New age of CBT -

Challenges and perspectives

BOOK OF
ABSTRACTS
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Народна библиотека Србије, Београд
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EUROPEAN association for behavioural and cognitive therapies. Annual
congress (54 ; 2024 ; Beograd)
New Age of CBT - Challenges and Perspectives : book of abstracts / 54th Annual
Congress EABCT 2024, Belgrade, September 4– 7, 2024 ; [editors Sanda Stanković
Marija Mitković Vončina Nikola Petrović] ; [organizer European association for
behavioural and cognitive therapies]. - Belgrade : Serbian association for cognitive
and behavioural therapies : Serbian association of behaviour and cognitive
therapists, 2024 (Belgrade : Unagraf ). - 416 str. : ilustr. ; 30 cm
Tiraž 100.
ISBN 978-86-906974-0-3
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COBISS.SR-ID 155948041
 54th Annual Congress EABCT 2024
New Age of CBT - Challenges and Perspectives

BOOK OF ABSTRACTS

Belgrade, Sava Center | September 4– 7, 2024

EABCT Organisation
54th annual Congress EABCT 2024
Belgrade, Sava Center, September 4 – 7, 2024

BOOK OF ABSTRACTS
NEW AGE OF CBT – CHALLENGES AND PERSPECTIVES

Editors
Sanda Stanković
Marija Mitković Vončina
Nikola Petrović

Scientific Committee /Reviewers:

Co-chairs
• Sanda Stanković
University of Belgrade, Faculty of Philosophy, LIRA Lab, Serbia; Association for Cognitive and Behavioural Therapies of Serbia
(ACBTS)
• Marija Mitković Vončina
University of Belgrade - Faculty of Medicine; Institute of Mental Health, Belgrade, Serbia; Serbian Association of Behaviour and
Cognitive Therapists (SRABCT)
Members
• Kirsti Akkermann
University of Tartu, Estonia
• Thomas Berger
Universität Bern, Switzerland
• Abdel. H. Boudoukha
Nantes Université, France
• Kate Davidson
University of Glasgow, United Kingdom
• Anca Dobrean
Babes-Bolyai University, Department of Clinical Psychology and Psychotherapy, Romania
• Thomas Heidenreich
Esslingen University of Applied Sciences, Germany
• Rod Holland
World Confederation of Cognitive and Behavioural Therapies (WCCBT)
• Kim de Jong
Leiden University, Institute of Psychology, the Netherlands
• Tobias Krieger
Universität Bern, Switzerland
• Irina Lazarova
Bulgarian Association for Cognitive-Behavioral Psychotherapy, Adaptacia Outpatient Psychiatric Clinic, Bulgaria
• Marija Lero
Institute of Mental Health, Belgrade, Serbia; Serbian Association of Behaviour and Cognitive Therapists (SRABCT)
• Sanja Leštarević
Institute of Mental Health, Belgrade, Serbia; Serbian Association of Behaviour and Cognitive Therapists (SRABCT)
• Pierre Philippot
UCLouvain (Université catholique de Louvain), Belgium
• Antonio Pinto
Societa Italiana di Terapia Comportamentale e Cognitiva (SITCC), Department of Mental Health in Naples, Italy
• Agnieszka Popiel
SWPS, University of Social Sciences and Humanities, Poland
• Shirley Reynolds
Child Mind Institute, University of Reading, United Kingdom
• Andreas Veith
World Confederation of Cognitive and Behavioural Therapies (WCCBT); Zentrum für Psychotherapie Dortmund, Dortmund,
Germany
• Ulrike Willutzki
Witten/Herdecke University, Germany,
• Ivanka Živčić-Bećirević
Faculty of Social Sciences and Humanities, University of Rijeka, Croatia

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EABCT 2024 ~ New Age of CBT – Challenges and Perspectives | September 4-7, 2024
Organization of the Congress
Organizer
European Association for Behavioural and Cognitive Therapies

Hosted by
Association for Cognitive and Behavioural Therapies of Serbia
Skenderbegova 3
11000 Belgrade, Serbia

In collaboration with
Serbian Association of Behaviour and Cognitive Therapists
Starca Vujadina 1
18000 Nis

Local Organizing Committee

• Tatjana Vukosavljević Gvozden, President
Psychology Department of the Philosophy Faculty, University of Belgrade, Belgrade, Serbia; Association for Cognitive and
Behavioural Therapies of Serbia (ACBTS)
• Ivana Vračkić, Copresident
City of Nis, City Administration for social issues, Sector for family, social and health care, Drug Abuse Prevention, Serbia; Serbian
Association of Behaviour and Cognitive Therapists (SRABCT)
• Nikola Petrović, Scientific Program, Logistics & Social Events Chair
Psychology Department of the Philosophy Faculty, University of Belgrade, Belgrade, Serbia; Association for Cognitive and
Behavioural Therapies of Serbia (ACBTS)

Members
• Zorica Marić
Association for Cognitive and Behavioural Therapies of Serbia
• Borjanka Batinić
Psychology Department of the Philosophy Faculty, University of Belgrade, Belgrade, Serbia; Association for Cognitive and
Behavioural Therapies of Serbia (ACBTS)
• Ivana Peruničić Mladenović
Psychology Department of the Philosophy Faculty, University of Belgrade, Belgrade, Serbia; Association for Cognitive and
Behavioural Therapies of Serbia (ACBTS)
• Tijana Stanković
Association for Cognitive and Behavioural Therapies of Serbia

Technical Organizer
CONGREXPO d.o.o.
Svetozara Markovica 81/5
11000 Belgrade, Serbia
T: +381-63-301043
E: [email protected]
W: www.congrexpo.co.rs

Publisher
Serbian Association for Cognitive and Behavioural Therapies
Skenderbegova 3, 11000 Belgrade, Serbia
Mail: [email protected]; Website: www.ukbt.org.rs

Co-publisher
Serbian Association of Behaviour and Cognitive Therapists
Starca Vujadina 1, 18000 Niš, Serbia
Email: [email protected], Website: https://srabct.rs

Press: Unagraf, Jovana Boškovića 114, Belgrade

Layout: Rade Đurić, Belgrade
Print run: 100 copies
Bеlgrade, 2024

ISBN-978-86-906974-0-3

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EABCT 2024 ~ New Age of CBT – Challenges and Perspectives | September 4-7, 2024
Welcome from the EABCT President

It is with great pleasure that I am welcoming you to the 54th Congress of the European Associ-
ation of Behavioural and Cognitive Therapies (EABCT).
EABCT is an umbrella association made up of 55 CBT associations across the geographical con-
tinent of Europe and each year the congress is hosted by a different EABCT member associa-
tion. This year we are in Belgrade in Serbia, last year we were in Antalya, Turkey and next year
we will be in Glasgow, Scotland, UK.
The annual congress is therefore a great opportunity to cross linguistic and cultural boundar-
ies, to learn about ground breaking research and practice from across Europe and internation-
ally. I do hope that you will bear this breadth and novelty in mind as you navigate your way
through the programme. Please do dip in and find out what is going on in other countries and
in other specialities to your own.
We will hear from some well known people, but ALL contributions to the congress are important, from those starting out
doing a poster or presenting their research for the first time, to EACH participant whose understanding is increased, who
learn a new skill, or whose curiosity is sparked!
So please do ask questions, chat to people afterwards, and take what you learn back into your practice. There will be some-
thing for everybody - and the ultimate beneficiaries will be your clients, their families and the public.
Welcome to the 2024 EABCT congress!!
Katy Grazebrook
EABCT President

A Message from the EABCT 2024 Host

Dear Colleagues,
Welcome to the 2024 EABCT Congress! It is with great excitement and pride that we host this year’s event, bringing together
a diverse and vibrant community of professionals dedicated to advancing the fields of behavioral and cognitive therapies.
The theme of the congress reflects our commitment to exploring cutting-edge research, innovative practices, and the evolv-
ing challenges within our discipline. Over the next few days, we will delve into a rich program that offers a blend of keynote
speeches, symposia, workshops, skill classes, panel debates, roundtables, early career sessions and poster presentations, all
designed to inspire, inform, and connect. This conference is more than just an academic gathering—it is a unique opportunity
to renew old friendships, forge new connections, and collaborate on ideas that will shape the future of our field. Whether you
are a seasoned expert or a new entrant to the world of cognitive and behavioral therapies, we hope you find the program both
enriching and stimulating.
We are deeply grateful to our keynote speakers, presenters, and workshop leaders who have generously shared their ex-
pertise and time. We also extend our heartfelt thanks to our sponsors, whose support has been instrumental in making this
event possible. As you navigate through the sessions, we encourage you to engage fully, ask questions, and share your expe-
riences. The strength of EABCT lies in the collective wisdom of its members, and it is this exchange of knowledge and ideas
that drives our community forward.
We hope you enjoy your time at EABCT 2024 and leave with renewed energy, fresh perspectives, and a deeper commitment
to our shared goals.
Thank you for being part of this exciting journey.
Warm regards,

Tatjana Vukosavljević Gvozden Ivana Vračkić

President of the EABCT 2024 Organizing Committee Copresident of the EABCT 2024 Organizing Committee
ACBTS President SRABCT President

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EABCT 2024 ~ New Age of CBT – Challenges and Perspectives | September 4-7, 2024
 KEYNOTE SPEECH

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EABCT 2024 ~ New Age of CBT – Challenges and Perspectives | September 4-7, 2024
 Keynote Speech

KN1: Re thinking CBT formulation: Hoarding Disorder as an example of

convergent processes in understanding and treating psychological problems
Paul Salkovskis
Oxford University, United Kingdom

Re-thinking CBT Formulation: Hoarding Disorder as an Example of Convergent Processes in Understanding and Treat-
ing Psychological Problems
In this lecture, participants will hear about re-evaluating cognitive-behavioral therapy formulations using hoarding
disorder as a case study to explore convergent processes in understanding and treating psychological issues

KN2: How Rational Emotive Behavior Therapy is Integral in Addressing Our

Current Global Challenges
Kristene Doyle
Executive Director Albert Ellis Institute, United States

In this session, I will discuss some of the global challenges and the emotional and behavioral toll it is taking
on our clients’ mental health. Some of those challenges include social media’s impact; the aftermath of the
global Covid-19 pandemic; polarizing political environments; national and international terrorism; and the
opioid/substance use crises. Recommendations on how Rational Emotive Behavior Therapy (REBT), the
original cognitive behavior therapy will be discussed.

KN3: What’s compassion got to do with it? Addressing the issues of shame
and self-criticism in therapy
Chris Irons
Balanced Minds, United Kingdom

In this keynote, i’ll outline how and why shame and self-criticism are not only common issues in therapy, but how
they can cause damage to the therapeutic process and outcome. We’ll look at ways of understanding these common
presenting issues, and consider how Compassion Focused Therapy can play a powerful role in addressing shame and
self-criticism in and outside the therapeutic space.

KN4: Emotion regulation for all: helping adolescents

in under-resourced settings
Marija Mitković-Vončina
Institute of Mental Health, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Serbia; Serbian Association of
Behavioural and Cognitive Therapists (SRABCT)

Milica Pejovic-Milovancevic
Institute of Mental Health, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Serbia; Association for Cogni-
tive and Behavioural Therapies of Serbia (ACBTS)

Adolescence (including the age of transitioning to adulthood) is a period of both opportunity and vulnerability when
it comes to mental health and development. Data suggest that up to three quarters of all mental disorders onset by
the age of 24, affecting both current functionality and the developmental pathway, with possible long-term adverse
outcomes, but that there is the reduced ability of services to deliver appropriate interventions that are timely and
evidence-based, especially in low and middle income countries where the allocation of resources for mental health in
general is low. The most common internalizing and externalizing mental health difficulties in youth may vary in inten-
sity, and have overlapping or comorbid presentations, resulting in the rise of transdiagnostic approaches for youth,
with emotion dysregulation (EDR) recognized as one of the promising transdiagnostic targets. In recent years, there

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EABCT 2024 ~ New Age of CBT – Challenges and Perspectives | September 4-7, 2024
 Keynote Speech
has been a proliferation of various interventions targeting EDR in youth, with overall promising outcomes, but with
highly variable study-by-study size effects, possibly due to heterogeneous methodologies, obstacles related to time
demands and challenges for mental health professionals to go through complicated training. This may also be related
to the challenge of evidence-based intervention effects decreasing when interventions move from research to the
“real-world” practice context, especially in under-resourced settings. These obstacles may result in a considerable
number of youth in need not accessing the appropriate help, indicating the necessity of individualized, less complex
and more implementable interventions. The lecture aims to provide an overview of these challenges and present how
the paradigm of targeting EDR of youth (from CBT perspective) could evolve on a national level, in a country where
public sectors providing mental health support to youth have been under-resourced while the number of youth in
need has been increasing. In Serbia, this paradigm shift has included research and prevention-intervention activities
on several levels. The research activities focus on investigating the associations between parental emotion regulation
strategies and aspects of parenting on a nationally representative sample of parents, the study of mental disorders
among adolescents in general population across the country, and the study of predictors and outcomes of EDR in a
clinical cohort with EDR followed through transitioning to adulthood. On prevention - intervention level, the nation-
wide models were introduced that include focus on regulating emotions - on supporting positive parenting and on
providing essential psychosocial interventions to youth (through training of professionals in public key sectors); as
well, a clinical division for adolescent EDR and tailoring interventions to be applicable in under-resourced settings has
been established. The efforts have resulted in the key stakeholders signing the memorandum of collaboration when
it comes to providing mental health support to youth, providing a first step to the future of helping all youth in need
in this field.
Acknowledgments: The data presented include the work supported by 1) UNICEF Serbia in the framework of the: a)
project “Supporting Adolescent Mental Health in Serbia: Strengthening Capacities of Mental Health Professionals”
(No. REF: BGD/PGM/DK/SV/2022-614), conducted in collaboration of the Institute of Mental Health, Belgrade, Serbia,
and Orygen, Australia, b) project “Support for professionals and parents in non-violent disciplining of children” con-
ducted in collaboration with the Association for Child and Adolescent Psychiatry and Allied Professions of Serbia –
DEAPS, c) project “Integrated response to violence towards women and girls in Serbia III”, conducted in collaboration
with UN Women, UNFPA, UNDP, the Government of Serbia, supported by the Government of Sweeden, and d) project
Research on Child Disciplining at Home in Serbia (conducted by the Institute of Psychology, University of Belgrade,
and the Institute of Mental Health); as well as by 2) DEAPS in the framework of the project “Emotion dysregulation of
adolescents: the study of predictors and outcomes” (No. REF: DEAPS-NIR-2022/01), and 3) Project of Crisis Psychoso-
cial Support to the Community (Institute of Mental Health, Belgrade and Faculty of Medicine, University of Belgrade),
implemented by the Institute for Mental Health and based on the Conclusion of the Working Group for Support to the
Mental Health and Safety of Youth, 08 Number 06-00-4564/2023-2 dated 05/24/2023, Government of the Republic
of Serbia, supported by the Ministry of Education, Science and Technological Development of the Republic of Serbia.

Keywords
emotion dysregulation, adolescents, emerging adults, CBT intervention, under-resourced settings

KN5: Differential predictor, mechanisms, and sustainers of CBT vs

antidepressants for treating Major Depression
Edward Craighead
Department of Psychology, Emory College of Arts and Sciences, United States

Differential Predictors, Mechanisms, and Sustainers of CBT vs Antidepressants for Treating Major Depression
In this lecture, participants will hear about the distinct predictors, mechanisms, and sustaining factors involved in the
effectiveness of cognitive-behavioral therapy compared to antidepressants in treating major depression.

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EABCT 2024 ~ New Age of CBT – Challenges and Perspectives | September 4-7, 2024
 Keynote Speech

KN6: Applications of REBT in forensic Mental Health

Ag Ahmed
College of Medicine, University of Saskatchewan, Canada

The Therapeutic Justice Program (TJP) is an innovative approach that combines elements of the criminal justice sys-
tem with therapeutic interventions to address the underlying issues contributing to criminal behavior. The TJP aims to
provide individuals involved in the criminal justice system with opportunities for rehabilitation and personal growth.
By incorporating therapeutic interventions, such as REBT, into the justice process, the TJP seeks to address the root
causes of criminal behavior and promote positive change. Within the TJP, REBT can be applied in various ways. By
targeting irrational beliefs and promoting adaptive thinking and behavior, REBT can contribute to the rehabilitation
and reintegration of individuals involved in the criminal justice system. Further research and collaboration between
mental health professionals and justice system personnel are needed to enhance the effectiveness and accessibility
of REBT within the TJP.
Learning Objectives:
1. To provide an overview of the Therapeutic Justice Program (TJP) and its goals in addressing the underlying issues
contributing to criminal behavior.
2. To explore the application of Rational Emotive Behavior Therapy (REBT) within the context of the TJP and its effec-
tiveness in promoting positive change and rehabilitation.
3. To discuss the unique challenges and considerations when implementing REBT within the TJP and identify strate-
gies for successful integration and adaptation of REBT techniques.

KN7: When climate-related disaster strikes: What should we do about PTSD?

James Bennett Levy
Southern Cross University, Lismore, New South Wales, Australia

This keynote, part research-based, part conceptual, part autobiographical, will reflect on the mental health impacts
of past 7 years in northern New South Wales, Australia. These years have seen 3 major floods, 2 seasons of bushfires,
and the 3 hottest years on record. I’ll describe the rationale, and evolution of the key elements for a 4-year stepped
care clinical trial to address climate-related PTSD. The trial features two kinds of low intensity intervention: arts-based
and nature-based compassion-focused groups. For the high intensity intervention, we have elected to trial group-
based MDMA-assisted therapy. Some of the initial challenges we face mounting this clinical trial in a small, highly
networked, traumatised community will be described.

KN8: Beyond CBT in the Treatment of Depression: Integrating current models

of risk and resilience
Keith Dobson
University of Calgary, Canada
​​
There are now a range of evidence- based psychological therapies for depression, including several models based on
cognitive- behavioral principles. Even so, the literature on risk and resilience factors for depression suggests that the
field needs to move “beyond CBT”, to a more integrated biopsychosocial and individualized approach. In this address,
some of the factors not well incorporated into CBT models are discussed, and a broader model is suggested. This
model uses CBT as its basis, but is able to integrate other evidence- based strategies into treatment for depression, to
make interventions more contextualized and likely more efficient and effective.

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EABCT 2024 ~ New Age of CBT – Challenges and Perspectives | September 4-7, 2024
 Keynote Speech

KN9: Challenges and perspectives in prolonged exposure therapy for PTSD

Maria Bragesjö
Center for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden

Challenges and Perspectives in Prolonged Exposure Therapy for PTSD

In this lecture, participants will hear about the various challenges and perspectives associated with the use of pro-
longed exposure therapy for treating post-traumatic stress disorder.

KN10: Should Culture be an Integral Part of Supervision?

