmann, A., Mueller, M., & Westbrook, D. (2004). Oxford Guide to Behavioural Experiments in Cognitive Therapy (Cognitive Behaviour Therapy: Science and Practice, 2).

Cohen, N., Mor, N., & Henik, A. (2015). Linking executive control and emotional response: A training procedure to reduce rumination. Clinical Psychological Science, 3(1), 15–25. https://doi.org/10.1177/2167702614530114

De Cuyper, N., Philippaers, K., Vanhercke, D., & De Witte, H. (2019). The Reciprocal Relationship Between Resources and Psychological Distress Among Unemployed Job Seekers. Journal of Career Development, 46(1), 17–30. https://doi.org/10.1177/0894845317730413

Dolan, E. W. (2023, August 25). Cognitive distancing appears to enhance decision-making performance, new study reveals.

Fenn, K., & Byrne, M. (2013). The key principles of cognitive behavioural therapy. InnovAiT: Education and Inspiration for General Practice, 6(9), 579–585. https://doi.org/10.1177/1755738012471029

Ganson, K. T., Tsai, A. C., Weiser, S. D., Benabou, S. E., & Nagata, J. M. (2021). Job Insecurity and Symptoms of Anxiety and Depression Among U.S. Young Adults During COVID-19. Journal of Adolescent Health, 68(1), 53–56. https://doi.org/10.1016/j.jadohealth.2020.10.008

Gautam, M., Tripathi, A., Deshmukh, D., & Gaur, M. (2020). Cognitive Behavioral Therapy for Depression. Indian Journal of Psychiatry, 62(8), S223–S229. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_772_19

Hamdani, S. U., Zill-e-Huma, Zafar, S. W., Suleman, N., Um-ul-Baneen, Waqas, A., & Rahman, A. (2022). Effectiveness of relaxation techniques ‘as an active ingredient of psychological interventions’ to reduce distress, anxiety and depression in adolescents: a systematic review and meta-analysis. In International Journal of Mental Health Systems (Vol. 16, Issue 1). BioMed Central Ltd. https://doi.org/10.1186/s13033-022-00541-y

Hanani, A., Badrasawi, M., Zidan, S., & Hunjul, M. (2022). Effect of cognitive behavioral therapy program on mental health status among medical student in Palestine during COVID pandemic. BMC Psychiatry, 22(1). https://doi.org/10.1186/s12888-022-03915-1

Haskell, A. M., Britton, P. C., & Servatius, R. J. (2020). Toward an assessment of escape/avoidance coping in depression. In Behavioural Brain Research (Vol. 381). Elsevier B.V. https://doi.org/10.1016/j.bbr.2019.112363

Hertel, P., Mor, N., Ferrari, C., Hunt, O., & Agrawal, N. (2014). Looking on the dark side: Rumination and cognitive-bias modification. Clinical Psychological Science, 2(6), 714–726. https://doi.org/10.1177/2167702614529111

Himle, J. A., Bybee, D., Steinberger, E., Laviolette, W. T., Weaver, A., Vlnka, S., Golenberg, Z., Levine, D. S., Heimberg, R. G., & O’Donnell, L. A. (2014). Work-related CBT versus vocational services as usual for unemployed persons with social anxiety disorder: A randomized controlled pilot trial. Behaviour Research and Therapy, 63, 169–176. https://doi.org/10.1016/j.brat.2014.10.005

Iacoviello, B. M., Wu, G., Alvarez, E., Huryk, K., Collins, K. A., Murrough, J. W., Iosifescu, D. V., & Charney, D. S. (2014). Cognitive-emotional training as an intervention for major depressive disorder. Depression and Anxiety, 31(8), 699–706. https://doi.org/10.1002/da.22266

Introzzi, I., Andrés, M. L., Canet-Juric, L., Stelzer, F., & Richard’s, M. M. (2016). The relationship between the rumination style and perceptual, cognitive, and behavioral inhibition. Psychology and Neuroscience, 9(4), 444–456. https://doi.org/10.1037/pne0000068

Kaplan, D. M., Palitsky, R., Carey, A. L., Crane, T. E., Havens, C. M., Medrano, M. R., Reznik, S. J., Sbarra, D. A., & O’Connor, M. F. (2016). Maladaptive repetitive thought as a transdiagnostic phenomenon and treatment target: An integrative review. In Journal of Clinical Psychology (Vol. 74, Issue 7, pp. 1126–1136). John Wiley and Sons Inc. https://doi.org/10.1002/jclp.22585

Kennedy, J. C., Dunlop, B. W., Craighead, L. W., Nemeroff, C. B., Mayberg, H. S., & Craighead, W. E. (2022). Assessing in-session rumination and its effects on CBT for depression. Behaviour Research and Therapy, 159. https://doi.org/10.1016/j.brat.2022.104209

Koster, E. H., De Lissnyder, E., Derakhshan, N., De Raedt, R., Lissnyder, D., Koster Ghent University, E., & Depressive Rumination, U. (2011). Understanding depressive rumination from a cognitive science perspective: The impaired disengagement hypothesis.

