The literature review produced for this thesis systematically analysed qualitative studies of cognitive therapy using a methodology checklist and a meta-synthesis technique. Ten papers which used qualitative analysis to look at clients’ experiences of Cognitive Behavioural Therapy (CBT) met the selection criteria. Seven themes emerged. Three were linked to a therapeutic relationships theme; the trusted listener, power and authority and others like me. Four were linked to the impact of cognitive therapy theme; empowering information, analysing the problem, thinking differently and doing things differently. It was concluded that future research should focus on the components of cognitive therapy and that differences in technique between CBT and Rational Emotive Behaviour Therapy (REBT) should be explored via a qualitative study of clients’ experiences of REBT. A qualitative approach was taken to look at clients’ experiences of REBT. Seven participants were interviewed using a semi-structured interview guide and the resulting transcripts were analysed using interpretive phenomenological analysis. Three themes emerged: one which looked at what it was like to have mental health problems; a second, which looked at clients’ expectations and experiences of the more technical aspects of therapy, and a third which examined the therapeutic relationship. All of the participants appeared to value therapy. However, the extent to which they knew about and used the theory and philosophy of REBT varied greatly. These results suggest that further research needs to be carried out which looks at how people benefit from therapy as clients views may differ from those of therapists. A critical appraisal of the research process was written using the REBT model to reflect the experience of producing the thesis.

Depression is a significant mental health concern with a pivotal increase of incidence during adolescence, specifically for females. Currently, cognitive behavioral therapy (CBT) is the most widely tested treatment for depression. Yet, it is unclear how CBT functions to produce effective outcomes. Adult studies have shown that behavioral components of CBT are more effective than cognitive components in reducing depression at acute treatment. Both behavioral and cognitive components have been shown to be effective in preventing relapse of depressive symptoms at follow up. Yet less is understood about how treatment components work together to provide positive outcomes, particularly for depressed youth. The overall goal of this study was to examine which parts of treatment (cognitive and/or behavioral) aid in symptom reduction and to determine if treatment outcome is mediated by cognitive change. Forty two pre-adolescent girls, aged 9-14, participated in a 20-session manualized group CBT program. The first portion of treatment (session 1-9) focused the behavioral intervention and the second portion of treatment (sessions 11-19) focused on cognitive interventions while continuing to reinforce behavioral interventions when necessary. Self report measures and diagnostic interviews were completed at pre-treatment and post-treatment. Using multiple regression analyses, the findings of this study supported the role of behavioral and cognitive interventions in reducing depression. Behavioral interventions were found to significantly reduce depression at post-treatment. Additionally, cognitive interventions were found to play a small, but significant role in post-treatment outcome, with preliminary evidence that cognitive interventions could also be linked to treatment outcome one year later. Treatment specificity could not be tested, as the cognitive change of depressed girls was not directly influenced by the behavior and cognitive interventions. Exploratory analysis demonstrated the significant role of behavioral techniques such as behavior activation, positive reinforcement, homework review, and skills training in predicting outcome of treatment. Implications of the results, limitations, and recommendations for future research are provided. / text

The fields of psychology and rhetoric share the goal of improving human mental health and behavior through persuasion. This thesis traces the history of rhetoric and psychology theory, focusing on the parallel theories of Nienkamp's internal rhetoric and Herman's dialogical self. Both theories model the human mind as having multiple psyches that actively interact to interpret human experience and project human behavior. I conclude with a case study of anorexic patients using ethos, pathos, and logos in dialectical behavior therapy (DBT), arguing that principles of rhetoric can help patients with mental disorders cognitively realign their thinking more effectively than drug treatments can.