Margo Ononaye
University of Southampton, United Kingdom

The aim of this keynote is to present the evidence exploring the importance culturally responsive supervisory prac-
tice. The focus will initially be on presenting research investigating whether therapists from racially and ethnically mi-
noritized (REM) backgrounds are being supported in supervision. It will also consider the research looking at whether
white psychological professionals are able to offer safe and supportive supervision to their supervisees from REM
backgrounds. The talk will all consider whether you, as a clinician, can learn the skills to develop a cultural narrative in
supervision. The overall aim is to support supervisors and supervisee to ensures that everyone benefits from culturally
responsive supervision.

KN11: Shall we add compassion to schema therapy

Gregoris Simos
University of Macedonia, Greece

Shall We Add Compassion to Schema Therapy

In this lecture, participants will hear about the potential benefits of incorporating compassion-focused elements into
schema therapy to enhance treatment outcomes.

KN12: Treating emotion dysregulation in autistic adults through dialectical

behavior therapy (DBT) and compassion-focused therapy
Luisa Weiner
University of Strasbourg, France

Emotion dysregulation (ED) is highly prevalent in autistic adults. Importantly, in autism, ED is associated with in-
creased rates of suicidal behavior, non-suicidal self-injury (NSSI) and poorer quality of life and overall functioning.
Nevertheless, few studies have investigated ED and its treatment in autistic adults. In this talk, we will focus on how
DBT and CFT may target ED in autistic adults. To do so, we will present the results from empirical studies led by our
team and clinical vignettes to illustrate the main principles and adaptations of both interventions.

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EABCT 2024 ~ New Age of CBT – Challenges and Perspectives | September 4-7, 2024
 Keynote Speech

KN13: Common Factors And Shared Strategies: What Makes Cognitive

Behavior Therapies Effective?
Raymond DiGiuseppe
St. John University, United States

Multiple types of Cognitive-Behavioral Therapies have appeared in the last 50 years. All have research data demon-
strating their effectiveness. What accounts for the effectiveness of the various forms of CBT? This presentation will
explore whether the Dodo bird effect applies to CBT and what common factors and active ingredients account for the
effectiveness of all forms of CBT.

KN14: Building bridges between the old and the new: Innovative
contributions in test anxiety conceptualization and intervention
Maria do Céu Salvador
University of Coimbra, Portugal

Test anxiety has been receiving attention since the 1950’s, and it has been approached from different perspectives.
However, despite its high prevalence and impact among adolescents and young adults, much remains to be under-
stood. This keynote tries to build some bridges in this field, bringing us across to recent approaches, and discussing
implications for assessment, conceptualization and intervention.

KN15: Infidelity and its Consequences: Is it possible to to re-build trust

following affairs?
Mehmet Sungur
Istanbul Kent University, Turkey

Infidelity and Its Consequences: Is It Possible to Re-build Trust Following Affairs?

In this lecture, participants will hear about the complexities of infidelity and explore strategies for rebuilding trust and
repairing relationships after affairs.\

KN16: Cultural Adaptation of CBT for Psychosis: Working with diverse

communities
Peter Phiri
University of Southampton, United Kingdom

Cultural Adaptation of CBT for Psychosis: Working with Diverse Communities

In this lecture, participants will hear about adapting cognitive-behavioral therapy for psychosis to effectively work
with and address the needs of diverse cultural communities.

KN17: EMDR therapy and research: the state of the art

Isabel Fernandez
EMDR Italy, Italy

It is just over 35 years since Francine published her first studies on EMDR. Since then, clinicians and researchers have
found EMDR to be effective beyond addressing simple PTSD experiences. The application of EMDR therapy include
children who have experienced trauma, depression, early interventions, chronic pain and certain types of complex
trauma populations such as war veterans. Most of the research on EMDR has been done in comparison with CBT.

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EABCT 2024 ~ New Age of CBT – Challenges and Perspectives | September 4-7, 2024
 Keynote Speech
As a result, Trauma-focused Cognitive-Behavioural Therapy (CBT) and Eye Movement Desensitization and Reprocess-
ing (EMDR) have been declared the two first-line treatments of the psychological effects of traumas according to
international guidelines.
During the presentation research on trauma-focused cognitive-behavioural therapy (TF-CBT) and/or eye movement
desensitization and reprocessing (EMDR) will be described as well as its integration.

KN18: Integrative and Multimodal CBT as a platform of evidence based

psychotherapy integration. Clinical and academic implications
Daniel David
International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Department of Clinical
Psychology and Psychotherapy, Babeș-Bolyai University, Romania

CBT is an umbrella paradigm, covering various approaches/schools of CBTs, following the classical “waves”: the be-
havioral first wave, the cognitive (restructuring) second wave (e.g., REBT, CT), and the cognitive acceptance (defusion)
third wave. Integrative and Multimodal CBT will teach you how to efficiently combine them (and other psychotherapy
treatments tributary to other paradigms) in personalised evidence-based psychological treatments, including the
new technological developments, based on current developments in cognitive (neuro) science. Both research and
clinical aspects will be covered.

KN19: You shouldn’t feel that way - but you do: Coping with Difficult Emotions
(online)
Robert Leahy
Weill Cornell Medical College, USA

We frequently hear invalidating comments about our difficult emotions, such as “You shouldn’t feel jealous, resentful,
envious, bored, or regretful”. But these are universal emotions that we all might feel and disowning this part of our self is
unrealistic and self-defeating. The emotional schema model views all emotions as the result of the evolutionary process
and that our cultural and socialization experiences make it difficult to integrate these experiences into our lives. Our
beliefs about emotions affect our tolerance of the inevitable difficulties of a completely human existence. The relentless
pursuit of happiness, existential and emotional perfectionism and beliefs in a “higher self” lead to attempts to suppress
these feelings which leads to more anxiety and beliefs that we are not “normal”. Complex emotions such as jealousy,
envy, and regret function as systemic “modes” which are integrated strategies for coping. For example, the regret
mode imagines a “better world” (alternative), compares outcomes to an ideal that does not exist, ignores the limits of our
knowledge in making decisions, rejects tradeoffs, and activates rumination and self-criticism to motivate us to try to pur-
sue maximum benefits. In its extreme form, regret becomes guilt, but the absence of guilt leads to distrust and sociopa-
thy. How do we help clients find the right balance? What is the right amount of regret, for the right reasons, expressed in
the right way, to produce the best outcome within our human limits? How do existential and emotional perfectionism
and biases in predicting emotions lead to our difficulty in using painful emotions to benefit us?

KN 20: Regulating Emotions

Stefan Hofmann
Philipps-Universität Marburg, Germany

Emotions are critical aspects of mental health. Although conventional treatments for emotional disorders are gener-
ally effective interventions, many people still suffer from residual emotional distress, such as anxiety, depression, and
anger problems. Moreover, contemporary treatments that have focused primarily on negative affect rarely lead to
lasting improvements in positive affect, quality of life, and happiness. Recent scientific evidence and theoretical mod-
els of emotions can enrich the therapeutic strategies when treating emotional disorders. These strategies range from
adaptive and flexible intrapersonal and interpersonal emotion regulation strategies to various mindfulness-based
practices. In the case of anxiety disorders, modern emotion theories clarify the mechanism of exposure procedures
and the role of avoidance strategies. These insights can inform the treatment for emotional disorders.

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EABCT 2024 ~ New Age of CBT – Challenges and Perspectives | September 4-7, 2024
 Keynote Speech

KN21: Entropy of mind and negative Entropy: A cognitive and Complex

Approach to Schizophrenia and its Therapy
Tullio Scrimali
University of Catania, Italy

Schizophrenia is the central problem in the sciences of the mind, not only for its etiological, psychopathological, and
clinical aspects, but also because of its implications for therapy and rehabilitation. In this keynote address the author
describes a series of new scientific and clinical perspectives for schizophrenia, influenced by some new cognitivist and
constructivist approaches and informed by the logic of complexity and non-linear, dynamic systems. The author de-
lineates a new complex theory of the brain and the mind, founded on the concept of the modular and gradient brain
and the coalitional mind. Furthermore, Scrimali underlines how the new paradigm of connectomics allows a better
understanding of schizophrenia (Scrimali, 2008).
Subsequently, the author presents a multi-factorial conceptualization of the etiological dynamic and an original, com-
plex, and evolutionary perspective concerning the psychotic condition, which has been redefined, in this case, as
Entropy of the Mind or Phrenentropy.
At this point the author illustrates an innovative, integrated protocol, denominated Negative Entropy, he developed
for the treatment and rehabilitation of patients with schizophrenia. This protocol includes and integrates some new
methods and devices coming from Applied Neuroscience, such as the MindLAB Set designed, developed, and exper-
imented by Scrimali (Scrimali, 2012).
A new, original, and patented drug for curing schizophrenia, developed by Scrimali and named NegEnt, is also pre-
sented (Scrimali, 2020). Concluding his keynote, the Author presents some data coming from a more than twenty
years lasting clinical research based on some controlled studies conducted with schizophrenic patients.

KN22: Is CBT only for White people?

Saiqa Naz
British Association for Behavioral and Cognitive Psychotherapies, United Kingdom

CBT has traditionally been conceptualised as being for White western populations. Dr Saiqa Naz will use research to
dismantle this narrative and position CBT in a multicultural context.

KN23: Because you had a bad day: emotional eating in youth

Caroline Braet
Ghent University, Belgium

During adolescence, young people undergo significant developments that make them emotionally vulnerable, result-
ing in increased emotional reactivity to negative emotions. As we cannot and should not ask them to avoid emotional
experiences, it seems especially important to pay attention to how young people deal with or regulate challenging
emotions. While researching emotion regulation processes I discovered that emotional eating is highly prevalent
(up to 44 % in community samples) and hinder weight control. Nevertheless, the causes and consequences are still
understudied. My research started from the observation that when challenging emotions are not successfully man-
aged, this is often associated with eating comfort food in the absence of hunger, also defined as emotional eating. I
will discuss some pertinent questions and show how young people can learn to master emotional eating patterns.

KN24: A Process-Based Approach to CBT: Focusing on Person-Level Processes

in Context (online)
Clarissa Ong
Department of Psychology, University of Toledo, USA

Cognitive behavioral therapy is one of the strongest evidence-based treatments available in the field of psychothera-
py, with research supporting its efficacy for a range of conditions, including obsessive-compulsive disorder (Olatunji

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EABCT 2024 ~ New Age of CBT – Challenges and Perspectives | September 4-7, 2024
 Keynote Speech
et al., 2013) , generalized anxiety disorder (Cuijpers et al., 2014) , depression (Cuijpers, 2017) , and insomnia (Okajima
et al., 2011) . At the same time, remission rates associated with CBT range from 48–56% (Springer et al., 2018) and
some evidence indicates that the efficacy of CBT may be stagnating (Bhattacharya et al., 2022; Cristea et al., 2017)
. Together, these findings suggest that CBT helps many but not all people struggling with psychological problems
and that CBT has not gotten significantly more effective after decades of research and practice. Part of the problem
paradoxically could be the standardized protocols and group-level randomized controlled trials that helped CBT be-
come the gold- standard psychotherapy in the first place. These nomothetic methods generally fail to consider the
individual in their specific context, which may be crucial when treating clients with unique problems and histories.
Process-based CBT (PBT) is designed to address this gap, relying on evidence-based methods that have been found to
be effective on average, while tailoring them to the idiographic needs of individual clients (Hofmann & Hayes, 2019)
. Specifically, PBT is an approach to therapy or a model for thinking about therapy from an evolution science lens,
focusing on dimensions of psychological functioning, levels of analysis, and principles of change (Hayes et al., 2020) .
This presentation will describe the PBT model, explore how it can be integrated with cognitive behavioral therapies,
and present examples of how it can be used with clients.

KN25: CBT of psychosis: the state of the art

Antonio Pinto
SITCC, APC,/SPC,CBT School, CEPICC, Department of Mental Health, Naples, Italy

Cognitive Behavioral Therapy (CBT) is considered an evidence-based treatment for people with a psychotic disorder.
In fact, substantial evidence has been reported for the effectiveness of CBT for psychosis in reduction of persistent
positive and negative symptoms, the overall symptomatology and the mental state, as well as in the early interven-
tion and in delaying the transition to psychosis.
The evolution of the treatment from standard CBTp to the integration with third and fourth generation therapies, and
its clinical implications, will be showed in this presentation

KN26: Cyberchondria: Hypochondria of the 21st century

Vladan Starčević
University of Sydney, Sydney, Australia

This presentation first addresses the frequency, precipitants, predictors and outcomes of online health information
seeking (OHIS), which has generally had a positive and empowering effect. However, health anxiety in some individ-
uals is exacerbated with OHIS, potentially leading to cyberchondria.
Cyberchondria is defined as an excessive and/or repetitive OHIS that persists despite its negative consequences and
is associated with increased distress or health anxiety. Cyberchondria is a relatively distinct construct. It is driven by
a combination of information insufficiency, intolerance of uncertainty, need for reassurance and imbalance between
trust and scepticism and has important relationships with health anxiety, problematic Internet use and compulsivity.
Although cyberchondria is closely related to health anxiety, it is not just a modern counterpart to hypochondriasis.
Cyberchondria is also significantly related to online health information management issues (e.g., difficulty coping
with information overload) and maladaptive interactions with the Internet (e.g., unrealistic expectations of the Inter-
net). The consequences and public health implications of cyberchondria include functional impairment, increased
healthcare utilisation, discontent with healthcare received and various changes in interactions with physicians and
patterns of seeking and receiving healthcare.
During the COVID-19 pandemic, a combination of COVID-19-related fears, infodemic, misinformation, uncertainty
and shaken trust in authorities led to more prominent manifestations of cyberchondria. Thus, cyberchondria may be
particularly relevant during public health crises such as pandemics. Prevention of cyberchondria entails changes in
the way online health information is presented and addressing risk factors for cyberchondria, but the key strategy is
improving online health information (e-health) literacy. The main goal in the management of cyberchondria is feel-
ing confident and being in control whilst performing OHIS so that it does not lead to an escalation of health anxiety.
Case formulation and modification of the existing behavioural and cognitive therapy techniques show promise in the
treatment of cyberchondria.

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 Keynote Speech

KN27: Recent Developments and Future Directions in Cognitive Behavior

Therapy (online)
Judith Beck
University of Pennsylvania, USA

While many clinicians, researchers, and educators are familiar with CBT theory, conceptualization, and treatment, they
may be unaware of the refinements made over the previous decade. This presentation will focus on important chang-
es, including the introduction of a strength-based conceptualization and a recovery orientation, integration of tech-
niques from other evidence-based modalities, using the conceptualization to overcome therapeutic ruptures, and
adapting treatment for each individual client, considering the client’s age, gender, developmental level, education,
socio-economic status, cultural background, history (including trauma), environmental contexts (such as racism), and
other factors. CBT has been researched and modified for many different populations around the world and is now
delivered by a wide range of professionals and non-professionals using a variety of novel delivery formats.

KN28: Cognitive Behavioural Writing Techniques for Posttraumatic Stress

Arnold Van Emmerick
University of Amsterdam, Netherlands

Therapeutic writing techniques are increasingly recognized as an evidence-based treatment for posttraumatic stress
symptoms or posttraumatic stress disorder. This lecture briefly describes three therapeutic writing models and sum-
marizes the main research findings on their efficacy. The procedures and positive outcome findings of a fourth model,
Structured Writing Therapy, are described in more detail.

KN29: Neurodevelopmental disorders: the reality of challenges

Milica Pejović Milovančević
Institute of Mental Health, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Serbia; Association for Cogni-
tive and Behavioural Therapies of Serbia (ACBTS)

Marija Mitković-Vončina
Institute of Mental Health, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Serbia; Serbian Association of
Behavioural and Cognitive Therapists (SRABCT)

Neurodevelopmental disorders include behavioral and cognitive disorders that occur during the developmental peri-
od and that are marked by significant difficulties in acquiring and performing specific intellectual, motor, language, or
social function. These disorders are multifactorial in origin, show gender differences, and have a chronic course with
consequences that last a lifetime. Conceptualizing these disorders has gone through challenges and changes over the
time, still causing controversy, with contemporary classifications now defining them as a separate group. The surpris-
ing rise in prevalence, the lifetime challenges for individuals and families, as well as the challenges for public systems
to help (and especially in LMICs) have put the neurodevelopmental disorders, and especially autism spectrum disor-
ders (ASD) and attention deficit hyperactivity disorders (ADHD) at the spot of special attention. This keynote lecture is
aimed at giving overview of the most concerning challenges when it comes to care for individuals and families with
ASD and ADHD, and to present the pathway of addressing these challenges in LMICs such as Serbia. The last 15 years
have been crucial to reaching the significant progress milestones in this domain. The past decade of child health care
reform on the primary level in Serbia was marked by national efforts aimed at elevating family-centered, strengths-
based care, early stimulation and developmental monitoring, home visiting, and early childhood interventions for the
most vulnerable families. The crucial role of the health sector was also recognized in the National Program for Early
Childhood Development (ECD) adopted by the Serbian Government in March 2016. It recognizes the importance of
the healthcare sector in promoting a childs development and supporting parents and wider environment in creating
conditions for optimal child’s development, but also stresses the importance of cross-sectoral coordination between
relevant sectors (healthcare, social welfare, education, culture and information, finance) in providing support to fam-
ilies. For the most at-risk children with developmental risks, difficulties and disabilities such as neurodevelopmental
disorders, family-oriented Early Childhood Intervention (ECI) services have been modeled in Serbia to bring together
primary healthcare centers, preschools, and social welfare services. Parents and caregivers are seen as equal partners

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 Keynote Speech
in planning and delivering early childhood intervention. Two editions of comprehensive guidelines for the diagnosis
and therapy of children and adults with ASD were created, numerous trainings of experts were carried out for the
application of modern diagnostic procedures, new evidence-based therapeutic modalities were introduced and a
professional distinction was made from those modalities that are not based on evidence. Changes were introduced
in individual work with children, and specific attention was given to working with parents through programs such as
caregiver skill training (CST), family oriented early intervention (PORI), etc. When it comes to ADHD, a new edition of
guidelines for diagnosis and treatment has been issued, with significant progress in identifying and tackling ADHD
in the adult population in recent years. Future plans will be presented, with focus on research and continuous pro-
fessional development that include the mechanisms for horizontal exchange, helping the alignment of pre-service
education with innovation in the in-service practice.

Key words: neurodevelopmental disorders, ASD, ADHD, CST, PORI

KN30: CBT and the seven secrets of mental health

Miro Jakovljević
University of Zagreb, Croatia

Mental disorders and suffering are generally caused by the lack of empathy and empathic gaps at all levels, from
family and community to society and our volatile, uncertain, complex and ambiguous world. Empathization-based
Cognitive, Emotional and Behavioral Therapy (EB-CEBT) is oriented to promote salutogenesis, wellness and positive
mental health not only to decrease illness and stop pathogenesis. To eliminate mental illness, we should help our
patients to overcome their rigid, biased, prejudiced, judgmental, destructive expectations, desires, hopes, intentions
related to their ordinary ways of thinking about themselves and the world around them. EB-CEBT promotes empathic
learning, creative praxis, love, happiness, power, freedom and purpose/meaning of life and is an essential component
of the Creative, Person-centered Narrative Psychopharmacotherapy.

