USING BRIEF COGNITIVE RESTRUCTURING AND COGNITIVE DEFUSION TECHNIQUES TO COPE WITH NEGATIVE THOUGHTS

Full text

Social Values & Society 1(4) (2019) 11-14
Cite The Article:
Portia R. Marasigan (2019).
Using Brief Cognitive Restructuring And Cognitive Defusion Techniques To Cope With Negative Thoughts .
Social Values & Society
, 1(4) : 11-14.
E-ISSN: 2682-7964 (Online)
CODEN : SVSOC5
ARTICLE DETAILS
Article History:
Received 16 August 2019
Accepted 20 September 2019
Available online 01 November 2019
ABSTRACT
This study aimed to compare the effectiveness of using brief cognitive restructuring and cognitive defusion techniques
in coping with negative thoughts of college students of Laguna State Polytechnic University. The study used quasi
experimental design and assigned thirty respondents in the group which was treated with cognitive restructuring and
another thirty respondents in the group that was treated with cognitive defusion. t-test was used to test for the
significant difference. Based from the findings of the study, there is significant difference between the mean scores of
the pre-test and post-test of the restructuring group. Also, there is significant difference between the mean scores of
the pre-test and post-test of the defusion group. Furthermore, mean score of the defusion group is significantly
different with the mean score of restructuring group in terms of the post-test but in terms of pre-test, the mean scores
of the two groups do not differ significantly.
KEYWORDS
Cognitive Defusion, Cognitive Restructuring, Negative Thoughts
1. INTRODUCTION
According to a study, people all have days where they feel like a dark cloud
is following them around and that’s normal [1]. If they’re a glass-half-full
kind of person, they might bounce back to seeing the sunshine pretty
quickly. Unfortunately, far too many of them get stuck in what seems like
a never-ending thunderstorm of negative thoughts and worries. Left
unchecked, these thought patterns can lead them down a spiral straight to
anxiety and depression. Hence, the bad news is that science has
determined that unhealthy thinking patterns largely contribute to mental
health conditions. Negative thought patterns can play a big role in causing
and worsening depression and anxiety.
Furthermore, negative thoughts are cognitions about the self, others, or
the world in general that are characterized by negative perceptions,
expectations, and attributions and are associated with unpleasant
emotions and adverse behavioral, physiological, and health outcomes
[2]. Cognitive models of psychopathology posit that dysfunctional
cognitions directly contribute to negative emotions [3]. Accordingly, a
common technique in traditional cognitive behavioral therapy (CBT) is
cognitive restructuring, in which the therapist and patient collaboratively
identify irrational or maladaptive thoughts and challenge their veracity
using strategies such as logical disputation, Socratic questioning, and
behavioral experiments [4]. The goal of this process is to encourage
patients to think in more accurate and adaptive ways, which facilitate
effective problem solving and living a more satisfying life [5].
CBT consists of various techniques, however, and the specific contribution
of cognitive restructuring to the overall efficacy of CBT has recently come
under scrutiny. In their review of treatment studies for anxiety and
depression that cognitive interventions do not consistently provide added
value to behavioral interventions [6]. Cognitive restructuring has also
been criticized on theoretical grounds by proponents of mindfulness and
acceptance-based approaches such as acceptance and commitment
therapy [7]. Cognitive therapists have vigorously disputed the notion that
cognitive restructuring encourages the suppression and avoidance of
negative thoughts and emphasize the contradiction between the negative
depiction of cognitive restructuring by ACT proponents and the
observation that cognitive therapy is “the most clearly established
effective psychotherapy that exists” [8].
Nevertheless, a cardinal feature of “third wave” approaches is their
marked departure from traditional CBT approaches toward negative
thoughts [9]. Rather than directly challenge the content (e.g., accuracy) of
negative thoughts, these methods emphasize changing the function of
thoughts by encouraging patients to adopt a different awareness of and
relationship to thoughts [10]. ACT is a type of therapy that helps in
changing the relationship with negative thoughts and feelings, so they can
engage in meaningful actions that line up with their values [11]. Various
“cognitive defusion” techniques teach patients to see the “bad thought as
a thought, no more, no less” and to refrain from trying to change thought
content or responding to dysfunctional thoughts with experiential
avoidance [7]. This approach is designed to circumvent the struggle to
more effectively regulate negative emotions by abandoning the agenda of
emotion regulation itself [12].
