Cognitive change process during group cognitive behaviour therapy for depression

Background: This study extended that of Kwon and Oei [Kwon, S.M., Oei, T.P.S., 2003. Cognitive change processes in a group cognitive behavior therapy of depression. J. Behav. Ther. Exp. Psychiatry, 3, 73-85], which outlined a number of testable models based on Beck's cognitive theory of depression. Specifically, the current study tested the following four competing models: the causal, consequential, fully and partially interactive cognitive models in patients with major depressive disorder. Methods: A total of 168 clinically depressed outpatients were recruited into a 12-week group cognitive behaviour therapy program. Data was collected at three time points: baseline, mid- and at termination of therapy using the ATQ DAS and BD1. The data were analysed with Amos 4.01 (Arbuckle, J.L., 1999. Amos 4.1. Smallwaters, Chicago.) structural equation modelling. Results: Results indicated that dysfunctional attitudes, negative automatic thoughts and symptoms of depression reduced significantly during treatment. Both the causal and consequential models equally provided an adequate fit to the data. The fully interactive model provided the best fit. However, after removing non-significant pathways, it was found that reduced depressive symptom contributed to reduced depressogenic automatic thoughts and dysfunctional attitudes, not the reverse. Conclusion: These findings did not fully support Beck's cognitive theory of depression that cognitions are primary in the reduction of depressed mood. (c) 2006 Elsevier B.V. All rights reserved.

Cognitive change processes in a group cognitive behavior therapy of depression

The present study attempted to examine the causal relationships among changes in automatic thoughts, dysfunctional attitudes, and depressive symptoms in a 12-week group cognitive behavior therapy (GCBT) program for depression. In all, 35 depressed patients attending the GCBT program were monitored with the Automatic Thoughts Questionnaire, Dysfunctional Attitudes Scale, and Beck Depression Inventory at the pre-treatment, 4th and 8th sessions, and post-treatment. The results were as follows: (1) GCBT reduces negative cognitions; (2) changes in automatic thoughts and dysfunctional attitudes lead to change in depressive symptoms; and (3) automatic thoughts play a mediating role between dysfunctional attitudes and depression. The findings taken as a whole support the Causal Cognition Model of depression. (C) 2003 Elsevier Science Ltd. All rights reserved.

Implementation of hospital-wide computer information system :a case study of this change process

This case study examines the impact of a computer information system as it was being implemented in one Ontario hospital. The attitudes of a cross section of the hospital staff acted as a barometer to measure their perceptions of the implementation process. With The Mississauga Hospital in the early stages of an extensive computer implementation project, the opportunity existed to identify staff attitudes about the computer system, overall knowledge and compare the findings with the literature. The goal of the study was to develop a greater base about the affective domain in the relationship between people and the computer system. Eight exploratory questions shaped the focus of the investigation. Data were collected from three sources: a survey questionnaire, focused interviews, and internal hospital documents. Both quantitative and qualitative data were analyzed. Instrumentation in the study consisted of a survey distributed at two points in time to randomly selected hospital employees who represented all staff levels.Other sources of data included hospital documents, and twenty-five focused interviews with staff who replied to both surveys. Leavitt's socio-technical system, with its four subsystems: task, structure, technology, and people was used to classify staff responses to the research questions. The study findings revealed that the majority of respondents felt positive about using the computer as part of their jobs. No apparent correlations were found between sex, age, or staff group and feelings about using the computer. Differences in attitudes, and attitude changes were found in potential relationship to the element of time. Another difference was found in staff group and perception of being involved in the decision making process. These findings and other evidence about the role of change agents in this change process help to emphasize that planning change is one thing, managing the transition is another.

Towards a communicative understanding of organizational change : Koumbit's change process

Comment comprendre les dynamiques qui sous-tendent les changements des organisations? Le changement organisationnel fait partie de la réalité quotidienne des organisations et, comme en témoigne une vaste littérature, le sujet a été abordé à partir de diverses perspectives conceptuelles. Toutefois, plusieurs questions fondamentales demeurent quant à la façon dont le changement organisationnel est accompli (Tsoukas & Chia, 2002; Chia, 1999). Je suggère que la clé pour répondre à ces questions se trouve dans l’étude de la communication. Cependant, le rôle de la communication dans la production du changement reste peu exploré dans les conceptualisations actuelles sur le sujet. Ainsi, l’objectif principal de cette thèse est de décrire la façon dont le changement émerge dans la communication, en d’autres termes, comment il est accompli à partir des interactions. Dans cette recherche, je propose que la compréhension du changement passe par une vision de la communication comme un processus constant dans lequel les réalités sont créées, négociées et transformées de manière interactive. Cette conception est fondée sur a plurified view of interactions (Cooren, Fox, Robichaud & Talih, 2005; Cooren 2010) qui prend en considération la contribution d’êtres appartenant à diverses ontologies (e.g., ordinateurs, règlements, principes, émotions, règles, c.) dans l’action. En mobilisant cette vision de la communication, j’ai étudié les changements qui ont eu lieu à Koumbit — une organisation à but non lucratif basée à Montréal qui œuvre dans le domaine des technologies de l’information. L’observation, les entrevues ainsi que la révision de documents officiels ont été les techniques choisies pour cueillir les données. Ma recherche m’a permis de déterminer que le changement organisationnel est un processus progressif qui se matérialise d’interaction en interaction. C’est en composant et en recomposant des ensembles d’associations que se crée une différence dans l’état des choses. Si bien les interactions sont accomplies dans le ici et le maintenant, leur caractère hybride leur permet de rendre compte de ce que l’organisation a été et de ce qu’elle sera. Cette étude suggère que, d’un point de vue communicationnel, les mécanismes à partir desquels le changement organisationnel est accompli n sont pas aussi différents de ceux qui produisent les processus organisants (organizing).