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WP1: The Assessment, Diagnosis and Treatment of Anger Problems

Raymond DiGiuseppe
St. John University, United States

In this pre-congress workshop participants will hear about effective strategies for assessing and diagnosing anger
problems and how to apply targeted CBT techniques in order to solve them.

WP2: Working with Self criticism using Compassion Focused Therapy

Chris Irons
Balanced Minds, United Kingdom

In this pre-congress workshop participants will learn about using compassion-focused therapy to address and man-
age self-criticism effectively.

WP3: A practical guide to CBT for Obsessive compulsive disorder: a

masterclass
Paul Salkovskis
Oxford University, United Kingdom

In this pre-congress workshop participants will hear about a comprehensive guide to implementing CBT for obses-
sive-compulsive disorder, with a focus on hands-on, advanced practices.

WP4: Acceptance and Compassion based interventions for Test Anxiety: New
approaches for an old problem
Maria Do Céu Salvador
Coimbra University, Portugal

Despite the absence of diagnostic criteria, test anxiety (or exam anxiety) is a highly prevalent condition, affecting pre-
dominantly secondary and university students. It has deleterious effects on students’ academic performance, mental
health, and well-being. Students with high test anxiety frequently feel guilty for not studying as hard as they should,
and ashamed and self-critical for what they consider poor performance. Furthermore, they are constantly anticipating
catastrophic results, and they try to fight or escape anxiety in any way they can (e.g., positive thoughts, medication,
or skipping exams).
In line with these clinical features, research finds test anxiety associated with high levels of shame and self-criticism,
and with low levels of mindfulness and experiential acceptance.
Contextual therapies emphasizing these processes have been shown to be effective in anxiety disorders, and some
steps in test anxiety are also being taken.
In this workshop, some clinical and research aspects of test anxiety will be presented and discussed. However, most
of the work will have a clinical focus. This part will start with a brief overview of the theory behind compassion-based
interventions and Acceptance and Commitment Therapy, after which we will focus on presenting, experiencing and
practicing mindfulness, compassion, and acceptance-based strategies tailored to help students cope with test anxi-
ety and lead a richer and more meaningful life.

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WP5: Chipping Away at the Marble: Developing Supervision Skills in

Culturally Responsive Supervision
Margo Ononaiye,
University of Southampton, United Kingdom

The aim of this keynote is to present the evidence exploring the importance culturally responsive supervisory prac-
tice. The focus will initially be on presenting research investigating whether therapists from racially and ethnically mi-
noritized (REM) backgrounds are being supported in supervision. It will also consider the research looking at whether
white psychological professionals are able to offer safe and supportive supervision to their supervisees from REM
backgrounds. The talk will all consider whether you, as a clinician, can learn the skills to develop a cultural narrative in
supervision. The overall aim is to support supervisors and supervisee to ensures that everyone benefits from culturally
responsive supervision.

WP6: Entering the World of Psychedelic-assisted Therapy

James Bennett Levy
Southern Cross University, Australia

James Hawkins
United Kingdom

Since the publication of Michael Pollan’s popular book “How to Change your Mind” (2018) and his subsequent
Netflix series, there has been an explosion of interest in psychedelic- assisted therapy (PAT) – and an explosion of
accompanying hype. Alongside the interest and hype, there has also been a rapidly growing body of research, which
suggests that PAT may be helpful for many clients who have had extended struggles with depression, PTSD, drug and
alcohol problems, and other disorders.

The world of PAT is currently a confusing landscape. It is hard to know where to start. This workshop is for therapists
contemplating taking their first steps into the world of PAT. Our primary aim is to answer some of your key questions;
and to provide pointers which may be helpful in your decision-making about whether or not to pursue the PAT path
at this time.

We shall aim to address issues such as: How solid is the evidence for PAT at this point? How promising is PAT as a
potentially paradigm-shifting therapy? What does PAT look like in practice? What are the protocols used in clinical
trials? What are the various psychedelic substances currently being investigated? Which disorders are particularly good
targets for PAT? For which medicines? What are the contraindications? Do the results justify the expense - and the
amount of therapist time involved? How can we best train PAT therapists? How translatable are your current therapist
skills (e.g. CBT skills) to this new environment? More than most workshops, there will be plenty of opportunities for
questions and answers, for discussion and for role-play.

.Learning Objectives
That you are:
1. Better informed about important psychedelic-assisted therapy developments, both with emerging research
and with developing licensing changes
2. Better able to respond to client questions about indications, safety and availability of these approaches.
3. Clearer about what is involved in practising psychedelic therapy
4. Clearer about your interests in this field and what further steps you might now want to take.

The Presenters
James Bennett-Levy and James Hawkins come from different continents and come at PAT from different angles. James
Hawkins is a medical doctor/psychotherapist from Scotland. James founded the Psychedelic Health Professionals
Network in 2019. He is an experienced PAT trainer and has been leading legal Netherlands-based psychedelic
retreats, with a particular emphasis on therapist self-experience to enhance PAT training. James Bennett- Levy comes
from Australia, the world’s first country to enable the clinical use of psychedelics for specific conditions. He is a PAT
researcher on several clinical trials, and was recently awarded an AUS$3.8mill government grant to evaluate a stepped
care approach to addressing disaster-related PTSD, with MDMA-assisted therapy as the ‘high intensity’ intervention.

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Some Key References
Carhart-Harris, R., et al. (2021). Trial of psilocybin versus escitalopram for depression. New England Journal of Medicine,
384, 1402-1411.
Ishak, W.W., et al. (2023). The impact of psilocybin on patients experiencing psychiatric symptoms: A systematic review
of randomized clinical trials. Innovations in Clinical Neuroscience, 20, 39-48.
Mitchell, J.M., et al. (2021). MDMA-assisted therapy for severe PTSD: a randomized, double- blind, placebo-controlled
phase 3 study. Nature Medicine, 27, 1025–1033.
Smith, K.W., et al. (2022). MDMA-assisted psychotherapy for treatment of posttraumatic stress disorder: A
systematic review with meta-analysis. Journal of Clinical Pharmacology, 62, 463-471.

WP7: Cognitive Behavioural Systems Approach to Couple Problems

Mehmet Sungur
Istanbul Kent University, Turkey

In this pre-congress workshop participants will hear about a cognitive-behavioral systems approach to understand-
ing and addressing challenges in couple dynamics.

WP8: Treatment and prevention of PTSD. A non-trauma self-efficacy-focused

cognitive therapy approach
Agnieszka Popiel
SWPS University of Social Sciences and Humanities, Warsaw; Polish Association for Cognitive Behaviour Therapy, In-
ternational representative., Poland

In the 21st century, war has never been so close to Central Europe as in the last two years. War
increases at least twice the prevalence of PTSD in its victims. Any effort to treat and prevent PTSD with evidence-based
methods is our obligation toward victims of trauma and to professionals who are at increased risk of job-related trau-
matisation. Trauma-focused CBT is a group of widely recognized group of highly recommended treatments for PTSD.
But how can professionals be prepared for job-related traumatization in the future? Is there any option for patients
who refuse to focus on trauma memories during treatment? The workshop will be based on 15 years of studies and
clinical experience that led to the elaboration of two process-based protocols: “Self-efficacy focused cognitive ther-
apy for PTSD”, and. “Effective performance under stress” is a prevention program designed for first responders to
prevent PTSD by enhancing coping self-efficacy in the face of the emotional consequences of traumatic stress. The
theoretical assumptions of both protocols take account of the basic psychological processes maintaining emotional
disorders, and in particular, coping-self efficacy as the core of the seven-factor PTSD model. While the purpose of the
therapy is to reduce the distress associated with PTSD by influencing beliefs on self-efficacy, in prevention, a targeted
influence of the development of these beliefs would result in resilience to trauma symptoms.
The workshop will consist of two parts
I. Review of evidence-based treatments for PTSD with a Prolonged Exposure (PE) treatment as an example of TF-
CBT. What if TF-CBT doesn’t work or people don`t want it? A TRAKT protocol of a “Process-based self-efficacy-focused
cognitive therapy for posttraumatic stress disorder” will be described step by step. Data on the efficacy of the TRAKT
protocol in comparison with PE will be presented. Temperamental moderators of outcome will be discussed in the
context of personalization of the treatment.
II. Can we prevent PTSD? In summary, the main assumptions of the “Effective performance under stress” program
designed to prevent PTSD in firefighters and other professions will be described and the results of its effectiveness
presented.

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WP9: ACT and the Self: From Self Esteem to Self Acceptance
Richard Bennett
University of Birmingham, Colombia

Background
Experiencing persistent negative or critical thoughts about the self is one of the most common issues to face people
in everyday life. It can affect our confidence, our relationships, and how we feel about ourselves in a range of situa-
tions. For some of us, this only occurs occasionally, whilst, for others, it can impact everything.
Consequently, self-critical thinking has the potential to impair our ability to lead a meaningful and fulfilling life.
Traditionally, approaches to managing pervasive self-criticism have attempted to boost self-esteem or build ‘new’ core
beliefs. However, this has produced variable results, with many people finding that they cannot access more positive
views about themselves in times of difficulty, which is when they need them most. Third-wave CBT approaches, nota-
bly Acceptance and Commitment Therapy (ACT), now focus on a model of self-acceptance, rather than self-esteem,
helping people to build healthier relationships with their whole self, by changing the context that these thoughts
arrive in, rather than seeking to change their content.
This workshop is based on Richard’s book, ‘The Mindfulness and Acceptance Workbook for Self-Esteem’, and will pres-
ent developments in contemporary theory and practice, drawing on Acceptance and Commitment Therapy (ACT)
and Relational Frame Theory (RFT) to help you learn tools and techniques to develop skills in promoting self-accep-
tance and self-compassion in your clients.
This workshop is for Practising therapists working with adult clients who present with depression, low self- esteem,
shame, or self-criticism Learning objectives Via attendance at this workshop, participants will learn:
1. An ACT & RFT informed contextual behavioural understanding of the self
2. How to use a range of perspective-taking interventions to help clients defuse from shame and self-criticism
3. How to develop ‘container’; metaphors that hierarchically frame the relationship between the observing self and
the content of self-critical thoughts
4. How to help clients identify values and develop valued action plans.

WP10: What did we learn from the pandemic? Using our enhanced
understanding of uncertainty to address life disruption, real world threats,
and unavoidable unknowns in people’s lives
Mark Freestone
Newcastle University, United Kingdom

What did we learn from the pandemic? Using our enhanced understanding of uncertainty to address life disruption,
real world threats, and unavoidable unknowns in people’s lives.
Intolerance of uncertainty (IU) has been established as a transdiagnostic vulnerability factor to various anxiety disor-
ders and other forms of emotional distress.
However, in recent years there is increasing evidence of IU as a trans-situational factor in both cross-sectional and
prospective studies. It is therefore of interest in understanding responses to and intervention strategies for what may
be understood as adjustment disorder. The workshop will briefly illustrate this with recent data on the prediction and
treatment of adjustment disorders. It will focus particularly on targets and intervention strategies and their applica-
tion in response to different situational stressors characterized by disruption, real world threat and uncertainties both
real and perceived.

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WP11: Brief Cognitive-Behavioral Group Therapy for Panic Disorder

Mehmet Hakan Türkçapar
University of Social Science, Psychology Department, Turkey

Kadir Özdel
University of Health Science, Etlik City Hospital, Psychiatry Clinic, Turkey

A panic attack can be defined from cognitive behavioral perspective as a sudden episode of cognitive, behavioral and
emotional reactions that reach a peak within minutes triggered by harmless (usually bodily) internal sensations. Panic
attacks are not specific for panic disorder in which the individual experiences unexpected panic attacks repeatedly
and worries about future panic attacks together with behavioral changes in maladaptive ways (e.g., avoidance of
exercise or of unfamiliar locations) (APA, 2013) .
From cognitive content specificity perspective (Woody, Taylor et al. 1998) , panic disorder is related to imminent dan-
ger cognitions which signify physical or mental catastrophe. Attentional bias toward danger signals, avoidance and
safety seeking behaviors are other mechanisms that maintain this clinical issue (Clark 1999) . In another words panic
disorder can be conceptualized as interoceptive sensations phobia with anticipatory anxiety.
Cognitive Behavioral Therapy (CBT) for panic disorder is excessively studied and confirmed as
an effective treatment option. Moreover, group CBT for panic disorder offers many advantageous like saving time and
money (Schwartze, Barkowski et al. 2017) even with shorter duration groups like 5-session group therapy (Yığman,
Efe et al. 2021) .
In this workshop we begin with a short introduction about panic disorder and its clinical features. This introduction
consists of current evidence for CBT group therapy for panic disorder. Then we discuss CBT models of panic disorder
and the relative importance and valance of the components of the models. After putting a general theoretical base
for the treatment, we kick off for the group therapy sessions step by step. We discuss pros and cons for the shorter
and longer protocols.
We will cover theoretically and practically following intervention areas during the workshop:
Psychoeducation (about the disorder, health issues, autonomic nervous system); cognitive restructuring of cata-
strophic thoughts and beliefs; behavioral experiment perspective for interoceptive exposure; cognitive restructuring
and behavioral experiment for agoraphobic beliefs; flexible attention management; termination and relapse preven-
tion.

WP12: CBT for Psychosis

Antonio Pinto
SITCC, APC,/SPC,CBT School, CEPICC, Department of Mental Health, Naples, Italy

WP13: Intensive Outpatient Treatment for Substance use Disorders in

Forensic/Correctional Populations
Ag Ahmed
College of Medicine, University of Saskatchewan, Canada

This workshop focuses on the development and implementation of a virtual intensive outpatient addiction treatment
program based on Rational Emotive Behavior Therapy (REBT). The program aims to provide individuals struggling
with addiction with a comprehensive and accessible treatment option that addresses the underlying beliefs and
thoughts contributing to addictive behaviors. This workshop outlines the structure and components of the program,
as well as its effectiveness in promoting recovery and long-term sobriety.
Learning Objectives:
1. Understand the core principles and techniques of REBT and their application in the treatment of addiction.
2. Explore the structure and components of a virtual intensive outpatient addiction treatment program.
3. Learn practical strategies and skills for challenging irrational beliefs, managing cravings, and preventing relapse.
4. Gain insights into the effectiveness of REBT-based virtual intensive outpatient addiction treatment programs
through research studies and clinical outcomes.

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WP14: Building an Effective Therapeutic Relationship in CBT

Keith Dobson
University of Calgary, Canada

An effective therapeutic relationship is the crucible in which CBT interventions are offered. A positive therapeutic
relationship provides the opportunity for therapeutic progress, while a difficult relationship creates challenges to the
treatment process, or even maintaining treatment at all. This workshop will review some of the principal aspects of a
positive therapeutic relationship in CBT and will encourage participants to consider their current ways of interacting
with clients. The workshop will emphasize strategies to build a positive therapeutic relationship, upon which thera-
peutic success can be built.
Learning objectives
1. Features of a positive therapeutic relationship n CBT
2. How the therapy alliance and relationship are typically measured in psychotherapy
3. Common challenges and obstacles to a positive therapy relationship
4. Strategies to address and overcome relationship challenges

WP15: #AppearanceAnxious- Investigating and treating Body image related

disorders in a digital world
Rachel Rodgers
Northeastern University, Boston

Fanny Diete
University of Osnabrueck, Germany

Body image and appearance related disorders are severe and impairing mental health concerns. Although their pre-
sentation may vary, they share commonalities such as an excessive preoccupation with appearance, and emotional,
cognitive, and behavioral reactivity to internal and external experiences that are appearance-related. Digital media,
and in particular photo-based social media have been implicated in increasing risk for these disorders, and potentially
their maintenance. In this workshop, we will focus on body Body Dismorphic Disorder, and Body Dissatisfaction as
overlapping but distinct forms of appearance concerns and outline the ways in which digital media contribute to
elevating risk of these concerns, as well as how they may be introduced into the clinical setting with a view to modi-
fying engagement with them. The workshop will be an interactive experience, and participants will come away with
a deepened understanding of the relationships between social media engagement and appearance concerns as well
as practical tools for working with these disorders.

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IN01: “Is it them, is it me, or is it us?”: working with interpersonal

process in CBT
Stirling Moorey
Independent CBT Practitioner, United Kingdom

Abstract
Unlike many psychotherapies, cognitive behaviour therapy does not view the therapeutic relationship as the primary
vehicle for change. Establishing a therapeutic relationship grounded in warmth, genuineness and empathy are con-
sidered necessary but not sufficient conditions, while therapists seek to develop a relationship where “collaborative
empiricism” allows patients to test their beliefs with the support of the therapist. The evidence for the place of Roge-
rian characteristics and the therapeutic alliance will be briefly reviewed and ways to enhance these considered. The
structure and form of CBT minimises the sort of regressive transference encouraged in other therapies, but as thera-
pists deal with increasingly complex clients negative therapeutic reactions are inevitable. The workshop will present
a framework for making decisions on when and how to focus on the therapist-client relationship in supervision. It will
show how we can translate “transference” and “countertransference” into more CBT friendly language by seeing it as
the interaction between the beliefs and schemas of therapist and client. Therapists may bring their own beliefs into
the session (e.g. “I must get all my patients better”). They may be overwhelmed by empathic overinvolvement (e.g.
“If I was in the situation I would be depressed too”). Or their own beliefs may clash or collude with the client’s beliefs
(e.g.a self sacrificing therapist may go above and beyond the call of duty for a dependent client). We will look at how
supervisors can help therapists identify and disentangle their own contribution from the client’s in understanding
therapeutic alliance ruptures and blocks to progress. There will be opportunities to formulate supervisees’ cases from
this perspective and to engage in an experiential exercise to empathise with a difficult client.

Keywords
Interpersonal process; transference; countertransference; therapeutic relationship

IN02: Perspective-taking interventions for shame and self-criticism

Richard Bennett
University of Birmingham, Colombia

Dawn Johnson
ACTivatingYourPractice.com, United Kingdom

Abstract
Perspective-taking is broadly defined as the ability to interpret and predict the cognitions, emotions and behaviours of
oneself and others. It is a skill that has been considered central to cognitive flexibility and adaptive behaviour change
in many domains, including maintaining individual wellbeing, healthy interpersonal relationships and strengthening
social bonds (Kavanagh et al., 2019).
The ability to respond adaptively to one’s own cognitions and emotions is crucial to the development of the self, and
this concept has been a feature of literature within CBT as far back as Skinner (1974). There is evidence of the efficacy
of perspective-taking interventions for ameliorating deficits (e.g. with children with ASD; MacDonald et al., 2006)
and in providing a rationale for psychotherapeutic interventions (e.g. relative benefits of different types of defusion
exercises in ACT; Foody et al., 2013).
This workshop will look at how behaviour-analytic principles can inform CBT interventions for clients prone to shame
and self-criticism. It will allow time to describe the relevant theoretical concepts and demonstrate clinical applications
of perspective-taking techniques, including interpersonal, spatial, and temporal perspective-taking methods. Practi-
cal demonstrations will be complemented with small group experiential exercises to allow delegates to practice the
skills and receive feedback from the facilitators.