One of the many cognitive defusion techniques in ACT consists of having
the patient rapidly speak a negative self-referential word (e.g., “fat”) until
the word appears to lose its literal meaning. Known as the “milk exercise,”
this technique was first studied by experimental psychologists a century
ago and was a frequent topic of investigation in the mid-1900s under the
label “semantic satiation” [5]. Numerous studies demonstrated that
Social Values and Society (SVS)
DOI : http://doi.org/10.26480/svs.04.2019.11.14
RESEARCH ARTICLE
USING BRIEF COGNITIVE RESTRUCTURING AND COGNITIVE DEFUSION
TECHNIQUES TO COPE WITH NEGATIVE THOUGHTS
Portia R. Marasigan*
Laguna State Polytechnic University, Philippines.
*Corresponding Author Email: bing_marasigan2001@yahoo.com
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any
medium, provided the original work is properly cited

Social Values & Society 1(4) (2019) 11-14
Cite The Article:
Portia R. Marasigan (2019).
Using Brief Cognitive Restructuring And Cognitive Defusion Techniques To Cope With Negative Thoughts .
Social Values & Society
, 1(4) :11-14.
continuous, fast verbal repetition of a word produced a temporary
decrease or loss in the word’s meaning [5]. This study aimed to compare
the effectiveness of using brief cognitive restructuring and cognitive
defusion techniques in coping with negative thoughts of college students
in Laguna State Polytechnic University and to design an intervention
program to teach students and employees of the school on how to use
cognitive defusion to cope up with negative thoughts.
2. STATEMENT OF THE PROBLEM
The aimed to determine the effectiveness of brief cognitive restructuring
and cognitive defusion to cope with negative thoughts and to compare
them. Specifically, it sought to answer the following questions: 1. What are
the mean scores of the pre-test and post-test of the restructuring and
defusion groups? 2. Is there a significant difference between the mean
scores of the pre-test and post-test of the restructuring group? 3. Is there
a significant difference between the mean scores of the pre-test and post-
test of the defusion group? 4. Is there a significant difference between the
mean scores of the pre-test of the restructuring group and defusion group?
5. Is there a significant difference between the mean scores of the post-test
of the restructuring group and defusion group?
3. METHODOLOGY
The study used quasi experimental design to determine the effectiveness
of using brief cognitive restructuring and cognitive defusion techniques to
cope with negative thoughts. It selected sixty (60) respondents from the
first year BS Business Administration students of the Laguna State
Polytechnic University, San Pablo City campus through random sampling
technique. Thirty (30) respondents were assigned in group 1 who were
treated using the cognitive restructuring and also thirty (30) respondents
were assigned in group 2 who were treated using the cognitive defusion.
The researcher adopted the procedure of the conduct of the study from the
book of Michael A. Britt, Ph. D. entitled Psych Experiments [13]. The
respondents were grouped into 2; Group 1 used restructuring and Group
2 used defusion. In group A: Restructuring Group: Sat with subjects down
one by one and showed them the statements on one side of the page. They
were told that these are things that some people sometimes say to
themselves. Ask them to pick a number between 1 and 20 and rate the
statements as to how uncomfortable that statement would probably make
someone feel if they said that to themselves. When they’re done have a
little talk with them about how irrational the statements are.
After the talk turn the paper over and ask them to rate the sentences again
from 1-20. In Group B: Defusion Group: Repeat step 1 from group A. After
they have rated the statements on one side of the paper, get the voice
changing app, have them record themselves saying each statement one at
a time into the app. Then change the recording of their voice into some
voice that is funny. Have subjects listen to the recording a couple times. Do
this same procedure with the other statements. Then turn the paper over
and ask them to rate the statements again from 1-20. And lastly, conduct
statistical analysis of data. The statistical tools used were Mean and t-test.
4. RESULTS AND DISCUSSION
This part contains the result of the gathered information presented in
graph and tables together with the statistical analyses.
Figure 1: Mean Scores of the Two Groups
Figure 1 shows the mean scores of the respondents. As to restructuring
group, in the pre-test, the group gained a mean score of 48.13 and in the
post-test, the group gained a mean score of 44.23. The mean difference
between the two mean scores is 3.9, since the mean difference is not equal
to 0 this shows that there was a change in the behavior of the respondents
since they lowered their ratings on the statements. As to the defusion
group, in the pre-test, the group gained a mean score of 49.67 and in the
post-test, the group gained a mean score of 31.37. The mean difference
between the two mean scores is 18.3, since the mean difference is not
equal to 0 this also shows that there was a change in the behavior of the
respondents since they also lowered their ratings on the statements.