An analysis of the role of soft systems methodology in the change process and the contribution of the facilitator within this process

This research aims to examine the effectiveness of Soft Systems Methodology (SSM) to enable systemic change within local goverment and local NHS environments and to examine the role of the facilitator within this process. Checkland's Mode 2 variant of Soft Systems Methodology was applied on an experimental basis in two environments, Herefordshire Health Authority and Sand well Health Authority. The Herefordshire application used SSM in the design of an Integrated Care Pathway for stroke patients. In Sandwell, SSM was deployed to assist in the design of an Infonnation Management and Technology (IM&T) Strategy for the boundary-spanning Sandwell Partnership. Both of these environments were experiencing significant organisational change as the experiments unfurled. The explicit objectives of the research were: To examine the evolution and development of SSM and to contribute to its further development. To apply the Soft Systems Methodology to change processes within the NHS. To evaluate the potential role of SSM in this wider process of change. To assess the role of the researcher as a facilitator within this process. To develop a critical framework through which the impact of SSM on change might be understood and assessed. In developing these objectives, it became apparent that there was a gap in knowledge relating to SSM. This gap concerns the evaluation of the role of the approach in the change process. The case studies highlighted issues in stakeholder selection and management; the communicative assumptions in SSM; the ambiguous role of the facilitator; and the impact of highly politicised problem environments on the effectiveness of the methodology in the process of change. An augmented variant on SSM that integrates an appropriate (social constructivist) evaluation method is outlined, together with a series of hypotheses about the operationalisation of this proposed method.

Implementing change in practice: Part 2- the change process

Pain management in premature and sick babies has long been recognisedas a vital component of neonatal care; however practices pertaining to painassessment and administration of analgesia remain variable in Neonatal Units(NNU). Sucrose has been identified as an effective agent in reducing pain during minorpainful procedures in premature babies but the uptake has been modest.This article (part 2) follows on from an earlier article on evidence to support theimplementation of sucrose administration as a measure for pain relief for minorprocedures (part 1) and will centre on practice-based change in the NNU and reflecton the strategies used as well as the effectiveness of the proposed change. A theoreticalchange model will be used as a framework to help unpack the influencesinherent within the change process.

Change in cognitive errors and coping over the course of brief psychodynamic intervention.

OBJECTIVE: Cognitive change over the course of psychodynamic psychotherapy has been postulated by several models, but has rarely been studied. Based on the adaptive skills model (Badgio, Halperin, & Barber, 1999), it is reasonable to expect that very brief dynamic psychotherapy may be associated with change in coping patterns and cognitive errors (also known as cognitive distortions) y. METHOD: N = 50 outpatients presenting with various psychiatric disorders and undergoing 4 sessions of Brief Psychodynamic Intervention (BPI; Despland, Drapeau, & de Roten, 2005; Despland, Michel, & de Roten, 2010) were included in this naturalistic study (mean age: 31 years; 56% female; all Caucasian). Cognitive errors and coping strategies were assessed using the Cognitive Errors Rating Scale (Drapeau et al., 2008) and Coping Patterns Rating Scale (Perry et al., 2005). These observer rated methods were applied to the verbatim transcriptions of all 4 therapy sessions completed by each patient. RESULTS: Results indicate change in both cognitive errors and coping patterns over the course of BPI, including an increase in the Overall Coping Functioning and a decrease in unhelpful coping processes, such as isolation, which reflects a shift in participant appraisal towards stress appraised as a challenge at the end of treatment. These changes predicted symptom change at the end of treatment. While cognitive errors also changed over the course of BPI, no predictive effect was found with regard to symptom change. CONCLUSIONS: These results are interpreted within the framework of common change principles in psychotherapy. Implications and future research are discussed.

Change in defense mechanisms and coping patterns during the course of 2-year-long psychotherapy and psychoanalysis for recurrent depression: a pilot study of a randomized controlled trial.