Keywords
ACT, Acceptance and Commitment Therapy, perspective taking, shame, self-criticism, third wave CBT

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IN03: Overcoming addiction: a core process approach

Frank Ryan
Imperial College, United Kingdom

Abstract
The workshop focuses on core motivational and cognitive processes that contribute to the development, mainte-
nance and therapeutic remediation of addictive behaviour. The approach draws on recent findings stemming from
the Research Domains Criteria (RDoC) framework. This core process model can account for the development of ad-
diction with reference to two pathways, the Positive Valence System (PVS) and the Negative Valence System (NVS).
The PVS is concerned with the pursuit of rewards and the hedonic states associated with the consummation of these
rewards. In the present context, the focus is on the processing of rewards linked to substance use, gambling and
gaming. Conversely, the NVS responds to threat, anxiety and loss. In the context of addiction, the NVS is specifically
implicated when people attempt to “self-medicate” in the face of pervasive negative affect and in the subsequent
dysphoria associated with drug withdrawal or gambling losses. Participants will be introduced to a “cognitive-moti-
vational” approach that aims to translate these core processes into therapeutic competences. This provides a novel
therapeutic focus predominantly on reward processing via the PVS in tandem with a more traditional emphasis on
managing negative affect via the core component processes of the NVS. Examples of cognitive strategies that enable
and sustain goal pursuit and the experience of novel, or latterly neglected, harm free rewards (i.e those not associated
with addiction) are:
(i) Episodic future thinking, the construction of vivid multi -sensory prospective memories of positively toned future
outcomes and experiences.
(ii) The “Now vs Later” technique which guides the person to acknowledge the immediate (“now”) rewarding or he-
donic experience of choosing to use a substance or gamble in parallel with considering the delayed (“later”) conse-
quences.
(iii) The “If…then” anticipatory plan coaches the client to identify simple actions when encountering triggers for ad-
dictive behaviour e.g. “if I am offered a cigarette then I will say “no thanks, I’ve quit”.
(iv) Identifying and addressing unhelpful thoughts about pleasurable experience e.g” I don’t deserve this” or assump-
tions e.g. “If something good happens to me something bad will happen to me next” typically associated with the
attainment or consumption of rewards.
More general learning objectives will include:
• Formulation focused on core processes enabling tailored intervention.
• Understanding that a focus on the anticipation, pursuit and experience of rewards is pivotal in the development
of and recovery from addictive disorders.
• Conducting a motivational conversation in order to identify alternative, non-addictive, rewards.
• Appreciate that fostering clients’ emotional regulation strategies (including acceptance and mindfulness) is
complementary a focus on reward processing and key to sustaining change in the context of addiction.

Keywords
Addiction, reward processing, Research Domains Criteria, RDoC

IN04: Suicide risk assessment & management in DBT practice

Karolina Vörös
Schema Therapy Center Belgrade, Serbia

Dmitrii Pushkarev
BE Company Training (Serbia), Serbia

Abstract
• CBT is considered to be effective for managing suicide risk / preventing suicide [Tarrier et al., 2008; Labelle,
Janelle, 2015].
• DBT is a CBT treatment that is specifically designed to help chronically suicidal people [Linehan M., 1993]. DBT
is effective at reducing the amount of suicide attempts and at reducing the amount of time spent in crisis care
units [Linehan M., 2006]. There are meta-analyses confirming DBT effectiveness [Panos et al., 2014].
• DBT implements a special protocol for suicide risk assessment & management – LRAMP (Linehan Risk Assess-
ment & Management Protocol) [Linehan M., 1993].
• LRAMP is used to assess acute suicide risk and in it’s assesment part has similarities to Columbia Suicide Severity
Rating Scale (CSSR-S) [Posner et al., 2011].

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• For risk management LRAMP implements behavioral analysis, some specific DBT strategies, as well safety plan-
ning instrument. Safety Planning is an evidence based instrument designed to manage suicide risk [Stanley B.
et al., 2018].
Key learning objectives:
• To differentiate chronic and acute suicidal risk, to know and recognize client populations with high chronic
suicidal risk
• Learn and use basic validation strategies to handle conversation with a suicidal individual
• To use LRAMP for assessment of acute suicidal risk
• To implement Safety Planning for suicide risk management
The implications for everyday CBT practice:
• Suicide risk assessment & management instruments, such as LRAMP and Safety Planning, can be used in every-
day CBT practice (not only within a specialized treatment such as DBT).
• Chronically highly suicidal clients still might be in need of more intensive / specialized care
The language of the workshop will be English, while the presentation and the printed material will be provid-
ed in Serbian, too. The practical part of the workshop can be done in the language by choice, so the partici-
pants can practice using the language they use in their psychotherapy setting. // Radionica će biti na engleskom
jeziku, dok će prezentacija i štampani materijal biti obezbeđen i na srpskom jeziku. Praktični deo radionice će
biti moguće raditi na jeziku po svom izboru, kako bi svi učesnici mogli da vežbaju koristeći jezik koji koriste u terapi-
jskom setingu.

Keywords Suicide risk, assessment, DBT

IN05: Positive CBT: a new age of CBT

Fredrike Bannink
Owner, Netherlands

Abstract
In today’s world with so many problems, a new age of CBT calls for a more positive perspective on traditional CBT. As
the next frontier, Positive CBT offers a different approach not only for our clients, but also for ourselves, therapists, as
an antidote against burnout and general negativity.
The implications for the everyday practice are that therapists, using the Positive CBT approach, are able to do more
than just symptom reduction. They invite their clients to think differently, describe their preferred future, notice pos-
itive differences, and make progress. Conversations become more positive, hopeful and lighthearted, ensuring less
burnout amongst therapists.
Research comparing Positive CBT with tradition, problem-focused, CBT in the treatment of depression shows that
Positive CBT is superior to traditional CBT. And that both clients and therapists prefer Positive CBT over traditional CBT.

Keywords
Positive CBT, positive cognitive behavioral therapy, synthesis paradigm, hope

IN06: Super Skills for Life: Transdiagnostic CBT based program to prevent
anxiety and depression in children and adolescents
Cecilia Essau
University of Roehampton, United Kingdom

Abstract
Cognitive-behavioral therapy (CBT) has a strong evidence base for preventing anxiety and depression in adolescents,
with up to 65% of adolescents showed significant improvement in anxiety- and depression-related outcomes to CBT.
However, despite strong evidence that lifestyle factors (e.g., exercise, diet and sleep), benefit mental health, interven-
tion programs that integrate healthy lifestyle habits within CBT-based interventions to address anxiety and depres-
sion are currently lacking.
This workshop will focus on “Super Skills for Life” program (SSL), a transdiagnostic CBT-based program for preventing
anxiety and depression and for promoting healthy lifestyles. SSL focuses on: (1) teaching about healthy lifestyles;
(2) building emotional resilience through stress management; (3) encouraging peer learning and building peer net-

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works; and (4) promoting self-confidence and social skills.
By using a “train-the-trainer approach”, SSL training has built capacity and shaped the practice of 25,000 practitioners
and has produced positive mental health outcomes in approximately one million young people in 21 countries.
Key Learning Objectives
At the conclusion of the workshop, participants should have a good knowledge of:
- The prevalence, comorbidity, course, and cultural manifestations of anxiety and depression in children and adoles-
cents.
- The core components of the “Super Skills for Life” program.
- Skills in delivering the core components of the “Super Skills for Life”.
- Barriers and challenges in adapting evidence-based CBT-based intervention across cultures.
Training Modalities
Techniques used in the Super Skills for Life program will be described and illustrated through lecture, role play, and
video clips.

Keywords
Transdiagnostic; Childhood Anxiety; Depression; Healthy lifestyles

IN08: How to effectively combine Motivational Interviewing with Cognitive

Behaviour Therapy
Georgi Vasilev
Bulgarian Addictions Institute, Bulgaria
Kiril Bozgunov
Bulgarian Addictions Institute, Bulgaria
Dimitar Nedelchev
Bulgarian Association of Motivational Interviewing, Bulgaria

Abstract
There has been substantial evidence and practice during the last decades about the effective combination between
Motivational Interviewing (MI) and Cognitive-behavioral Therapy (CBT) as the leading evidence-based contemporary
psychotherapeutic approaches. The studies show that the combination results in increased therapeutic effectiveness
compared to their independent use.
The current workshop is presenting the Bulgarian experience in combining MI and CBT during the last decade and
features upgrades of the previous workshop on this topic presented at EABCT 2018 in Sofia, Bulgaria. The workshop
consists of two parts. The first part includes an introduction to MI with a short description of the spirit, main tech-
niques, therapists’ reaction to client language and the main tasks of MI that are introduced by means of didactic
presentations and a set of interactive exercises. The second part consists of short theoretical introduction to the com-
bination of MI and CBT and practical exercises that illustrate the ideas how MI and CBT could be combined – i.e. 1) the
use of MI as a prelude to CBT aiming at building the therapeutic relationship and the client’s motivation for change;
2) Blending of MI and CBT during the whole duration of the treatment. The workshop will be a flexible mix of short
theoretical presentations, group discussions and interactive exercises reflecting the theoretical development and the
practical experience in the field during the last decade.

Keywords
Motivational Interviewing, Combination with CBT

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IN09: The road to happiness: Facilitating positive emotions in clients

Tammie Ronen
Tel-Aviv University, Israel
Yair Dangoor
Tel-Aviv University, Israel

Abstract
The last decade has seen an increase in the rates of anxiety, fear, stress, and trauma. Concurrently, there is an increased
understanding that humans can live better, improve their wellbeing, and flourish. Studies in the area of CBT and posi-
tive psychology have laid the groundwork for understanding the role of positive emotions in the ability to be satisfied
with life and happy. Thus, we can see a growing interest in the role of emotions in general, and the ability to express
positive emotions, in particular.
The workshop combines theory, practice, demonstrations and research outcomes.
There will be four parts:
First, there will be a short presentation on the basic components of positive psychology integrated with basic CBT:
subjective wellbeing, positive affect, happiness, positivity ratio, satisfaction with life, strength and virtues and the way
they help people flourish.
Second, there will be a presentation of the developmental nature of emotion through 5 basic steps: expressing emo-
tion, identifying emotion, accepting emotion in self and others, understanding emotion and controlling emotion, all
of which help people to enhance positive emotions.
Third, research studies on the role of positive emotions in mediating the link between crisis, stress, difficulties and
flourishing will be presented.
Fourth, the workshop will focus on innovative ways to increase positive emotions among clients in CBT therapy using
verbal individual and group therapy, as well as non-verbal approaches, such as art, sport and music.
Objective:
To learn the role of change processes, emotional development, emotion, flourishing, virtues and strength.
The participants will exercise ways to express, identify and increase positive emotions in themselves and their clients.
The workshop combines lectures, demonstrations, exercises, practice and training.

Keywords
Emotion, satisfaction with life, happiness, flourishing, change process , skills

IN10: Process-based Case Conceptualization:

A collaborative and empiric approach
Céline Baeyens
Université de Grenoble Alpes, France
Martine Bouvard
Université de Savoie Mont-Blanc, France
Nathalie Fournet
Université de Savoie Mont-Blanc, France
Pierre Philippot
UCLouvain, Belgium

Abstract
Many psychological disorders are characterized by common processes that are responsible for their development and
maintenance. In fact, a limited set of psychological processes explains most of the psychopathological phenomena
observed in mood and anxiety disorders. These processes include, for example, experiential avoidance, rumination
or intolerance of uncertainty. The transdiagnostic approach posits that treatments should specifically target the pro-
cesses that maintain the disorder in a given individual. From this perspective, case conceptualization, aimed at identi-
fying active ethiopathogenic processes, is of particular importance. Furthermore, case conceptualization constitutes
a privileged moment for building the therapeutic relationship and research suggests that unsuccessful interventions
are often due to inappropriate target identification during case conceptualization.
The workshop will present a process-based case conceptualization methodology. In the spirit of collaborative empir-
icism, it is based on the co-construction of two models with the client. In the first stage, a holistic model is used to
account for the entire situation presented by the client, and to select the psychological problem on which the inter-

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vention will focus. Secondly, a process-based functional model identifies the specific psychological processes that are
responsible for maintaining this problem, and which will therefore be the focus of the intervention. This latter model
is an extension of the SORC model.
After a brief presentation of the theoretical foundations of process-based case conceptualization, we will present a
concrete application through two case studies illustrated by role-playing. During this presentation, the different steps
and procedures will be presented in a concrete way. Participants will then be invited to apply this conceptualization
method to one of their own cases, in small groups supervised by one of the instructors. They will also be invited to
role-play certain steps in these small groups.

Keywords
Case conceptualization

IN11: Managing couple’s problems with Rational Emotive Behavior Therapy

(REBT)
Maria Celeste Airaldi
International Association for Rational Emotive Behavior Therapy, Paraguay

Abstract
REBT is the first cognitive-behavioral therapy, developed by Albert Ellis in 1955. When applied to couple and relation-
ship’s problems, it focuses on a variety of cognitive, behavioral, and emotive clinical resources to help clients overcome
their emotional problems and dissatisfaction related to relationships. One of its key features is the emphasis REBT puts
on identifying and disputing the irrational beliefs the clients hold about how the partner (and the relationship itself )
should be, to be able to develop unconditional acceptance and frustration tolerance as a way to promote wellbeing.
In this workshop, participants will learn how REBT conceptualizes relationship’s problems and what are the most
frequent irrational beliefs that perpetuate them. Cognitive, behavioral, and emotive clinical resources to address cou-
ple’s problems will be presented and a brief live session will be demonstrated.

Keywords
REBT, couple’s therapy, relationships, irrational beliefs

IN12: CBT for Chronic Pain – evidence based approaches to support self-
management of persistent pain
Helen Macdonald
BABCP, United Kingdom

Abstract
• Very short scientific background
• Persistent pain affects up to 30% of the global population, having a significant impact on the individual. People
with pain and other long term health conditions have poorer outcomes in mental and physical health as well
as having high healthcare costs. CBT-based interventions are effective in improving depression, anxiety, overall
functioning despite ongoing pain and improved quality of life.
• Key learning objectives
• In this workshop, participants will
- enhance their application of a bio-psycho-social approach to understanding persistent pain
- practice skills in assessment of the impact of pain and using detailed case conceptualisation
- enhance their use of a flexible and creative approach to applying evidence-based interventions which promote
self-management of long term pain

Keywords
CBT for Chronic and Persistent Pain Long term conditions self-management

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IN13: Reinventing the Therapeutic Relationship in Schema Therapy Supervi-

sion by Using Group Schema mode Role-play Technique
Zsolt Unoka
Semmelweis University – Medicine and Health Sciences, Hungary

Abstract
We aim to introduce a supervision technique that targets problematic interaction sequences in the therapeutic re-
lationship. The aim of the workshop is to help supervisees gain a better understanding of the complex interaction
patterns between their and their patients’ schema modes by the group dramatizing and acting out the modes. Partic-
ipants acting out the interaction sequences of the therapist and the patient’s child, critical parent, and coping modes
will share reflections that will contribute to the supervisee’s comprehension of the processes that characterize the
regulation of the therapeutic relationship. They will also gain new insights by actively participating in the schema
mode role-play technique.
We start with a short theoretical summary of the schema mode theory. As often limited reparenting is impaired by
the therapist having received unhelpful messages from professional/instituational „figures” we have extended the
mode theory and included the critical supervisor role (as part of the critical parent mode). We will also focus on the
healthy adult therapist mode and give examples of the typical schema mode interaction sequences between patient
and therapist. After the PowerPoint presentation, we will present our schemamode-drama supervision model by do-
ing a role-play demonstration with the group’s participation. The aim of the role -play is to help supervisees with the
following:
Mode awareness: identifying different modes and sequences of their own and their patient’s mode flips and the in-
teraction between these modes.
Mode managements: The aim of this part is to will help the supervisee understand their patient’s core needs and
reach the patient’s child modes. It will also be beneficial in rearranging the therapist’s maladaptive coping modes and
strengthen the healthy adult therapist mode, replace internalized punitive messages with Good parent /supervisor,
etc., and empathize with their own child modes and core needs.
Behavior pattern breaking: Finally, the group will create and act out a new patient-therapist mode interaction se-
quence where the Healthy adult therapist behaves more adaptively than in the original situation.
This method will allow participants to gain a new insight into the interaction of the moment-to-moment mode-flips
in the therapeutic relationship. The dramatization of the interaction process helps participants restructure the rapidly
changing therapeutic relationship if needed and to understand needs, coping, internalized parental/professional/
institutional others that may block effective therapeutic work. The advantage of the group format is that group mem-
bers have a chance to contribute by sharing what they experienced when in a mode role. In addition, the group
setting also allows participants to gain more schema mode awareness, self-reflection, and practice schema mode
management. Based on the previous feedback, we can say that the group schema mode drama supervision helps the
therapist develop a very accurate representation of patient-therapist schema mode interaction. It also makes it possi-
ble for therapists to be simultaneously aware of their own and their patient’s needs, child modes, coping, and critical
modes. Following the Deliberate Practice modell our aim is to identify interpersonal skill deficits and develope and
practice new skills for self-reflections, and mutual emotion regulation skills in the therapeutic relationship.

Keywords
Group-supervision, schema-modes, dramatic role-play, therapeutic interaction patterns

IN14: A practical introduction to providing psychological therapies to

ethnically and religiously diverse communities
Andrew Beck
Bradford Teaching Hospitals NHS Trust, United Kingdom

Abstract
This workshop is designed to introduce therapists working in mental health services to the broad ideas that underpin
adapting therapies largely developed for majority populations to increase their effectiveness and accessibility for mi-
noritised communities. The workshop is based on the key principles of the IAPT BAME Positive Practice Guide (2019)
which has been used to reduce the access and outcomes gap for minority communities in England. Most ethnic mi-
nority patients had much worse outcomes than white majority patients in therapy but this gap has closed for most
communities and is closing for others.