Table 1: Test of Difference between the Mean Scores of the Restructuring Group
Variable
Mean
Difference
t-value
Critical value
Decision
Interpretation
Pre-test
Vs
Post-test
48.13
44.23
3.9
2.10
1.7
Reject Ho
S
Table 1 shows the t-test result between the mean scores of the pre-test
and post-test of the restructuring group. With a t-value of 2.10 which is
greater than the critical value of 1.7, thus reject the null hypothesis
therefore it is significant. This implies that there is a significant difference
between the mean scores of the pre-test and post-test of the respondents
who were treated with cognitive restructuring. This means that the change
in the behavior of the respondents was due to the cognitive restructuring
of the negative thoughts of the respondents. In the treatment given which
was cognitive restructuring, the negatively distorted thoughts were
modified and lessen.
The result may be similar to the study entitled Effectiveness of Cognitive
Restructuring and Proper Study Skills in the Reduction of Test Anxiety
Symptoms among Students in Khalkhal, Iran, the purpose of this study was
to evaluate the efficacy of cognitive restructuring therapy and the
appropriate methods of study in reducing test anxiety symptoms among
third grade high school students in Khalkhal, Iran [14]. The research
method was quasi-experimental with pretest, posttest and control
group. The population of the study was all students in the third grade of
high school in Khalkhal city. The participants included 300 sampled
through Spielberger test anxiety questionnaire and clinical interview.
After determining the prevalence, 30 people who had high anxiety
scores were randomly classified into two 15-subject groups in
experimental group and control group. Then, data were analyzed by
SPSS at two levels (descriptive and inferential). The results showed that
the prevalence of test anxiety among students was 36.6%. Results of the
standard Hotelling test showed that the impact of cognitive
restructuring method and study methods were significant in reducing
the symptoms of test anxiety of students. Moreover, the Helmert bound
contrast statistics reported that the effect of cognitive restructuring
therapy in reducing the symptoms of test anxiety in students is more
effective than the appropriate methods.
0
10
20
30
40
50
Pre-test Post-test
Restructuring Group
Defusion Group

Social Values & Society 1(4) (2019) 11-14
Cite The Article:
Portia R. Marasigan (2019).
Using Brief Cognitive Restructuring And Cognitive Defusion Techniques To Cope With Negative Thoughts .
Social Values & Society
, 1(4) : 11-14.
Table 2: Test of Difference between the Mean Scores of the Defusion Group
Variable
Mean
Difference
t-value
Critical value
Decision
Interpretation
Pre-test
Vs
Post-test
49.67
31.37
18.3
10.66
1.7
Reject Ho
S
Table 2 shows the t-test result between the mean scores of the pre-test
and post-test of the defusion group. With a t-value of 10.66 which is
greater than the critical value of 1.7, thus reject the null hypothesis
therefore it is significant. This implies that there is a significant difference
between the mean scores of the pre-test and post-test of the respondents
who were treated with cognitive defusion. This means that the change in
the behavior of the respondents was due to the cognitive defusion of the
negative thoughts of the respondents. It can be implied that defusion
technique has reduced the functions of thoughts by altering the context.
Recording the voice of the respondents saying the statements with
negative thoughts then changing their voice into some voice that is funny
and repeated for several times has reduced the respondents’ discomfort.
Cognitive defusion diverts attention away from the content or meaning of
words and sentences toward the process of forming words and stringing
them into sentences by concentrating on their sound, pattern, rhythm,
frequency, and individual letters or words. Defusion temporarily disrupts
the usual meaning of thoughts or spoken/written words even though their
form or content may stay the same [15].
Same result may be seen from the study entitled A Parametric Study of
Defusion and the Believability and Discomfort of Negative Self-Relevant
Thoughts, a previous time-series study showed that rapidly repeating a
single-word version of a negative self-referential thought reduced the
discomfort and the believability associated with that thought [16]. The
present parametric study examined whether durations of word repetition
were differentially effective in altering the discomfort and believability of
negative self-referential thought. In two studies, both discomfort and
believability varied systematically with the duration of word repetition.
The effects of rapid repetition on emotional discomfort bottomed out after
3 s to 10 s of rapid repetition, whereas the effects on believability did so
after 20 s to 30 s of repetition. This study lends support to the cognitive
defusion interpretation of the effect of word repetition, suggesting that
emotional discomfort and believability may be distinctive functional
aspects of cognitive events.