Very little research has been conducted so far to study the potential mechanisms of change in long-term active psychological treatments of recurrent depression. The present pilot randomized controlled trial aimed to determine the feasibility of studying the change process occurring in patients during the course of 2-year-long dynamic psychotherapy, psychoanalysis, and cognitive therapy, as compared with clinical management. In total, eight outpatients presenting with recurrent depression, two patients per treatment arm, were included. All patients were randomly assigned to one of the four treatment conditions. Defense mechanisms and coping patterns were assessed using validated observer-rated methodology based on transcribed, semistructured follow-along independent dynamic interviews. The results indicated that, whereas some patients in the active treatments changed on the symptomatic levels, some others remained unchanged during the course of their 2-year-long treatment. However, with regard to potential mechanisms of change in these patients, changes in defense mechanisms and coping patterns were revealed to be important processes over time in successful therapies and, to a lesser extent, in less successful treatments. No change was found either on outcome or on the process measure for the control condition, that is, clinical management. These results are discussed along with previous data comparing change in defense mechanisms and coping during the course of treatments.

Successful IFRS standard change implementation process after the initial IFRS implementation

The main objective of the study was to form a strategic process model and project management tool to help IFRS change implementation projects in the future. These research results were designed based on the theoretical framework of Total Quality Management and leaning on the facts that were collected during the empirical case study of IAS 17 change. The us-age of the process oriented approach in IFRS standard change implementation after the initial IFRS implementation is rationalized with the following arguments: 1) well designed process tools lead to optimization of resources 2) With the help of process stages and related tasks it is easy to ensure the efficient way of working and managing the project as well as make sure to include all necessary stakeholders to the change process. This research is following the qualitative approach and the analysis is in describing format. The first part of the study is a literature review and the latter part has been conducted as a case study. The data has been col-lected in the case company with interviews and observation. The main findings are a process model for IFRS standard change process and a check-list formatted management tool for up-coming IFRS standard change projects. The process flow follows the main cornerstones in IASB’s standard setting process and the management tool has been divided to stages accordingly.

Analysis of the Change Management Process in a Multinational Company

The purpose of this thesis was to study change management and find out how the theory applies to practise with the help of studying an organizational change process. The goal was to investigate the different ways of the change management and how those could be utilized in practise. The purpose was also to see what kind of tools and information packages for change management the company involved has developed and taken in to use and check if these could have been utilized in the change process studied in this thesis. This thesis was established by studying the theory of change management and interviewing the people involved in the organizational change and the stakeholders. The questions were formed in line with the change management theory. The main theory used was John P. Kotter’s Eight Steps of Change. The study revealed valuable details about change processes in real life and concrete improvement ideas were recognized from the interviews. Overall the people were quite happy with the outcome of the change process. There were also some failures identified in this change process. Most probably those can be avoided in the future if people planning the change are familiar with the company’s new information packages and tools for change management. Change management is a complex area that is still today quite often forgotten by companies. Effective change management can give a huge competitive advantage for a company. Acknowledging that change process is always complex and not easy is already a good step forward in handling change processes. All changes need change management and understanding the way people react on change. A good and efficient change management is the key to make the change process smooth and easier for the people involved.

A stress and coping approach to organisational change: Evidence from three field studies

In this paper, a stress and coping perspective is used to outline the processes that determine employee adaptation to organisational change. A theoretical framework that simultaneously considers the effects of event characteristics, situational appraisals, coping strategies, and coping resources is reviewed, Three empirical investigations of organisational change that have tested various components of the model are then presented. In the first study, there was evidence linking event characteristics, situational appraisals, coping strategies and coping resources to levels of employee adjustment in a sample of pilots employed in a newly merged airline company. In a more focused test of the model with a sample of employees experiencing a restructuring process in their Organisation it was found that the provision of change-related information enhanced levels of efficacy to deal with the change process which, in turn, predicted psychological wellbeing, client engagement, and job satisfaction. In a study of managers affected by a new remuneration scheme, there was evidence to suggest that managers who received change-specific information and opportunities to participate in the change process reported higher levels of change readiness. Managers who reported higher levels of readiness for change also reported higher levels of psychological wellbeing and job satisfaction. These studies highlight ways in which managers and change agents can help employees to cope during times of organisational change.

Using process mapping and business process simulation to support a process-based approach to change in a public sector organisation

A case study demonstrates the use of a process-based approach to change regarding the implementation of an information system for road traffic accident reporting in a UK police force. The supporting tools of process mapping and business process simulation are used in the change process and assist in communicating the current process design and people's roles in the overall performance of that design. The simulation model is also used to predict the performance of new designs incorporating the use of information technology. The approach is seen to have a number of advantages in the context of a public sector organisation. These include the ability for personnel to move from a traditional grouping of staff in occupational groups with relationships defined by reporting requirements to a view of their role in a process, which delivers a performance to a customer. By running the simulation through time it is also possible to gauge how changes at an operational level can lead to the meeting of strategic targets over time. Also the ability of simulation to proof new designs was seen as particularly important in a government agency were past failures of information technology investments had contributed to a more risk averse approach to their implementation. © 2004 Elsevier Ltd. All rights reserved.

Mudança narrativa: emergência e evolução de protonarrativas em terapia cognitivo - comportamental

Dissertação de mestrado integrado em Psicologia