Introdução: A psicoterapia infantil mediada com o computador pode tornar os pacientes mais colaborativos e motivados, diminuir o estigma de ir à terapia, aproximar e melhorar a relação com o terapeuta, facilitar a compreensão de conceitos terapêuticos fundamentais dentro da abordagem cognitivo-comportamental, melhorando suas habilidades de resolução de problemas além de estruturar as sessões de terapia. Objetivo: Criar um protocolo computadorizado para tratamento psicoterápico de crianças denominado Projeto Transformador. Avaliar o projeto para saber de sua viabilidade e utilidade como instrumento terapêutico. Método: Foram realizados dois estudos, um com as crianças e outro com os terapeutas. Os dois estudos foram abertos e utilizaram métodos quantitativos e qualitativos. O primeiro ensaio (A), foi realizado com 10 crianças com transtornos de ansiedade, que responderam a escalas de avaliação e a questionários. No segundo estudo (B), 12 terapeutas usaram o Projeto Transformador em sua prática clínica e sua experiência foi ouvida e analisada. Resultados: Os dados coletados mostraram que as crianças e os terapeutas ficaram satisfeitos com o programa computadorizado Projeto Transformador e este mostrou-se útil motivando a execução de um ensaio clínico randomizado / Introduction: Computer-mediated child psychotherapy can make patients more collaborative and motivated, decrease the stigma of going to therapy, closen and improve the relationship with the therapist, facilitate the understanding of fundamental therapeutic concepts within the cognitive-behavioral approach, improving their problem solving skills, as well as structure therapy sessions. Objective: To create a computerized protocol for psychotherapeutic treatment of children called Projeto Transformador. To assess the project\'s feasibility and usefulness as a therapeutic instrument. Method: Two studies were performed, one with children and one with therapists. Both studies were open and used quantitative and qualitative methods. The first study (A) was conducted with ten children with anxiety disorders who responded to evaluation scales and questionnaires. In the second study (B), twelve therapists used Projeto Transformador in their clinical practice and their experiences were heard and analyzed. Results: The data collected showed that both children and therapists were satisfied with the computerized program Projeto Transformador and that the program proved to be useful, motivating the implementation of randomized clinical tests

Introdução: A psicoterapia infantil mediada com o computador pode tornar os pacientes mais colaborativos e motivados, diminuir o estigma de ir à terapia, aproximar e melhorar a relação com o terapeuta, facilitar a compreensão de conceitos terapêuticos fundamentais dentro da abordagem cognitivo-comportamental, melhorando suas habilidades de resolução de problemas além de estruturar as sessões de terapia. Objetivo: Criar um protocolo computadorizado para tratamento psicoterápico de crianças denominado Projeto Transformador. Avaliar o projeto para saber de sua viabilidade e utilidade como instrumento terapêutico. Método: Foram realizados dois estudos, um com as crianças e outro com os terapeutas. Os dois estudos foram abertos e utilizaram métodos quantitativos e qualitativos. O primeiro ensaio (A), foi realizado com 10 crianças com transtornos de ansiedade, que responderam a escalas de avaliação e a questionários. No segundo estudo (B), 12 terapeutas usaram o Projeto Transformador em sua prática clínica e sua experiência foi ouvida e analisada. Resultados: Os dados coletados mostraram que as crianças e os terapeutas ficaram satisfeitos com o programa computadorizado Projeto Transformador e este mostrou-se útil motivando a execução de um ensaio clínico randomizado / Introduction: Computer-mediated child psychotherapy can make patients more collaborative and motivated, decrease the stigma of going to therapy, closen and improve the relationship with the therapist, facilitate the understanding of fundamental therapeutic concepts within the cognitive-behavioral approach, improving their problem solving skills, as well as structure therapy sessions. Objective: To create a computerized protocol for psychotherapeutic treatment of children called Projeto Transformador. To assess the project\'s feasibility and usefulness as a therapeutic instrument. Method: Two studies were performed, one with children and one with therapists. Both studies were open and used quantitative and qualitative methods. The first study (A) was conducted with ten children with anxiety disorders who responded to evaluation scales and questionnaires. In the second study (B), twelve therapists used Projeto Transformador in their clinical practice and their experiences were heard and analyzed. Results: The data collected showed that both children and therapists were satisfied with the computerized program Projeto Transformador and that the program proved to be useful, motivating the implementation of randomized clinical tests