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This engaging workshops start with first principles of why adaptation of therapies is important and then uses case
examples to steer participants through the key skills necessary to make those adaptions. The workshop includes con-
sideration of the way that culture shapes people’s understanding of mental health difficulties and so informs the way
they seek help, looks at the role of spirituality and faith in mental health treatments, outlines the impact that experi-
ences of racism and other forms of discrimination can have on mental health and provides therapists with the skills to
respond to this effectively. The workshop includes an overview of the importance of maintaining cultural humility in
the way that we offer and think about treatments.
The key learning outcomes are:
• Understanding the needs of the communities served
• Asking about and understanding the ethnic and religious background of service users
• Understanding the role of family systems in someone’s life
• Understanding how therapists can work with cultural and spiritual beliefs about the causes of emotional distress
• Recognising the impact of discrimination and racism on mental health

Keywords
marginalisation adaptation equality diversity racism

IN15: Neuroscience-Based Cognitive Therapy for Schizophrenic Patients

Tullio Scrimali
University of Catania, Italy

The workshop is focused in demonstrating and discussing the important topic concerning how some recent develop-
ments of Neuroscience can be applied to better the clinical intervention when carrying out a Cognitive Therapy with
patients affected by schizophrenia, according to the protocol developed by the Author (Scrimali, 2008). A method,
coming from Neuroscience Laboratories, that can be easily applied to the clinic setting of Cognitive Therapy, will be
illustrated, and explained. This is Quantitative Electrodermal Activity and Biofeedback (Scrimali, 2012).
Such parameter, today, can be monitorized, in the clinical setting, thanks to some new hardware and software which
are inexpensive and that can be easily used, after a short training, by any CBT Therapist. Quantitative Monitoring of
Electrodermal Activity is a new method that Tullio Scrimali developed and experimented for many years. This method
is the simplest to be put into practice in CBT and it is also the less expensive. A new tool, called MindLAB Set, devel-
oped by Tullio Scrimali, will be carefully explained.
It can be used, both when assessing the patient, and during the treatment. It allows any CBT Therapist and Psychia-
trist, to make in place some interesting new methods of self-regulation such as biofeedback and Biofeedback Based
Mindfulness.
MindLAB Set is also very useful for monitoring the arousal and the warning signs of relapse and for preventing any
further psychotic crisis.
Furthermore, MindLAB Set allows any Therapist to apply the Family Strange Situation Procedure, an original method,
developed by Scrimali, for assessing Expressed Emotion in the family of schizophrenic patients.
Some MindLAB Set will be at disposal of the audience for practicing during the workshop that includes some practical
trials, both in the field of assessment and in that of self-regulation.

IN16: Prolonged Exposure Therapy for PTSD

Maria Bragesjö
Center for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden

Join us for a one-day interactive workshop on Prolonged Exposure Therapy (PE) for PTSD. This workshop is designed
for mental health professionals who want to improve their skills in the application of PE. At the same time, you will
learn about the challenges and new perspectives on the mechanisms of change and their clinical implications when
conducting Prolonged Exposure. The workshop will be a dynamic learning experience through lecturing, discussions,
recorded therapy sessions, and participant role-play with feedback.
Key components of the workshop:
- Understanding the theory of emotional processing
- Understand the mechanisms of change in PE
- Understand how more intensive treatment approaches can reduce dropout rates in PE
- Be able to adapt PE to individual client responses

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IN17: Externalisation and behavioural experiments as therapy for OCD in

children and adolescents
Miodrag Stanković
Medical Faculty University of Nis, Serbia, Serbia

Abstract
This workshop focuses on use of externalisation and behavioural experiments in the treatment of Obsessive-Com-
pulsive Disorder (OCD) in children and adolescents. Externalisation is a narrative therapy technique that helps young
clients distance themselves from their OCD symptoms, empowering them to combat “the OCD” rather than feeling
defined by it. This workshop will teach practitioners how to effectively employ externalisation to enhance motivation
in young clients. Through role-playing and case studies, participants will learn to help children and adolescents ar-
ticulate their experiences and develop a new perspective on their relationship with OCD. Behavioural experiments, a
cornerstone of CBT, will be tailored specifically for young clients in this workshop. These experiments are designed to
test and challenge the beliefs and fears underlying OCD symptoms. Attendees will learn to create developmentally
appropriate experiments that engage young clients in active problem-solving and evidence gathering. The workshop
will cover strategies for designing, implementing, and evaluating these experiments, ensuring they are both effective
and engaging for children and adolescents.
Interactive sessions will include demonstrations and hands-on practice, to foster a collaborative learning environ-
ment. Participants will gain practical skills and confidence in using these techniques to help young clients achieve
significant symptom relief and improved functioning.
This workshop is for psychologists, (child and adolescent) psychiatrist , social workers, and other mental health profes-
sionals working with children and adolescents. It aims to provide participants with innovative tools to enhance their
therapeutic practice and improve the lives of young clients with OCD.

Keywords
Externalisation, Behavioural Experiment, OCD, Children and Adolescents

IN18: After the Heartbreak: Understanding and Treatment of Infidelity in CB

Couples Therapy
Josko Jurman
Croatian Association for Behavioral and Cognitive Therapy, Croatia
Nada Anić
Croatian Association for Behavioral and Cognitive Therapies, Croatia

Abstract
Infidelity is one of the most common reasons for attending couples therapy. This workshop will demonstrate the as-
sessment procedure and treatment plan for addressing infidelity.
Individuals who discover infidelity often feel emotionally overwhelmed by a highly unpleasant and disturbing mix-
ture of emotions. Emotional distress is usually strongly influenced by cognitions related to infidelity, including expec-
tations, attitudes, and rules about what should be done and what reactions must occur.
CBT targets these cognitions and their impact on emotions and behavior to help clients cope with infidelity. During
the workshop, participants will be encouraged to explore their own beliefs about infidelity because, as we know, our
own beliefs can influence therapeutic process.
The workshop is divided into three parts:
1. CB Model for Understanding Infidelity: Exploring cognitive-behavioral frameworks for understanding the
dynamics of infidelity.
2. Treatment Plans: Developing and implementing effective treatment plans to address infidelity in couples
therapy.
3. Rebuilding Confidence: Strategies for moving forward and rebuilding trust and confidence in the relation-
ship.
Learning Objectives:
1. Understanding the Cognitive-Behavioral Model for Infidelity:
• Participants will gain insight into the cognitive-behavioral model’s application in understanding the com-
plexities of infidelity within relationships.
2. Mastering Assessment Procedures:

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• Attendees will learn effective assessment techniques to identify underlying beliefs, attitudes, and behav-
ioral patterns contributing to infidelity.
3. Developing Tailored Treatment Plans:
• Through case studies and interactive exercises, participants will learn how to develop personalized treat-
ment plans that address the unique needs and challenges of couples affected by infidelity.
4. Enhancing Communication and Coping Skills:
• Participants will acquire practical strategies for improving communication, managing emotions, and cop-
ing with triggers related to infidelity.
5. Fostering Trust and Rebuilding Intimacy:
• Attendees will explore evidence-based techniques for rebuilding trust, fostering intimacy, and strengthen-
ing the foundation of the relationship post-infidelity.
Implications for everyday clinical practice of CBT:
1. Improved Clinical Competence:
• By mastering CBT techniques specific to infidelity, therapists can enhance their clinical competence in
addressing one of the most common challenges faced by couples in therapy.
2. Enhanced Client Outcomes:
• Implementing the strategies learned in this workshop can lead to improved client outcomes, including
reduced distress, increased relationship satisfaction, and better communication skills.
3. Continued Professional Development:
• This workshop provides a foundation for ongoing professional development, encouraging therapists to
stay updated on the latest techniques in the field of couples therapy and infidelity treatment.

Keywords
infidelity, beliefs, couples, cognitions

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PD1: When Should We Reflect on the Past versus Think

about the Future in CBT?
Hila Sorka
The Hebrew University of Jerusalem, Israel
Iris Engelhard
Utrecht University, Netherlands
Stefan Hofmann
Philipps University Marburg, Germany
Jonathan D. Huppert
The Hebrew University of Jerusalem, Israel
Paul Salkovskis
Oxford University, United Kingdom

Abstract
This panel debate aims to enrich the understanding of how temporal focus in CBT can be optimized for treating dif-
ferent psychological disorders, offering nuanced insights into the strategic clinical decisions that enhance therapeutic
outcomes. Participants of the discussion include international experts in CBT who have different emphases and per-
spectives on this issue. They include: Iris Engelhard, Stefan Hofmann, Jonathan Huppert, and Paul Salkovskis.
Prevailing cognitive models of anxiety and related disorders predominantly prioritize anticipatory mechanisms,
where clinical emphasis is placed on patients’ expectations and fears concerning present and future events. This
forward-looking approach forms the cornerstone of traditional CBT techniques, which aim to modify dysfunctional
thinking and behavior through strategies to modify future-oriented predictions. However, the treatment of PTSD ne-
cessitates a distinct therapeutic focus, centrally via the processing of past traumatic events. However, more recently,
there has been a blurring of the past-future boundaries: novel interventions for anxiety and related disorders have
started to integrate processing of past events (particularly, but not only, for non-responders) and future expectations
are addressed in the treatment of PTSD. This integration has sparked potential advancements in therapeutic practices,
particularly by adopting techniques including imagery rescripting and imaginal exposure. These methods, originally
developed for PTSD, are now being effectively applied to a broader spectrum of psychological issues, directing atten-
tion to traumatic or distressing memories to alter their emotional impact and cognitive interpretations.
This expansion raises a critical clinical decision-making point concerning the temporal focus in therapeutic interven-
tions: when is it appropriate to concentrate on past events versus future-oriented concerns? Addressing this question,
our debate convenes international experts in CBT, who will explore the implications of choosing between these tem-
poral orientations. The discussion will center around the clinical choice points of when to use past-focused techniques
such as imagery rescripting or imaginal exposure along with or instead of traditional present and future-focused CBT
approaches. The discussion will include questions such as “What factors influence this choice?” and “Does the nature
of the disorder matter?”.

Keywords
CBT; Temporal focus; Imagery; Flashforwards; Trauma; Anxiety

PD2: Issues regarding the training and delivery of evidence based CBT
interventions to refugees - experiences from EABCT member associations
Katy Grazebrook
EABCT President
Anca Dobrean
Babes-Bolyai University, Romania
Monica Bartucz
Dept of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Romania, Romania
Valentyna Parobii
Ukranian Institute of CBT; Psychotherapiepraktijk Keuze: Trauma Therapy and Training Choice; Ukranian Association
of CBT, international representative., Ukraine
Agnieszka Popiel
SWPS University of Social Sciences and Humanities, Warsaw; Polish Association for Cognitive Behaviour Therapy,
International representative., Poland

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 PANEL DEBATE
Diana Ridic
Counselling Centre Domino, Bosnia & Herzegovina; Bosnia & Herzegovina Cognitive Behaviour Therapy Association,
international representative.
Kerry Young
Woodfield Trauma Service, London, UK, United Kingdom
Ketevan Abdushelishvili
Caucasus School of Humanities and Social Sciences, Caucasus University, Tbilisi; Faculty of Psychology and Educa-
tional Science, Dept of Psychology, Tbilisi State University; Tbilisi Family Mental Health Center, Tbilisi, Georgia

Abstract
Issues regarding the training and delivery of evidence based CBT interventions to refugees - experiences from EABCT
member associations in response to the war in Ukraine.
The humanitarian crises of displaced people caused by wars and natural disasters in Europe have a ripple effect across
neighbouring countries and beyond. EABCT is in a prime position to see and hear about the mental health impact of
such events. The EABCT working group on Humanitarian Crises Response Resources would like to share the experi-
ences of members of the group in setting up evidence based training and interventions aimed at supporting refugees
following the humanitarian crisis in Ukraine.
The experiences range from delivering ‘CBT for Trauma’ training in Romania; Identifying the psychosocial needs and
delivering support for Ukranian refugees in Georgia, Poland, Romania and Slovenia; obstacles to delivery such as
regulation and funding; adaptation of CBT and the needs of supervises in Bosnia; issues of access, therapist skills and
confidence - learning from the UK.

Keywords
Refugees, Trauma, access

PD3: Metacognitive perspectives on psychiatric disorders

Gül Teks n
Sisli Hamidiye Etfal Research and Training Hospital, Turkey
Gulsen Teksin
Tekirdağ Namık Kemal University, Department of Psychiatry, Turkey
Özge Şahmelikoğlu Onur
3rd Psychiatry Clinic, Bakirkoy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery, Turkey

Abstract
Psychiatric disorders have long been studied through various lenses, yet the metacognitive perspective offers unique
insights into their understanding and treatment. This panel aims to explore the role of metacognition in three specific
psychiatric conditions: Bipolar Disorder, Obsessive-Compulsive Disorder (OCD), and Vaginismus. By examining these
disorders through the metacognitive framework, we can better understand how individuals process and regulate
their thoughts and beliefs, which in turn affects the emotional and behavioral responses.
Metacognitive Perspectives on Bipolar Disorder: Bipolar disorder is characterized by extreme mood swings between
mania and depression. From a metacognitive standpoint, individuals with Bipolar Disorder may struggle with dys-
functional beliefs about their cognitive processes. For example, during manic episodes, they may overestimate their
cognitive abilities and engage in risky behaviors. In contrast, during depressive episodes, they may have pervasive
negative thoughts about their self-worth and future. This segment will explore how metacognitive therapy (MCT) can
help patients recognize and alter these dysfunctional beliefs, promoting more stable mood regulation.
Metacognitive Perspectives on Obsessive-Compulsive Disorder (OCD): OCD is marked by intrusive thoughts and com-
pulsive behaviors. The metacognitive model posits that individuals with OCD have maladaptive beliefs about the
significance and control of their thoughts. They often believe that having a thought is as bad as acting on it, leading to
heightened anxiety and compulsions aimed at neutralizing these thoughts. This section will discuss how MCT targets
these metacognitive beliefs, helping individuals to understand that thought.
Metacognitive Perspectives on Vaginismus: Vaginismus, a condition characterized by involuntary contraction of the
vaginal muscles during attempted intercourse, is often rooted in psychological factors. From a metacognitive per-
spective, women with vaginismus may have negative beliefs about their bodily sensations and sexual experiences.
They might anticipate pain and failure, which exacerbates anxiety and the physical response. This part of the panel
will examine how MCT can help patients challenge and change these metacognitive beliefs, reducing anxiety and
improving sexual function.
By focusing on these three conditions, the panel will highlight the broad applicability of the metacognitive approach
in understanding and treating psychiatric disorders. It will also provide practical insights into how metacognitive ther-

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apy can be implemented to address specific cognitive and emotional patterns associated with each disorder. Through
this exploration, we aim to demonstrate that metacognitive perspectives deepen our comprehension of psychiatric
conditions and offer effective therapeutic strategies to enhance patient outcomes.

Keywords
Metacognitive Therapy, Bipolar Disorder, Obsessive-Compulsive Disorder, Vaginismus, PsychiatricDisorders, Cognitive
Beliefs

PD5: Trauma-Informed Education in European Universities: Enhancing

Teaching Practices through the Trauma Studies EuniWell Project
Abdel. H. Boudoukha
Nantes University, France
Anna Menyhért
University of Florence, Italy
Zsolt Unoka
Semmelweis University – Medicine and Health Sciences, Hungary
Svitlana Paschenko
National Taras Shevchenko University of Kyiv, Ukraine
Evelyn Levay
Semmelweis University – Medicine and Health Sciences, Hungary
Liliia Sirokha
Taras Shevchenko National University of Kyiv, Ukraine
Lilla Gerlinger
Semmelweis University – Medicine and Health Sciences, Hungary
Beatrice Tottossy
Università degli Studi di Firenze (University of Florence), Italy

Abstract
Exposure to trauma is a common experience throughout one’s lifetime, as consistently demonstrated by epidemio-
logical studies worldwide (Benjet et al., 2016; Kessler et al., 2017). This exposure is linked to a wide range of symptoms
and disorders, including PTSD, depression, anxiety, interpersonal difficulties, sexual problems, and sleep disturbances.
Additionally, trauma has a cultural dimension, where collective experiences of trauma can profoundly impact group
identity and consciousness. Preventing the development of such symptoms and conditions is advocated by major
health organizations, including the WHO and EABCT.
In light of this, Trauma-Informed Education offers a promising approach. This panel debate aims to explore how trau-
ma studies are taught in four European universities (Italy, France, Hungary, and Ukraine). With funding from EUniWell
(European University for Well-Being), we conducted a survey involving over 800 students, investigating their current
knowledge of psychological and cultural trauma and their interest in specific trauma-related topics.

Keywords
Trauma, teaching, education, students

PD6: EABCT panel: From understanding to wise change. European

perspectives on diversity in CBT
Katy Grazebrook
EABCT President
Irina Lazarova
Bulgarian Association for Cognitive-Behavioral Psychotherapy, Bulgaria
Diana Ridic
Psychological Counselling Centre, Domino and Bosnia and Herzegovina Association for Cognitive Behaviour Thera-
py (BHACBT)

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Adela Salceanu
Romanian Association for Behavioural and Cognitive Therapy (RABCT - Bucarest), Romania
Maria Evangelopoulou
Greek Association for Behavioural Modification and Research (GBA), Greece
Peter Phiri
University of Southampton, United Kingdom
Andrew Beck
Bradford Teaching Hospitals NHS Trust, United Kingdom

Abstract
Chair Katy Grazebrook, President of the EABCT
Each country within Europe has unique challenges in terms of understanding and meeting the mental health needs
of the diverse communities within that country. EABCT member organisations are beginning to work across national
borders to share good practice and develop better ways of working to ensure equality, diversity and inclusion are at
the heart of training, accreditation and the provision of therapy. This session will provide and opportunity to look at
initiatives where sexuality, ethnicity, migration status, religion and gender are considered by member organisations.
Irina Lazarova and Diana Ridjic
How CBT students from Bosnia and Bulgaria perceive iconic women in Cognitive Behavioural Therapy
Adela Salceanu and Maria Evangelopoulou
Steps towards a more inclusive perspective within our CBT Associations – the Romanian and Greek example
Peter Phiri
The role of an Equality, Diversity and Inclusion lead on a conference organising committee
Andrew Beck
Audits can be a lot more interesting than you think! How the National Health Service and the British Association of
Cognitive and Behavioural Psychotherapies have used audits to become more inclusive organisations and improve
patient outcomes

Keywords
diversity, CBT associations

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PD7: Razumevanje mentalnog zdravlja u digitalnoj eri: uloga KBT za

milenijalce
Ivana Vračkić
SRABCT, Serbia
Miodrag Stanković
Medical Faculty University of Nis, Serbia, Serbia
Branislava Krasić
SRABCT, Serbia
Ana Milenković
SRABCT, Serbia
Maja Todorović
SRABCT, Serbia

Abstract
As millennials navigate the complexities of the digital age, their mental health faces unique challenges which indicate
innovative approaches for support and intervention. This panel debate explores the intersection of millennial mental
health with cognitive behavioral therapy (CBT), shedding light on how this evidence-based approach can empower
individuals in the digital landscape. The panel starts with the landscape of millennial mental health, highlighting the
impact of social media comparison, information overload, and work-life balance struggles. The idea is to illustrate
how CBT principles resonate with these challenges, offering practical tools for managing stress, challenging distort-
ed thinking patterns, and enhancing resilience. The panel folows discussion on harnessing technology for mental
wellness which explores the huge number of digital platforms, from mobile apps to virtual reality interventions. The
discussion will lean on how CBT is integrated into these innovations while addressing concerns about their efficacy
and ethical issues. Taking into the consideration cultural and societal factors influencing millennial mental health,
the panelist will emphasize the importance of addressing stigma, promoting inclusivity, and adapting CBT to diverse
cultural contexts. Within evolving role of CBT personalized mental health services, the panel will discuss the land-
scape shaped by teletherapy and AI-driven interventions. Although many find online mental health platforms are
very useful because they are convenient, ensure privacy, are cost-effective, have a variety of modalities, there are also
potential risks to it such as the lack of personal conections, limited effectiveness, risk of misdiagnosis or problems in
treatment. By synthesizing different perspectives, this panel debate offers insights into the multifaceted nature of
millennials’ mental health and the pivotal role of CBT in fostering resilience, empowerment, and selfcare in the digital
era. This approach recognizes the complexity of mental health challenges faced by millennials and the importance of
evidence-based interventions in addressing them effectively.