Table 3: Test of Difference between the Mean Scores of Pre-test of the Two Groups
Variable
Mean
Difference
t-value
Critical value
Decision
Interpretation
Restructuring
Vs
Defusion
48.13
49.67
1.54
0.44
1.7
Accept Ho
NS
Table 3 shows the t-test result between the mean scores of the pre-test of
the two groups. With a t-value of 0.46 which is less than the critical value
of 1.7, thus accept the null hypothesis therefore it is not significant. This
implies that the respondents on both groups have the same level of
discomfort in the statements presented to them.
Table 4: Test of Difference between the Mean Scores of Post-test of the Two Groups
Variable
Mean
Difference
t-value
Critical value
Decision
Interpretation
Restructuring
Vs
Defusion
44.23
31.37
12.86
5.26
1.7
Reject Ho
S
Table 4 shows the t-test result between the mean scores of the post-test of
the two groups. With a t-value of 5.26 which is greater than the critical
value of 1.7, thus reject the null hypothesis therefore it is significant. Since
the mean score of the defusion group is lower than the mean score of the
restructuring group this only shows that the treatment using the cognitive
defusion was more effective than the treatment using the cognitive
restructuring in reducing the discomfort of the respondents on the
negative thoughts. Defusion involves teaching individuals to view their
thoughts as thoughts rather than considering them as having literal
meaning [17]. Therefore, while restructuring aims to challenge negative
thoughts and find evidence against them, defusion does not attempt to
control or change unwanted thoughts in form or frequency [18]. Instead,
it trains individuals to change their relationship to their thoughts, to view
them without the need to dispute or challenge them to change overt
behavior.
The result of the study may be similar to the study entitled Using Brief
Cognitive Restructuring and Cognitive Defusion Techniques to Cope With
Negative Thoughts, negative thoughts, experienced by 80% to 99% of the
non-clinical population, have been linked to the development of
psychopathology [19]. The current study aimed to compare a cognitive
restructuring and cognitive defusion technique for coping with a
personally relevant negative thought. Over a 5-day period, participants
used either a restructuring, defusion, or control strategy to manage a
negative thought. Pre- and post-intervention participants reported (a)
believability of the thought, (b) discomfort associated with the thought, (c)
negativity associated with the thought, and (d) willingness to experience
the thought. Daily online questionnaires assessing the total frequency of
negative thought intrusions and their level of willingness to experience the
negative thought were also used [20]. Also, 10 positive and negative self-
statements were rated on the same scales, and self-report measures of
mood and psychological flexibility were completed. Findings indicated
that defusion lowered believability, increased comfort and willingness to
have the target thought, and increased positive affect significantly more
than the control and cognitive restructuring. Within groups, cognitive
restructuring also made significant gains in target thought discomfort,
negativity, and “willingness to have” in the same direction as defusion but
the no-instruction control did not [21,22]. Negative thought frequency was
reduced in the defusion group, maintained in the restructuring group, and
increased in the no-instruction control group. Similar trends emerged
from the secondary outcome measures, that is, the effects of the strategies
on the positive and negative self-statements. The current findings support
the efficacy of using defusion as a strategy for managing negative thoughts.

Social Values & Society 1(4) (2019) 11-14
Cite The Article:
Portia R. Marasigan (2019).
Using Brief Cognitive Restructuring And Cognitive Defusion Techniques To Cope With Negative Thoughts .
Social Values & Society
, 1(4) : 11-14.
5. CONCLUSIONS
Since the group that was treated with cognitive diffusion technique had
shown a greater reduction of discomfort thus it can be concluded that this
technique is more effective to use in coping with negative thoughts and
may be used to reduce discomfort due to the negative thoughts.
REFERENCES
[1] Hampton, D. 2017. 10 Common Negative Thought Patterns and How to
Change Them. Retrived from
https://www.businessstudent.com/topics/common-negative-thought-
patterns/
[2] Hawkley, L.C. 2013. Negative Thoughts. In: Gellman M.D., Turner
J.R. (eds) Encyclopedia of Behavioral Medicine. Springer, New York,
NY
[3] Beck, A.T. 1979. Cognitive therapy for depression. New York,
NY: Guilford Press. Google Scholar
[4] Hofmann, S.G., Asmundson, G.J.G. 2008. Acceptance and Mindfulness-
Based Therapy: New Wave or Old Hat? Clinical Psycology Review, Boston,
28, 1-16.
http://contextualscience.org/files/hofmann_asmundson_2008.pdf
[5] Deacon, B.J., Fawzy, T.I., Lickel, J.J., Wolitzky-Taylor, K.B.