LeMoult, J., & Gotlib, I. H. (2019). Depression: A cognitive perspective. In Clinical Psychology Review (Vol. 69, pp. 51–66). Elsevier Inc. https://doi.org/10.1016/j.cpr.2018.06.008

Lim, A. Y., Lee, S. H., Jeon, Y., Yoo, R., & Jung, H. Y. (2018). Job-seeking stress, mental health problems, and the role of perceived social support in university graduates in Korea. Journal of Korean Medical Science, 33(19). https://doi.org/10.3346/jkms.2018.33.e149

Lorenzo-Luaces, L., German, R. E., & DeRubeis, R. J. (2015). It’s complicated: The relation between cognitive change procedures, cognitive change, and symptom change in cognitive therapy for depression. In Clinical Psychology Review (Vol. 41, pp. 3–15). Elsevier Inc. https://doi.org/10.1016/j.cpr.2014.12.003

Modini, M., & Abbott, M. J. (2017). Negative rumination in social anxiety: A randomised trial investigating the effects of a brief intervention on cognitive processes before, during and after a social situation. Journal of Behavior Therapy and Experimental Psychiatry, 55, 73–80. https://doi.org/10.1016/j.jbtep.2016.12.002

Mor, N., & Daches, S. (2015). Ruminative thinking: Lessons learned from cognitive training. Clinical Psychological Science, 3(4), 574–592. https://doi.org/10.1177/2167702615578130

Morley, S. (2018). Stephen Morley - Single Case Methods in Clinical Psychology_ A Practical Guide-Routledge (2017). Routledge.

Murray, H. B., Juarascio, A. S., Di Lorenzo, C., Drossman, D. A., & Thomas, J. J. (2019). Diagnosis and Treatment of Rumination Syndrome: A Critical Review. In American Journal of Gastroenterology (Vol. 114, Issue 4, pp. 562–578). Wolters Kluwer Health. https://doi.org/10.14309/ajg.0000000000000060

Murray, H., & El-Leithy, S. (2021). Behavioural Experiments in Cognitive Therapy for Posttraumatic Stress Disorder: Why, When, and How? Verhaltenstherapie, 31(1), 50–60. https://doi.org/10.1159/000511921

Obrenovic, B., Du, J., Godinic, D., Baslom, M. M. M., & Tsoy, D. (2021). The Threat of COVID-19 and Job Insecurity Impact on Depression and Anxiety: An Empirical Study in the USA. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.648572

Orzechowska, A., Bliźniewska-Kowalska, K., Gałecki, P., Szulc, A., Płaza, O., Su, K. P., Georgescu, D., & Gałecka, M. (2022). Ways of Coping with Stress among Patients with Depressive Disorders. Journal of Clinical Medicine, 11(21). https://doi.org/10.3390/jcm11216500

Rose, V. K., Perz, J., & Harris, E. (2012). Vocationally oriented cognitive behavioural training for the very long-term unemployed. Occupational Medicine, 62(4), 298–300. https://doi.org/10.1093/occmed/kqs038

Saberi, S., Ahmadi, R., Khakpoor, S., Pirzeh, R., Hasani, M., Moradveisi, L., & Saed, O. (2024). Comparing the effectiveness of behavioral activation in group vs. self-help format for reducing depression, repetitive thoughts, and enhancing performance of patients with major depressive disorder: a randomized clinical trial. BMC Psychiatry, 24(1). https://doi.org/10.1186/s12888-024-05973-z

Seitz, R. J., & Angel, H. F. (2020). Belief formation – A driving force for brain evolution. Brain and Cognition, 140. https://doi.org/10.1016/j.bandc.2020.105548

Shahrokhian, N., Hassanzadeh, S., Hashemi Razini, H., & Ramshini, M. (2022). The Effects of Cognitive-Behavioral Therapy (CBT) in Well-Being and Perceived Stress in Adolescents with Low Academic Performance During the COVID-19 Pandemic. International Journal of Sport Studies for Health, 4(2). https://doi.org/10.5812/intjssh.122504

Watkins, E. (2015). Psychological treatment of depressive rumination. In Current Opinion in Psychology (Vol. 4, pp. 32–36). Elsevier. https://doi.org/10.1016/j.copsyc.2015.01.020

Watkins, E. A. R., Scott, J. ;, Wingrove, J. ;, Watkins, E. R., Mullan, E., Wingrove, J., Rimes, K., Steiner, H., Bathurst, N., Eastman, R., & Scott, J. (2013). ORE Open Research Exeter TITLE Rumination-focused cognitive behaviour therapy for residual depression: a case series A NOTE ON VERSIONS. http://hdl.handle.net/10871/11164

Watkins, E., Moberly, N. J., & Moulds, M. L. (2008). Processing Mode Causally Influences Emotional Reactivity: Distinct Effects of Abstract Versus Concrete Construal on Emotional Response. Emotion, 8(3), 364–378. https://doi.org/10.1037/1528-3542.8.3.364

Watkins, E. R. (2009). Depressive rumination: Investigating mechanisms to improve cognitive behavioural treatments. Cognitive Behaviour Therapy, 38(SUPPL.1), 8–14. https://doi.org/10.1080/16506070902980695

Watkins, E. R., & Roberts, H. (2020). Reflecting on rumination: Consequences, causes, mechanisms and treatment of rumination. In Behaviour Research and Therapy (Vol. 127). Elsevier Ltd. https://doi.org/10.1016/j.brat.2020.103573

Woods, K. E., Luiselli, J. K., & Tomassone, S. (2013). Functional analysis and intervention for chronic rumination. Journal of Applied Behavior Analysis, 46(1), 328–332. https://doi.org/10.1002/jaba.24

Zhou, X., Wu, X., Fu, F., & An, Y. (2015). Core belief challenge and rumination as predictors of PTSD and PTG among adolescent survivors of the wenchuan earthquake. Psychological Trauma: Theory, Research, Practice, and Policy, 7(4), 391–397. https://doi.org/10.1037/tra0000031




DOI: https://doi.org/10.21831/pri.v7i2.81799

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