Keywords
millennials, mental health, cognitive behavioral therapy, digital age

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RT1: Addiction and Mindfulness

Ezgi Uzun
Medicana Ataköy Hastanesi, Turkey
Ece Ilgin
Marmara University Research & Training Hospital, Turkey
Alexander Kancsev
Faculty of Health Sciences at the University, Debrecen, Hungary
Nikola Petrović
Department of Psychology, Faculty of Philosophy, Belgrade, Serbia

Abstract
Despite addiction in general proved to be harmful and life limiting, addiction continues to be growing problem. there
are adverse effects linked to substance use, including issues with mental health, increased level of unemployment
and difficulties finding a job, etc.
Studies conducted in this field has shown that the use of mindfulness techniques could be effective when it comes
to addiction treatment (e.g., Byrne et al., 2019; Cavicchioli et al., 2018). Rosenthal and colleagues’ 2021 study that
evaluated various meta-analyses concluded that the use of mindfulness-based interventions in addiction treatment
is promising, however, more studies should be conducted for further clinical findings.
The authors will talk about their cases and what issues arise from using mindfulness with people with addictions. The
authors will also talk about the ways in which future research should be widened in order to better understand the
mechanisms through which mindfulness exerts its effects. Additionally, expanding research in this area could help
identify which specific mindfulness techniques are most effective for different types of addiction. This deeper under-
standing can lead to more targeted and efficient treatment programs, ultimately contributing to more sustainable
recovery outcomes for individuals struggling with addiction.

Keywords
addictions, mindfulness, case studies

RT2: Accompany woman in the transition to motherhood

Menekse Sila Yazar
Altinbas University Faculty of Medicine, Department of Psychiatry, Turkey
Kumru Şenyaşar Meterelliyoz
Bakirköy Prof. Dr. Mazhar Osman Ruh Sağliği Ve Hastaliklari Eğitim Araştırma , Turkey
Özlem Baş Uluyol
Şehit Prof Dr İlhan Varank Sancaktepe Eğitim ve Araştırma Hastanesi, Turkey

Abstract
Being mother from the perspective of the woman:
The transition from “feminity” to “motherhood” signifies the major role transformation in a woman’s life. Although
childbirth is a universal and natural experience, motherhood is a completely new and multidimensional experience
for a woman which cause many expectations and burdens for the woman mentally and emotionally . However, com-
monly it is assumed that the woman is naturally equipped and ready for the motherhood, the expectations and ap-
proaches based on this assumption can cause a psychological burden. Therefore, there is a need for a perspective that
places women’s needs and challenges in the center, not the role of motherhood.
CBT based Guideline Recommendation for Transition to motherhood:Psychoeducation about cognitive process
-Challenges of transition to motherhood as a psychological experience
-Myths about motherhood
-Introducing Beliefs and Dysfunctional attitudes
-Beliefs and Dysfunctional attitudes towards motherhood
CBT based Guideline Recommendation for Transition to motherhood: Psychoeducation about management strate-
gies
-Determining of emotional distress situations related with motherhood
-Training of Emotional Regulation skills
-Improving of coping strategies : Time management; Acitvation of the support sources and mechanisms; Recognition
of the own needs
-Adressing the red flags of psychopathologies

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CBT-Based Guideline Recommendation for Transition to Motherhood:

Psychoeducation About Management Strategies
Dr. Kumru Şenyaşar Meterelliyoz*
* Department of Psychiatry, Bakırkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology
and Neurosurgery
Pregnancy and the postnatal period have significant effects on women’s physical and mental health. It is an inher-
ently stressful life event involving a new role transition and significant physical changes. It is also a developmental
and dynamic period of growth. The rapid changes in the family structure over the last century and the idealization
of motherhood are unique challenges and difficulties for women. Peopl’s reactions to the same situations are closely
related to their coping attitudes, emotion regulation techniques and learned behavior skills.
Psychoeducation is recommended to recognize the signs of psychopathologies early in this period, to make this
process more comfortable and to increase mother-baby adjustment. CBT- based psychoeducation and mindfulness
exercises have been shown to reduce stress levels and increase psychological well-being. This session suggests some
strategies on how proven
CBT techniques can be adapted to the woman’s transition to motherhood.
1) Determining of Emotional Distress Situations Related with Motherhood
Maladaptive cognitions about motherhood, dysfunctional attitudes towards
motherhood and the expectations that these engender.
a) Biological factors; including sleep deprivation, hormonal fluctuations,
postnatal recovery, and changing body image
b) Social factors; such as a lack of social support, a critical environment,
financial difficulties, and career-related concerns
2) Training of Emotional Regulation Skills
a) Mind-body exercises
3) Improving of Coping Strategies
a) Strengthening problem focused coping strategies
b) Identification of emotionally focused coping strategies
c) Time management
4) Activation of the Support Sources and Mechanisms
a) Recognition of the own needs
b) Parenting skills training
c) Enhancing social supports; supports group settings, parenting partner
involvement
5) Addressing the Red Flags of Psychopathologies
a) Mood symptoms (e.g., hopelessness, helplessness, depressive mood, severe
and persistent anxiety)
b) Thought content (e.g., ruminations, obsessive thoughts)
c) Impulse control difficulties and behavioral problems (e.g., suicide, infanticide,
maltreatment, etc.)

Keywords
motherhood, CBT, guideline, psychoeducation, cognitive beliefs

TRANSITION TO MOTHERHOOD OF THE WOMAN AS A MENTAL RESTRUCTURING EXPERIENCE AND ITS NEEDS
M. Sıla Yazar, MD
Associate Professor of Psychiatry
Altınbaş University, Medical School, Department of Psychiatry
The transition from "feminity" to "motherhood" signifies the major role transformation and
a mental restructuring process in a woman's life. Although childbirth is a natural experience, motherhood is a
completely new and multidimensional experience for a woman which cause many expectations and burdens for the
woman mentally and emotionally . However, commonly it is assumed that the woman is naturally ready for the moth-
erhood, the expectations and approaches based on this assumption can cause a psychological burden.
There is a need for a perspective that places women's needs and challenges in the center, not the role of moth-
erhood. This psychological burden and distress starting with the experience of motherhood may lead to an impact on
a woman's mental well-being, quality of life, and loss of functionality in her self-realization process. Moreover, it
may play a role in the development of postpartum psychopathologies like depression and anxiety disorders. Mother’s
bonding process with the baby may also be affected negatively. While woman are happy to be a mother, she also ex-
perience an internal growth and force to change by realizing that her individual autonomy may lost and also her own
live is no longer regulated by her own. In this process that involves conflicts and difficulties, there is a mental change

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that pushes the woman to redefine and restructure herself and her interpersonal relationships, her life-goals and her
entire life areas on the basis of the motherhood role. This experience also forces the woman to a transformation pro-
cess characterized by mental restructuring in many dimensions.
There is a need a model which should offer a perspective include an approach that guides
woman to internalize motherhood -which she is in the process of becoming involved with- as an element of her iden-
tity as an individual and focuses on ensuring her self-sufficiency and self-efficay. Especially in today's modern so-
cieties, where women are expected to manage many role delegations along with motherhood. During transition from
feminity to motherhood process, psychological intervention and psychotherapeutic support and guidence should be
considered as an important resource to ensure women they are not alone and be supported in this challenging and
unique experience.
Considering the strong evidences that CBT interventions are one of the most effective tools for the treatment of
psychopathologies in the perinatal period, the theoretical and methodological tools of CBT can offer a fruitful and
feasible opportunity to understand, represent and support women in their transition to motherhood experience.

CBT-Based Guideline Recommendation for Transition to Motherhood:

Psychoeducation About Management Strategies Dr. Kumru Şenyaşar Meterelliyoz* * Department of Psychiatry,
Bakırkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery Pregnan-
cy and the postnatal period have significant effects on women’s physical and mental health. It is an inherently stressful
life event involving a new role transition and significant physical changes. It is also a developmental and dynamic
period of growth. The rapid changes in the family structure over the last century and the idealization of motherhood
are unique challenges and difficulties for women. People’s reactions to the same situations are closely related to their
coping attitudes, emotion regulation techniques and learned behavior skills.
Psychoeducation is recommended to recognize the signs of psychopathologies early in this period, to make this
process more comfortable and to increase mother-baby adjustment. CBT-based psychoeducation and mindfulness
exercises have been shown to reduce stress levels and increase psychological well-being. This session suggests some
strategies on how proven CBT techniques can be adapted to the woman’s transition to motherhood.
1) Determining of Emotional Distress Situations Related with Motherhood Maladaptive cognitions about mother-
hood, dysfunctional attitudes towards motherhood and the expectations that these engender.
a) Biological factors; including sleep deprivation, hormonal fluctuations, postnatal recovery, and changing body im-
age
b) Social factors; such as a lack of social support, a critical environment,
financial difficulties, and career-related concerns
2) Training of Emotional Regulation Skills
a) Mind-body exercises
3) Improving of Coping Strategies
a) Strengthening problem focused coping strategies
b) Identification of emotionally focused coping strategies
c) Time management
4) Activation of the Support Sources and Mechanisms
a) Recognition of the own needs
b) Parenting skills training
c) Enhancing social supports; supports group settings, parenting partner
involvement
5) Addressing the Red Flags of Psychopathologies
a) Mood symptoms (e.g., hopelessness, helplessness, depressive mood, severe
and persistent anxiety)
b) Thought content (e.g., ruminations, obsessive thoughts)
c) Impulse control difficulties and behavioral problems (e.g., suicide, infanticide,
maltreatment, etc.)

CBT Based Guideline Recommendation for Transition toMotherhood:Psychoeducation

About Cognitive Process
Dr. Özlem Baş Uluyol
Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, Department of
Psychiatry, Istanbul-Turkey
Women experience many physiological changes during the perinatal period that affect their physical and mental
health.These changes can cause high levels of stress and anxiety for many expectant mothers.This can have negative
consequences for the mother and the baby.
Studies have shown that cognitive behavioral therapy is beneficial for the psychological difficulties experienced by
women in the perinatal period .Providing psychoeducation about the woman's transition to motherhood, myths

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about this period, and cognition and dysfunctional attitudes towards motherhood is the first step of the therapy pro-
cess and can be useful in reducing stress.
-Challenges of transition to motherhood as a psychological experience The transition from “womanhood” to “moth-
erhood” represents a significant role transformation in a woman’s life. It is a process that must be understood from a
psychosocial perspective, and there is a spiritual transformation process that pushes women to redefine themselves,
their mental structures, their relationships, their goals and all areas of their lives.
“Expectations from Motherhood and Self”
“Role Conflicts”
-Myths about motherhood
“Motherhood is a natural talent bestowed upon women.”
“A woman who has not become a mother is not considered self-actualized.”
“When a woman becomes a mother, she must put motherhood before everything else she does in life.”
-Introducing Beliefs and Dysfunctional attitudes
The basis of cognitive theory is that the emotions that disturb a person are not directly caused by the events experi-
enced, but by the interpretation of these events by the person. According to cognitive theory, current problems are
related to the dysfunctional thoughts and attitudes of the person.
-Beliefs and Dysfunctional attitudes towards motherhood
From a cognitive model perspective, beliefs and attitudes towards motherhood are a risk source specific to mental
illnesses in the perinatal period. Rubin and his colleagues stated that women evaluate events differently during preg-
nancy than during other periods and defined cognitions related to motherhood for the first time.Cognitive themes
specific to pregnancy & motherhood; The role of motherhood, The female body during and after pregnancy, Expec-
tations regarding the behavior of the unborn baby. Cognitive themes specific to pregnancy and motherhood are
related to the adaptation process to motherhood.

RT3: The diversity of Case Conceptualization across Europe: Learning from

each other to progress further
Pierre Philippot
UCLouvain, Belgium
Céline Baeyens
Université de Grenoble Alpes, France
Tobias Krieger
Universität Bern, Switzerland
Helen Macdonald
BABCP, United Kingdom
Nikola Petrović,
University of Belgrade, Faculty of Philosophy, Serbia
Maria Do Céu Salvador
Coimbra University, Portugal

Abstract
Case conceptualization is an essential and critical first step in psychological treatment: Research suggests that unsuc-
cessful interventions are often due to inappropriate target identification during case conceptualization. Also, many
practitioners consider that case conceptualization constitutes a privileged moment for building the therapeutic rela-
tionship. Across Europe, one can observe a large variability in training and practice regarding case conceptualization,
ranging from the mere attribution of a DSM diagnosis to elaborate modeling.
The aim of this round table is threefold: (a) to present different traditions of case conceptualization across Europe, (b)
to discuss the strength and limitations of each tradition as well as their links with research and the evolution of evi-
dence-based therapies, and (c) to open perspectives for cross-fertilization and guidelines. Five speakers, from differ-
ent geographical origins, will contribute to this round table: Céline Baeyens (France), Tobias Krieger (“Central” Europe),
Helen Macdonald (UK), Nikola Petrovic (Eastern Europe), and Ceu Salvador (Southern Europe).

Keywords
Case conceptualization

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RT4: Treating Generalized Anxiety Disorder: Different Evidence-Based

Therapeutic Approaches
Ayşegül Kervancioğlu
Private Practice, Ankara, Turkey
Canan Efe
Private Practice, Ankara, Turkey
Hakan Öğütlü
Cognitive Behavioral Psychotherapies Association - Türkiye, Turkey

Abstract
Generalized Anxiety Disorder (GAD) presents significant challenges in clinical practice, demanding versatile therapeu-
tic approaches. This clinical roundtable aims to explore and contrast three distinct therapeutic models—Cognitive
Behavioral Therapy (CBT), Schema Therapy (ST), and Metacognitive Therapy (MCT)—in their application to a case
of GAD. The session will commence with a detailed presentation of a patient diagnosed with GAD, including symp-
tomatology, psychosocial background, and treatment history. Following this, three experts will each advocate for a
different therapeutic approach. The first expert will discuss the principles and efficacy of CBT in managing anxiety,
emphasizing its structured, short-term, and problem-focused techniques. The second expert will explore Schema
Therapy, highlighting its focus on identifying and restructuring deep-seated patterns and beliefs that perpetuate
anxiety. The third panelist will present Metacognitive Therapy, detailing its unique approach to controlling worry and
modifying metacognitive beliefs that contribute to sustained anxiety states. This roundtable will not only dissect the
theoretical underpinnings and practical applications of each method but also engage in a critical discussion on their
comparative benefits, potential synergies, and case-specific recommendations. The session aims to provide a com-
prehensive understanding of how these therapies can be effectively tailored to meet individual patient needs in GAD
treatment, fostering a deeper clinical insight and encouraging evidence-based practice.

Keywords
Generalized Anxiety Disorder (GAD), Cognitive Behavioral Therapy (CBT), Schema Therapy (ST), Metacognitive Thera-
py (MCT), anxiety

RT5: New processes in cognitive behavioural therapies: the “dark down

arrow” in personal development, cultural distinctions and case formulation
Giovanni Maria Ruggiero
Sigmund Freud University, Italy
Murat Artiran
Rumeli University, Istanbul, Turkey
Raymond DiGiuseppe
St. John University, United States

Abstract
The panel discusses three possible directions of the management of the psychotherapeutic process in Cognitive be-
havioral therapy (CBT). The first direction explores an application of the down arrow to personal development in
therapists that should explore the beliefs and coping strategies related to the therapist’s dysfunctional reactions in
potentially worst scenario sessions, i.e. uncooperative, dismissive and aggressive reactions of the therapist. In order
to obtain this type of self-knowledge, a methodological variant of performing the down arrow, called the “dark” down
arrow, is described, the aim of which is to assess the therapist’s potentially worst dismissive or aggressive self-beliefs
and coping strategies towards the other people. The second direction explores how embracing and honoring distinc-
tions can greatly enrich the alliance and enhance the overall effectiveness of CBT therapists should remain conscious
of their biases and remain receptive to learning about their clients beliefs and cultural values. Psychotherapists must
excel in listening, empathy and nonverbal cues to forge a connection with their clients. Moreover they should be
able to adjust their communication approach to cater to the needs of clients, from varying backgrounds. Additionally
psychotherapists need to recognize how cultural diversity could influence both the presentation and treatment of
health concerns. The third direction explores Case formulation as a key aspect of REBT which involves the therapist
and client working together to understand the client’s presenting problems and identify the underlying irrational
beliefs that are causing these problems. Through this collaborative process, the therapist can help the client develop
a more rational framework for understanding their experiences. The process of case formulation holds significant

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importance in the objectives of therapy, and it encompasses two key components: elegant and inelegant solutions.
Formulating solutions is equally crucial as analyzing problems, and it is highly beneficial to have a solution-focused
case formulation.