2011. Cognitive defusion versus cognitive restructuring in the treatment
of negative self-referential thoughts: An investigation of process and
outcome. Journal of Cognitive Psychotherapy: An International Quarterly,
25, 218-228.
[6] Longmore, R.J., Worrell, M. 2007. Do we need to challenge thoughts in
cognitive behavior therapy? Clinical Psychology Review, 27 (2), 173–187.
[7] Hayes, S.C., Strosahl, K.D., Wilson, K.G. 1999. Acceptance and
Commitment Therapy: An experiential approach to behavior change. New
York, NY: Guilford Press. Google Scholar
[8] Leahy, R.L. 2008. A closer look at ACT. The Behavior Therapist, 31(8),
148–150.
[9] Hayes, S.C., Strosahl, K.D., Wilson, K.G., Bissett, R.T., Pistorello, J.,
Toarmino, D., McCurry, S.M. 2004. Measuring experiential avoidance: A
preliminary test of a working model. The Psychological Record, 54, 553-
578. Google Scholar, Crossref
[10] Segal, Z.V., Teasdale, J.D., Williams, J.M.G. 2004. Mindfulness-based
cognitive therapy: Theoretical rationale and empirical status. In S. C.
Hayes, V. M. Follette, & M. Linehan (Eds.), Mindfulness and acceptance:
Expanding the cognitive-behavioral tradition (pp. 45–65). New York:
Guilford Press.
[11] Hyde, K. 2018. Accept Negative Thoughts and Feelings. Retrieved
from https://www.therapyden.com/blog/accept-negative-thoughts-and-
emotions-ick
[12] Eifert, G.H., Forsyth, J.P. 2005. Acceptance & Commitment Therapy for
anxiety disorders: A practitioner's treatment guide to using mindfulness,
acceptance, and values-based behavior change strategies. Oakland, CA:
New Harbinger Publications.
[13] Britt, M.A. 2017. Psych Experiments. Massachusetts, USA: Adams
Media.
[14] Ghamari Kivi, H., Rafeie, S.H., Kiani, A.R. 2015. Effectiveness of
Cognitive Restructuring and Proper Study Skills in the Reduction of Test
Anxiety Symptoms among Students in Khalkhal, Iran. American Journal of
Educational Research, 3 (10), Pp. 1230-1236. doi: 10.12691/education-3-
10-4, http://pubs.sciepub.com/education/3/10/4/index.html
[15] Blackledge, J.T. 2007. Disrupting verbal processes: Cognitive defusion
in acceptance and commitment therapy and other mindfulness-based
psychotherapies. The Psychological Record, 57, 555-576.
[16] Masuda, A., Hayes, S.C., Twohig, M.P., Drossel, C., Lillis, J., Washio, Y.
2009. A parametric study of cognitive defusion and the believability and
discomfort of negative self-relevant thoughts. Behavior Modification, 33
(2), 250–262.
[17] Healy, H., Barnes-Holmes, Y., Barnes-Holmes, D., Keogh, C., Luciano, C.,
Wilson, K. 2010. An experimental test of cognitive defusion exercise:
Coping with negative and positive self-statements. The Psychological
Record, 58 (4), Article 8. Google Scholar
[18] Beck, J.S., Beck, A.T. 2011. Cognitive Behavior Therapy: Basics and
beyond. New York, NY: Guilford Press. Google Scholar
[19] Larsson, A., Hooper, N., Osborne, L. 2016. Using Brief Cognitive
Restructuring and Cognitive Defusion Techniques to Cope with Negative
Thoughts. Sage Journals, Behavior Modification 40 (3), 452-482.
http://journals.sagepub.com/doi/full/10.1177/0145445515621488
[20] Hayes, S.C., Barnes-Holmes, D., Roche, B. (Eds.). 2001. Relational
frame theory: A post-Skinnerian account of human language and
cognition. New York, NY: Plenum Press. Google Scholar
[21] Hayes, S.C., Brownstein, A.J. 1986. Mentalism, behavior-behavior
relations, and a behavior-analytic view of the purposes of science. The
Behavior Analyst, 9, 175-190. Google Scholar, Crossref, Medline
[22] Butler, A.C., Chapman, J.E., Forman, E.M., Beck, A.T. 2006. The
empirical status of cognitive-behavioral therapy: A review of meta-
analyses. Clinical Psychological Review, 26, 17-31. Google
Scholar, Crossref, Medline
n
m
i
l
l
i
o
n