Keywords
Personal Development; Cultural issues; Case formulation

RT6: EMDR and Crisis Support Following Mass Shootings in Serbia

Tamara Džamonja Ignjatović
Faculty of Philosophy and Faculty of Political Sciences – University of Belgrade, Serbia
Isabel Fernandez
EMDR Italy, Italy
Vesna Bogdanović
EMDR Serbia, Serbia
Jelena Zulevć
EMDR Serbia, Serbia

Abstract
In response to unprecedented mass shootings in Serbia in 2023, including a shooting at a primary school in Belgrade,
the capital city, as well as subsequent shootings in two small villages, Dubona and Malo Orašje, this abstract presents
a comprehensive overview of the challenges and innovations encountered in integrating Eye Movement Desensi-
tization and Reprocessing (EMDR) into crisis support interventions. These efforts aimed to address trauma-related
symptoms and promote recovery in affected individuals and communities.
The implementation of EMDR within crisis settings posed several significant challenges. Firstly, EMDR was relatively
unknown outside professional circles in Serbia, necessitating efforts to educate stakeholders and gain acceptance for
this modality in crisis response protocols. Secondly, delivering crisis support in rural environments presented logis-
tical and resource-related hurdles, requiring innovative adaptations to effectively reach and assist impacted popula-
tions. Additionally, ensuring confidentiality and adherence to protocols amidst widespread media sensationalism and
general distrust was crucial for maintaining trust and integrity in crisis interventions.
Lessons learned from these challenges informed the development of a responsive crisis team model tailored to future
traumatic events. This model emphasized the importance of agile and feedback-informed response mechanisms,
trauma-sensitive practices, and adapting evidence-based protocols and practices to specific cultural contexts to ef-
fectively address the unique dynamics of crisis situations, particularly in rural settings.
The case study presented in this abstract highlights specific strategies and interventions used to integrate EMDR into
crisis support initiatives. It underscores the importance of community engagement, ethical considerations, and ongo-
ing evaluation of effectiveness in crisis interventions.
The insights gained from this experience are valuable for mental health professionals, policymakers, and stakeholders
engaged in trauma-informed care and crisis intervention efforts, not only in Serbia but also in similar contexts glob-
ally. This session contributes to the growing body of knowledge on crisis intervention strategies and underscores the
significance of adapting evidence-based modalities to address the complex needs of communities affected by mass
shootings and other traumatic events.
In conclusion, this discussion emphasizes the importance of integrating innovative therapeutic approaches such as
EMDR into crisis support frameworks, highlighting the potential for positive outcomes in promoting resilience and
recovery in the aftermath of mass shootings in rural Serbia.

Keywords
EMDR, Crisis support, Mass shootings, Trauma-sensitive practice, Culturally sensitive practice

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RT7: Pitfalls in therapeutic alliance in cognitive behavior therapy

Neda Ali Beigi
University of Social Welfare and Rehabilitation Sciences, Islamic Republic of Iran
Saeedeh Zenoozian
zanjan university of medical sciences, Islamic Republic of Iran
Keith Dobson
University of Calgary, Canada
Kristene Doyle
Executive Director Albert Ellis Institute, United States

Abstract
The therapeutic alliance is one of the important factors to predict treatment process and outcome in a variety of ther-
apy models. However, the definition of the therapeutic alliance and the appropriate methods to create an alliance has
encountered some controversy in cognitive behavior therapy (CBT). Cognitive behavior therapy, traditionally seen
as manual-based therapy, allows for less opportunity to develop a therapeutic relationship, while new perspectives
indicate alliance and adherence playing crucial roles in CBT.
The view of clients and the therapist towards the therapeutic process also significantly influences treatment outcome.
Clients sometimes exhibit behaviors that therapists find unappealing. In some cases, clients behave inappropriately
and create discomfort for the therapist. At times, clients may simply resist ideas from the therapist or choose inaction
even while they wish to remain in treatment. Resistance is used in the CBT literature to refer to client behaviors that
signal a lack of collaboration between patient and therapist. Resistance has different dimensions (Leahy, 2003) includ-
ing the patient’s high need for validation, an inability to change and insistence on maintaining the current situation,
emotional ambivalence, or being extremely ethical and following the rules. The CBT framework conceptualizes resis-
tance as an interpersonal process, and a type of pathology in the therapeutic relationship. Wolf and Goldfried (2014)
found that 37% of therapists endorsed resistance as a roadblock to progress in CBT.
Transference and countertransference are concepts from psychanalysis that provide useful insights into the inner
world of the client and therapist. Role-playing, guided discovery and imagery are common approaches to evaluate
the processes in CBT. Whether resistance in patients or countertransference in the therapist, both are traps facing
the therapeutic alliance with inevitable challenges. In the cognitive model, the client’s resistance and the therapist’s
countertransference are conceptualized based on beliefs and schemas. Client’s faulty beliefs and schemas lead to
behaviors that indicate their resistance to treatment and may threaten treatment outcomes. On the other hand, the
therapist maladaptive schemas may also affect the therapeutic alliance and treatment progress. Therapists’ reaction
to clients are likely similar to the reactions of people in their real life. Therapists can use their reaction as a window
into the client’s social world. In this symposium we discuss how to deal with roadblocks that typically arise on the
therapeutic alliance.

Keywords
therapeutic alliance, Pitfall, resistance

RT9: Introducing DBT (Everything You Wanted to Know About DBT but Were
Afraid to Ask)
Karolina Vörös
Schema Therapy Center Belgrade, Serbia

Abstract
This symposium aims to introduce the professional community in our region to Dialectical Behavior Therapy (DBT),
a therapeutic approach that is still relatively new in Serbia, officially established through the Center for Dialectical
Behavior Therapy in 2020. The foundation of this group of psychotherapists from various modalities began in Sub-
otica. A few months before the start and continuing through the COVID-19 pandemic, the first group from Belgrade
was formed, followed by Novi Sad and Subotica. Together, they formed the first team for formal DBT education at the
Behavioral Tech Institute (formerly known as Linehan Institute). Today, there are three DBT teams comprising 16 thera-
pists from Serbia. This year, we are establishing a collaboration with a team from Russia, now located in Serbia, led by a
Behavioral Tech, LLC trainer. In this introductory DBT symposium, representatives from Serbia and Russia will provide
comprehensive information about the therapeutic model. They will present the basics of the theoretical approach to
emotional dysregulation, the significance and benefits of the team approach that is a hallmark of DBT, and the struc-

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ture and conditions of accredited education within the Behavioral Tech Institute. Additionally, they will discuss the
application process for therapists interested in joining new training cohorts and forming DBT teams. We also aim to
motivate psychotherapists from other therapeutic modalities by presenting the implications and possibilities of inte-
grating DBT with RE/CBT, schema therapy, and EMDR, which are well-established therapeutic modalities in our region.
The symposium will feature the following presenters: Karolina Vörös (overview of the history of DBT in Serbia), Dr.
Dmitrii Puškarev (fundamentals of DBT treatment), Milja Krivokuća (education conditions), Ksenija Kolkova (DBT con-
sultation team), and Jelena Zulević (integration of DBT with other therapeutic modalities and methods).
Chair: Nikola Petrović, University of Belgrade, Faculty of Philosophy, Serbia
Convenor: Karolina Vörös

Keywords
DBT

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SC1: Free Styling REBT: Making Powerful Disputation Gently

Zohra Master
Inner Planet, India

Abstract
In response to common feedback from clients undergoing Rational Emotive Behavior Therapy (REBT), this workshop
aims to address the challenge of bridging the gap between intellectual understanding and practical application.
While clients may grasp REBT concepts theoretically, they often struggle to integrate them into their daily lives or
experience them on an emotional level. This discrepancy arises from the tendency to rigidly adhere to the traditional
A-B-C format, which can limit the therapeutic process to an academic exercise.
To facilitate more impactful therapeutic outcomes, this workshop will empower REBT therapists to elevate their as-
sessment and disputation techniques. By transcending the conventional A-B-C structure, therapists will learn to nav-
igate dynamically between cognitive restructuring components, fostering a deeper and more experiential change in
clients. The workshop will cover the following key components:
1. Therapy Congruence: Aligning client expectations with therapeutic experiences to enhance congruence and
efficacy.
2. Comprehensive Emotion Assessment: Utilizing a diverse emotional vocabulary to assess clients’ emotional
states thoroughly, especially in cases where clients struggle to articulate their emotions.
3. In-depth Irrational Belief Assessment: Engaging clients in exploring their emotions and past experiences to
gain a nuanced understanding of their irrational beliefs. This comprehensive assessment lays the foundation
for effective disputation, enabling clients to develop critical thinking skills and challenge their distortions.
4. Personalized Disputation Style: Empowering therapists to cultivate an authentic and personalized approach
to disputing irrational beliefs

Keywords
Disputation techniques, building personal therapeutic style, Emotions, Irrational Beliefs, Self of therapist

SC2: The power of progress feedback. Using standardized measures to

enhance Outcomes
Kim De Jong
Leiden University, Netherlands
Hidde Kuiper
GGZcentraal, Netherlands

Abstract
In CBT, it is common to check in with your client at the start of each session on how they are doing and what their
symptoms currently are. Some therapists use standardized measures. The latter is referred to as progress feedback
and has been shown to enhance treatment outcomes and reduce dropout (De Jong et al., 2021). That is, provided
that the information is actively used by the therapist to support clinical decision-making. However, it is fairly common
for therapists to not actively use the feedback; for example, in one study 50% of the therapists did nothing with the
collected information, despite it being delivered to them automatically via e-mail (De Jong et al, 2012).
One reason why therapists do not use progress feedback actively in treatment is that they are often not trained in how
to discuss feedback with patients, especially when a patient is not progressing well. In this skills class we will discuss
how to introduce progress feedback to patients, how to discuss and recognize progress and lack of progress and
adapt treatment when necessary. We will also discuss using progress feedback on multiple patients in supervision to
learn from your own data.
During the skills class participants will actively practice with role plays. If they are already using standardized mea-
sures, they are invited to bring anonymized examples of progress charts.

Keywords
routine outcome monitoring; measurement-based care; feedback

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SC3: Learn key elements in the SIBS intervention for siblings and parents of
children with chronic disorders
Krister Fjermestad
University of Oslo, Norway

Abstract
The scientific background for this skills class rests on multiple reviews demonstrating that siblings of children with
chronic disorders are at increased risk of mental health problems due to extra care burdens. Health care providers are
becoming more aware of siblings’ health needs, and countries and legislators are increasingly incorporating children
who care for children (i.e., siblings) into their definitions of “young carers”. The mental health risk for siblings indicate
they may need tailored interventions, but few evidence-based interventions tailored for siblings exist.
The key learning objectives of the current skills class is for participants to learn key skills from one of the most re-
searched interventions tailored for siblings and parents of children with chronic disorders. This is the SIBS interven-
tion, a five-session manual-based group intervention developed in Norway and implemented and evaluated in Nor-
way, Denmark, and Cambodia, with ongoing and/or planned trials in Australia, the Netherlands, USA, and the United
Kingdom.
The SIBS intervention is built on cognitive behavioral therapy (CBT) principles and rests on a decade of developmen-
tal research. The intervention comprises three parallel sibling-parent group sessions with multiple families and two
joint sessions where each sibling-parent dyad meets separate from other families. The aim of the SIBS intervention is
to enhance parent-child communication, and thereby prevent sibling mental health problems. As such, the manual
focuses on specific techniques that parents are meant to practice for more open and warm communication with their
children. The skills class focuses on these techniques.
The key skills to be learnt in this class is specific techniques for how to work with parents to enhance parent-child
communication. This is done via example videos of real parent-child conversation, animated information videos, and
role-plays with parents involving feedback. The class will provide insights into key elements of the SIBS intervention
and how these could be implemented. Video examples from live groups will be shared and key tasks will be presented
and role-played. The participants will get hands-on training in how to work on enhancing parent-child communica-
tion, with feedback.
The implications for everyday CBT practice include for audience members to become familiar with key elements in
the intervention manual, watch and reflect on example videos and discuss intervention strategies targeting siblings.
The aim is for participants to learn and get inspired about how to best support siblings as young carers. Given that
enhancing family communication is generally associated with mental health and family relations, the skills class is also
relevant beyond the field of chronic disorders as a supplement to family-based CBT.
The skills class leader is Krister W. Fjermestad. He is a Clinical Psychologist and Professor at the Department of Psychol-
ogy, University of Oslo and Frambu resource centre for rare disorders, Norway. He is one of the main authors of the
SIBS intervention and has more than a decade of clinical and research experience working with families of children
with chronic disorders.

Keywords
families; children; chronic disorders; siblings; interventions; communication

SC4: Problems in integrating mindfulness into standard CBT protocols and

how to overcome them
Dragica Barbarić
Private practice, Croatia
Laura Mirić
“PUNA SVJESNOST”; “Mindfulness centar KBT opcija”, Croatia

Abstract
Note: this skills class is held in the Croatian-Serbian language
Scientific background - CBT therapists have been increasingly integrating mindfulness-based interventions (MBI),
most often only meditation practice, into the traditional CBT protocol, but there is little research on the effect of this.
Some randomized controlled trails (RCT) have investigated the effects of adding only a very brief mindfulness medi-
tation at the beginning of each session in CBT protocols for anxiety and depression (even without the home practice
essential to both CBT and MBIs) and found no advantage of adding a brief meditation versus TAU (Mander et al., 2018;
Pruessner at al., 2024). The authors argue that the procedure of the studies reflects the way that practitioners usually

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integrate mindfulness into individual therapy routines. However, Mindfulness Based Cognitive Therapy (MBCT) and
other evidence-based manualized group MBIs have been shown to be effective in numerous RCTs. When scientists
investigate the effects of mindfulness interventions incorporated into CBT and also when CBT therapists integrate
mindfulness into traditional CBT, it would be reasonable to transfer more of the core interventions of these group
programs into individual CBT rather than just meditation. These core interventions include: formal and informal mind-
fulness practices (meditations, mindful everyday activities), experiential exercises, inquiry following each practice and
exercise, home practice and its review at the next session. Also, according to the framework and ethical standards for
an MBI training program, the therapist working with mindfulness should have at least 2 years of experience of daily
mindfulness practice (Segal et al., 2013). Among other problems, using only meditation in a therapy session, without
inquiry technique following it and without other interventions, can lead to increased attention, but increased atten-
tion without attention quality training may even worsen symptoms.
Key learning objectives of this skills class:
• Participants will understand the mechanisms of change underlying some core mindfulness interventions in or-
der to fit them meaningfully and flexibly into a traditional CBT protocol;
• Participants will understand why it is important that CBT therapists have their own regular mindfulness practice
in order to effectively teach these skills to their clients and how the practice can support therapists’ wellbeing
and efficacy even when they do not use MBIs with the clients;
• Participants will learn how to apply some core elements of the Inquiry technique (somewhat analogous to Soc-
ratic questioning), which should follow every mindfulness practice and exercise.

Keywords
mindfulness, CBT protocols, MBCT, mindfulness-based interventions

SC5: Treatment of sexual orientation OCD

Dmitrii Komarov
Educational association ‘Behavioral Company”, Russian Federation

Abstract
Rationale
Sexual Orientation Obsessive-Compulsive Disorder (SO-OCD) is a condition which is characterized by significantly dis-
turbing intrusive doubts about one’s possible homosexuality in the absence of actual homosexual desire. Occurrence
of those intrusions is associated with typical cognitive biases for OCD such as Moral and Likelihood Thought-Action
Fusion (TAF), intolerance of uncertainty, overestimation of threat and excessive need for thought control1. These bi-
ases reinforce massive fear and shame often escalating to suicidal ideation2. Striving to cope with both intrusive
thoughts and emotional distress, patients steep into endless neutralizing behaviors such as scanning bodily sensa-
tions for arousal, compulsive masturbation and meticulous analysis of their past and present sexual experience.
Up to 1/3 of patients with obsessive-compulsive disorder report having sexual obsessions during their lives3. At the
same time 39% of psychologists misdiagnose OCD in general and 77% could not recognize sexual orientation ob-
sessions4. Instead such symptoms get erroneously interpreted as a ‘sexual identity crisis’ that in turn consolidates
patients’ catastrophic misinterpretation of their intrusive doubts. However well-established CBT techniques show
promising results when tailored for the specific nuances of these sexually-charged obsessions.
Learning objectives
This skills training class is aimed to help practitioners obtain proficiency in the following aspects: 1) recognition of
sexual obsessions and their differentiation from ego-syntonic sexual fantasies; 2) revealing typical explicit and implicit
(overt and covert) compulsions; 3) correcting fear-provoking cognitive beliefs; 4) planning relevant exposures and
response prevention; 5) maintaining a firm therapeutic stance against rigorous reassurance seeking.
Description
The first step for the therapists is to elicit and normalize intrusions, educating the patients about the basic mecha-
nisms of psychosexual development: that sexual orientation is a constant trait and cannot be altered neither by ex-
ternal influence nor by inward thoughts5, although homosexual intrusions is a widespread phenomenon6. Next, the
clinicians should be willing to validate patients’ reactions to thoughts of fear and shame to enhance the therapeutic
working alliance and to further normalize patients’ emotional struggles. To be able to do so, therapists will be taught
to identify clients’ thought evaluations – that is, according to Salkovskis’ and Clark’s models7,8, underlying personal
meanings attributed to sexual intrusions. Those evaluations – oftentimes equal to Core Beliefs (usually in the domains
of unlovability and worthlessness) – are the targets for further cognitive restructuring. Clinicians should deploy their
CBT repertoire fully and encourage patients to participate in behavioral experiments to disprove their thought-action
fusion bias, manifested in the fear of losing control and acting out their dreadful mental images. The above-men-
tioned techniques must be complemented by Exposure and Response Prevention – the essential ingredient of effec-
tive treatment. For SO-OCD, that consists of instructing the clients to cease their compulsive searching for signs of

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arousal (both mentally and behaviorally) and to expose oneself to lasting uncertainty with regards to their sexuality.
Additionally, the participants of the skills class will be trained to handle patients’ reassurance seeking: alliance-dis-
rupting and recovery-undermining behavior, which invariably goes along with this condition based on pathological
doubt.

Keywords
Obsessive-compulsive disorder, sexual obsessions

SC6: Treating tics and Tourette Syndrome with evidence based interventions
and adaptations needed for the ‘real world’
Tara Murphy
Great Ormond Street Hospital, United Kingdom
Jolande Van De Griendt
Griendt, TicXperts, Netherlands
Cara Verdellen
PsyQ Nijmegen, Netherlands

Abstract
Gilles de la Tourette syndrome (TS) and chronic tic disorders (CTD) are complex neuropsychiatric disorders primar-
ily characterized by tics but often accompanied by additional symptoms. In this skills class workshop, diagnostics
and treatment options for TS and tic disorders are discussed with pragmatic adaptations for commonly co-occurring
conditions. Tic disorders are often treated with medication, while behaviour therapy can be a good, or even better
alternative. Behaviour therapy can consist of either habit reversal treatment (HRT) or exposure and response preven-
tion (ERP). HRT consists of an awareness training, followed by a competing response training to prevent or inhibit
the tic. ERP consists of prolonged exposure to premonitory sensations during response prevention of the tics. Both
treatments have been proven effectively in the treatment of tic disorders, leading to an average of about 30% tic
reduction. Behaviour therapy has recently been recommended in the European Guidelines as a first line intervention
for tic disorders across the lifespan.
Implications for everyday clinical practice of CBT
Despite strong evidence for behavioural treatment for tics and Tourette, and the availability of treatment manuals,
many patients do not receive a first line evidence based intervention for tics. Currently, few therapists are trained in
delivering these interventions. This skills class aims to increase the awareness in practitioners about behaviour ther-
apy for tics.
Key learning objectives
• Learn the diagnostics, differential diagnoses and commonly co-occurring conditions of Tourette Syndrome and
other tic disorders
• Knowing the available evidence for behaviour therapy for tic disorders
• Step-by-step demonstration of both habit reversal training and exposure & response prevention, illustrated with
videomaterial.

Keywords
Tics; Tourette; Exposure & Response Prevention; Habit Reversal

SC7: The use of deliberate practice in cognitive behavioral therapy

supervision and training
Dan Sacks
Ben-Gurion University of the Negev, Israel

Abstract
There are several factors that lead to expert-level performance in psychotherapy. Theoretical knowledge and clini-
cal experience for example, are likely to be fundamental to psychotherapy expertise. Yet despite their importance,
declarative knowledge and clinical experience do not necessarily lead to expert-level performance. Considering this,
attempts have been made to pinpoint what distinguishes the most effective therapists.
One aspect of expertise with a growing consensus regarding it’s importance for expertise, is the behavioral rehearsal

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of CBT skills. Role plays and skill trainings have been a part of CBT training for many years, but there is still no robust
learning framework that fully incorporates findings from the science of expertise.
A form of learning termed Deliberate Practice (DP) has shown promise. Deliberate Practice is a research-support-
ed learning framework for skill acquisition and refinement, with the number of hours committed to DP predicting
expertise across numerous fields of expertise. Deliberate practice incorporates three core principles that we shall
implement in this workshop:
1. Identify a skill deficit
2.Define a small learning goal
3. Implement a rehearsal and feedback loop
The goal of this workshop is to give you a taste of Deliberate Practice learning for CBT skills, together with the knowl-
edge needed to start incorporating deliberate practice into supervision and training.
Teaching Methods: In this workshop the components of deliberate practice for CBT will be taught through brief in-
struction, live demonstration, video and a lot of practice (role-plays in small groups and work with video-prompts).
Learning objectives:
1. Identify a personal skill deficit
2. Define a small, personalized learning goal
3. Implement personalized behavioral rehearsal
4.Give actionable feedback
Note: This is a noisy, active and fun workshop. Bring your good vibes and openness to learning, and you won’t regret it!

Keywords
Deliberate Practice, Supervision, CBT skills, rehearsal

SC8: Breaking Free from Mind Loops: A Contextual Behavioral Approach to

Repetitive Negative Thinking
Seher Cömertoğlu Yalçin
Cansagligi Foundation Center for Contextual Behavioral Science, Turkey
Fatih Yavuz
Istanbul Medipol University, Turkey

Abstract
Repetitive thinking is defined as the process of prolonged, attentive, and recurrent contemplation of oneself or the
world (Segerstrom et al., 2003). It is specified that repetitive thinking can be adaptive or maladaptive, leading to either
destructive or constructive outcomes in a person’s life. Repetitive thinking can take various forms, such as mind wan-
dering, rumination, worry, planning, daydreaming, counterfactual thinking, and reflection, serving different functions
in different contexts.
Maladaptive forms of repetitive thinking, known as Repetitive Negative Thinking (RNT), encompass worry and rumi-
nation and are linked to various psychopathologies such as depression, anxiety, insomnia, eating disorders, and psy-
chotic disorders (Ehring & Watkins, 2008; Harvey et al., 2004). Therefore, RNT is defined as a ‘transdiagnostic’ process
that underlies various psychological disorders (Ehring & Watkins, 2008; Harvey et al., 2004; Drost et al., 2014).
Analyzing transdiagnostic processes like RNT supports the development of brief and effective interventions (Ruiz et
al., 2020). By understanding the underlying mechanisms of these processes, we can create interventions that address
multiple psychological symptoms simultaneously. This approach can potentially enhance the efficiency and cost-ef-
fectiveness of care.
In this workshop, we will examine RNT based on the philosophical and theoretical frameworks of functional contex-
tualism and contextual behavioral therapy. Accordingly, RNT is considered an implicit behavior, and understanding
a behavior involves not only recognizing what the behavior is but also the context in which it occurs—its ‘anteced-
ents’ and ‘consequences,’ which are of central importance. Only in this way will it be possible to influence or change
a behavior. Thus, when we work on RNT during therapy, this framework provides us with the ability to offer brief and
effective intervention opportunities.
Key Learning Objectives:
• Describe the different forms of repetitive negative thinking from a functional contextual perspective.
• View repetitive negative thinking as a behavior and to develop skills for conducting Functional Behavior Analy-
sis on these behaviors to understand their antecedents, consequences, and functions.
• Learn strategies and techniques for working with RNT during therapy sessions, using the functional contextual-
ism and contextual behavioral therapy frameworks.

Keywords
repetitive negative thinking, contextual behavioural science, rumination, worry, self criticism

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SC9: Rumination in Obsessive-compulsive disorder: Catching the sneakiest of

compulsions
Jean-Philippe Gagné
McGill University, Canada

Abstract
Targeted Audience:
This class targets clinicians who assess/treat obsessive-compulsive disorder (OCD) using cognitive-behavioural ther-
apy (CBT) or exposure, who wish to refine their case formulations and interventions.
Background:
Rumination is a mental process during which one repetitively analyzes their concerns without taking concrete or
helpful action (Watkins, 2008). Rumination has been shown to be transdiagnostic (Ehring & Watkins, 2008) and to be
involved in the maintenance and worsening of symptoms across various mental disorders (Watkins & Roberts, 2020),
including OCD (Wahl et al., 2021). In the context of OCD, rumination has historically been conceptualized as part of
the obsessional domain, mainly because of overlapping characteristics, such as being repetitive and difficult to con-
trol (Salkovskis & Westbrook, 1989). However, rumination is now better understood as one of the many covert com-
pulsions reinforcing the overimportance given to normal yet unwanted intrusive thoughts, particularly repugnant
obsessions (Raines et al., 2017). It is therefore critical for clinicians to frame rumination as a mental habit or behaviour
(Watkins & Nolen-Hoeksema, 2014), wherein an individual with OCD attempts to identify the causes, meaning, and
consequences of their intrusive thoughts (Wahl et al., 2021). This time-consuming and unproductive process leads to
more intrusive doubts but also to worsened mood, making individuals with OCD at high risk for comorbid depression
(Wahl et al., 2021). This class will teach evidence-based strategies from CBT for OCD and related disorders, as well as
principles of behavioural activation, to equip clinicians with tools to target rumination in OCD.
Learning Objectives:
By the end of the class, attendees will be able to:
1. Understand the concept of rumination as a compulsion and its role in the maintenance of OCD (particularly
repugnant obsessions) and other symptoms (e.g., depressed mood)
2. Integrate rumination in cognitive-behavioural formulations of OCD as a way to further refine their conceptu-
alization of their patients’ difficulties
3. Assess rumination in patients with OCD to better understand its manifestation and monitor its frequency and
intensity throughout CBT
4. Use CBT strategies (e.g., psychoeducation, behavioural experiments, exposure and response prevention,
habit reversal, grounding, behavioural activation) to target rumination in OCD and help symptom reduction
5. Recognize rumination in a session and encourage its discontinuation
Teaching Methods:
A mixed-method approach to teaching will be used. First, attendees will be provided with theoretical and practical
information. Second, experiential activities will be emphasized, consisting mainly in practicing the skills within small
groups of attendees based on a case vignette.

Keywords
obsessive-compulsive disorder, rumination, exposure and response prevention, habit reversal, behavioural activation

SC10: Disputing irrational beliefs by working with Critic Modes in personality

disorders
Maria Cristina Sterie
International Society of Schema Therapy, Romania
Roxana Nicolau
Romanian Association of Behavioural and Cognitive Therapy (ARTCC), Romania

Abstract
Join us for a dynamic skills class that delves into the scientific exploration of working with critical parts in therapeutic
interventions designed to reshape clients’ mindsets. This class draws upon established psychological theories and
empirical research to provide participants with a deep understanding of the mechanisms behind critical self-talk and
its profound impact on clients’ cognitive, emotional, and behavioral well-being.
Participants will explore how maladaptive schemas, cognitive distortions, and learned behaviors perpetuate self-crit-
icism, while learning how to apply schema therapy techniques to identify and address critical parts within the client’s

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internal system. Practical interventions such as limited reparenting, imagery rescripting, and chair work will be ex-
plored to challenge and transform critical schemas.
Moreover, participants will gain insights into evidence-based emotion regulation strategies essential for helping cli-
ents manage distress associated with critical self-talk. Skills such as mindfulness, emotion labeling, and distress toler-
ance will be taught to foster self-compassion and resilience in clients.
Through interactive exercises and real-world examples, participants will have the opportunity to apply theoretical
concepts and therapeutic techniques to diverse scenarios. The workshop will offer practical guidance on navigating
therapeutic challenges and customizing interventions to meet the fundamental emotional needs of clients.
By the end of this skills class, participants will emerge equipped with a comprehensive understanding of the scien-
tific principles underpinning the restructuring of critical parts, along with practical skills to effectively intervene with
clients struggling with self-criticism. Join us to enhance your therapeutic toolkit and make a positive impact in your
clients’ lives.
Key learning objectives:
1. Understanding the Concept of Critical Parts or Modes: Participants will gain a thorough understanding of
critical parts within the context of schema therapy and cognitive-behavioral therapy (CBT), including their
origins, functions, and impact on clients’ well-being.
2. Integration of Schema Therapy and CBT: Participants will learn how to integrate principles and techniques
from schema therapy and CBT to effectively identify and work with critical parts in therapy sessions. This
includes exploring how cognitive distortions and maladaptive schemas contribute to the development and
maintenance of critical inner voices.
3. Assessment and Formulation Skills: Participants will develop skills in conducting comprehensive assessments
and case formulations to identify the presence of critical parts in clients. They will learn how to conceptualize
the interplay between core beliefs, early maladaptive schemas, and critical inner voices in shaping clients’
cognitive and emotional experiences.
4. Intervention strategies: Participants will learn to apply different intervention strategies to combat, dispute,
reduce or negotiate and make friends with critical parts. They will learn how to identify the need for a certain
type of intervention and how to adapt their strategy to the type of Critical part they are addressing.

Keywords
personality disorders, schema therapy, critic modes, irrational beliefs

SC11: DBT informed therapy: using DBT outside of comprehensive

treatment program
Magdalena Skuza
Centrum Zdrowia Psychicznego HarmonJa, Poland

Abstract
The goal of the seminar is to present how cognitive-behavioral therapists can use DBT principles and strat-
egies in their work with patients. Research unequivocally supports the effectiveness of holistic DBT therapy
that includes 4 modes of therapy: individual therapy, group skills training, telephone coaching and a consul-
tation team. This is an effective therapy, but it requires a team, training and resources that may not be available
to many therapists. Many therapists and patients are eager to use DBT techniques, but doing so inconsistent-
ly may find them disappointing and unhelpful. At the same time, we know that using the transactional mod-
el to conceptualise and plan therapy, adhering to DBT assumptions and principles in the therapeutic pro-
cess, consistently and appropriately applying behavioural strategies in a dialectical manner, can enhance the
effectiveness of therapy itself and strengthen the therapeutic relationship. This is called a “DBT-informed treatment”.
The class will present how the basic DBT paradigms (acceptance, change and dialectics) and strategies can enhance
the practice of a cognitive-behavioural therapist, as well as be the basis for developing a comprehensive DBT treat-
ment program.

Keywords
DBT-informed treatment; DBT skills training; transactional model; suicidal risk management; emotional dysregulation;
case formulation

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SC12: Big Picture Appraisal Mindfulness based cognitive therapy

Mugur Ciumageanu
West University of Timisoara, Romania

Abstract
Mindfulness based cognitive therapy (MBCT) is a third wave CBT practice that immerses the client in dealing with
thoughts and other mental object-like content by promoting an intentional response instead of an automated re-
action. MBCT proved itself useful in reducing meta-cognitive load associated with episodic emotional disorders. Big
picture appraisal (BPA) is a rather new way of inducing in emotionally disturbed clients a state of broad de-centering
from their distress. BPA procedures imply the learning of broad perspective taking, both temporally and personally.
The skill-class I intend to conduct will center on the reformulation of the classical 8 week training program in order
to include BPA instructions - advanced MBCT practitioners will have the opportunity to explore experientially the
modified sitting meditations, while therapists less familiar to MBCT will have the opportunity to have a glimpse on
the MBCT practice.

Keywords
MBCT, Big Picture Appraisal

SC13: Breaking Boundaries: A Skill Class for Overcoming

Social Anxiety Disorder
Ivana Vračkić
SRABCT, Serbia
Branislava Krasić
SRABCT, Serbia

Abstract
Title
Breaking Boundaries: A Skill Class for Overcoming Social Anxiety Disorder
Scientific Background
Social anxiety disorder is a prevalent mental health condition characterized by an intense fear of social situations
and being judged or embarrassed in front of others. Cognitive Behavioral Therapy (CBT) has been established as an
effective treatment for social anxiety disorder. The behavioral experiment technique is a crucial tool in CBT for treat-
ing social anxiety. It’s an evidence-based approach that allows individuals to actively test their anxious beliefs and
assumptions in real-life situations. Behavioral experiments are a way to break out of the vicious cycle of anxiety and
avoidance and test our social fears. By engaging in controlled experiments, participants gradually confront their fears
and learn that their anticipated negative outcomes are often exaggerated or unlikely to occur.
Key Learning Objectives
By the end of the class, participants will be able to help clients to:
1. Understand the importance of applying behavioral experiment techniques in the CBT treatment of Social
Anxiety Disorder.
2. Effectively applying key behavioral experiments in therapeutic practice for the treatment of social anxiety.
3. Enhancing the design and implementation of individualized behavioral experiments in therapeutic practice
and how can therapist adapt their methods for different patients.
The idea is with this skill class to foster a sense of community and mutual support among participants providing a safe
space for sharing experiences and learning from one another’s successes and challenges.

Keywords
social anxiety disorder, anxiety, cbt, cognitive behavioral therapy

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SC14: Mindfulness Techniques in Acceptance and Commitment Therapy (ACT)

Ana Milenković
SRABCT, Serbia

Abstract
Acceptance and Commitment Therapy (ACT) combines acceptance and mindfulness strategies with commitment
and behavior-change techniques to increase psychological flexibility.

Mindfulness in ACT is defined as The defused, accepting, open contact with the present moment and the private
events it contains, as a conscious human being experientially distinct from the content being noticed.
This workshop aims to introduce participants to the fundamentals of mindfulness-based techniques in ACT, providing
practical tools to manage stress and enhance overall mental health. Participants will engage in a series of interactive
sessions that include:
• An introduction to mindfulness and its benefits
• Guided mindfulness meditation practices used in ACT
• Techniques for integrating mindfulness into daily life
• Exercises to enhance present-moment awareness
• Strategies for managing negative thoughts and emotions
By the end of the workshop, participants will:
• Understand the core principles of mindfulness
• Develop practical skills working with clients to reduce stress and anxiety
• Learn methods to improve focus, emotional and behavioral regulation
• Gain tools for incorporating mindfulness into their everyday routines

No prior experience with mindfulness or ACT is necessary. The workshop will be conducted over half a day.

Keywords
Mindfulness, ACT, Anxiety

SC15: Spiritual Psychology: How to engage clients with religious beliefs

(online)
Deepak Dhuna
BABCP, United Kingdom

Abstract
Often, therapy has supported clients as individuals without a holistic context, however this skills class aims to widen
the appreciation of adaptations that could be made to engage persons within a psycho-spiritual framework. Vari-
ous research has found that therapies can conflict with other belief systems on numerous elements from aetiology
through to treatment and prognosis (Naeem et all, 2019). An individual’s cultural/religious values can impact on the
nature of their core beliefs, assumptions and automatic thoughts (Tam et al, 2007) and therefore their mental health.
Taking a rigid approach to the initial guidance to CBT without any adaptation often may result in poor outcomes, and
so new research posits adaptations to CBT to ensure relevancy and accessibility for cultural minorities and religious
groups (Phiri, et al, 2023) is vital. Indeed, the importance of paying attention to spirituality is a key element in ensuring
positive health outcomes (Katerndahl, 2008). This session will explore to how to assess, conceptualize and treat the
followers of some of the major religions. Considerations will be made around Christianity, Islam, Hinduism, Buddhism,
Sikhism and others, drawing on salient themes and techniques which may help alleviate mental distress in a more
meaningful way.

Keywords
spiritual issues, competence, CBT

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SC16: Enhancing Therapeutic Communication: The Impact of Language on

Perception and Treatment Efficacy
Hidde Kuiper
GGZcentraal, Netherlands

Abstract
Effective communication in therapy is not solely about what is said, but also about how it is said. This workshop ex-
plores the influence of language on the perception of pathology and treatment efficacy through case studies. Partic-
ipants are challenged to delve into the nuances of language selection and phrasing during the therapeutic process,
examining which words and phrases are more likely to induce change in clients’ perceptions and behaviors, while also
considering their impact on the therapist’s experience. Drawing from existing research and literature, we will explore
the current understanding of language in therapy. Through interactive exercises, attendees will practice alternative
word choices and expressions, and learn strategies for managing disruptions in the therapeutic relationship. Addi-
tionally, we will discuss appropriate responses and word choices for early treatment improvements (Sudden Gains)
and crisis situations. In this workshop the different phases in therapy will be addressed by proposing corresponding
appropriate language. Especially the end phase (how to end a not so successful therapy) will be addressed.

Keywords
Effect of therapeutic language

SC17: Deep CBT for anxiety disorders and beyond: assessing and treating core
threats
Elad Zlotnick,
The Hebrew University of Jerusalem, Israel
Jonathan D. Huppert
The Hebrew University of Jerusalem, Israel

Abstract
Core threats represent the fundamental underlying anxieties individuals face in relation to their anxiety when they
refrain from avoiding or engaging in safety behaviors. Typically accessed through the downward arrow technique,
where one repeatedly asks “and then what would happen?” until reaching the ultimate concern, core threats can
manifest in various forms. For instance, patients with OCD often engage in checking rituals. However, the underlying
motivation can be due to many fears, including fear of harming oneself or others, losing precious objects, losing
control, or facing social ostracization. Despite their significance and clinical utility, core threats have received limited
attention in research.
Addressing core threats in clinical practice necessitates accurate assessment of underlying anxieties, which can prove
challenging. To assist in this process, we developed a structured interview to aid both research and clinical practice.
Moreover, we posit that prioritizing core threats during CBT for anxiety enhances therapeutic efficacy.
Participants will develop the following skills:
1. Systematically assessing core threats using a structured approach.
2. Overcoming obstacles in identifying core threats.
3. Integrating core threats into in-vivo exposures and behavioral experiments.
4. Designing imaginal exposure techniques to target core threats.

Keywords
Core threats, Deep CBT, anxiety disorders, assessment, treatment

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SC18: Using ACT to define healthy boundaries

Richard Bennett
University of Birmingham, Colombia
Dawn Johnson
ACTivatingYourPractice.com, United Kingdom

Abstract
Overview
Do you use ACT with people who find it hard to set healthy boundaries with others? Do you struggle with the same
yourself? Does fusion with blame and other thoughts lead to getting overwhelmed by unwanted emotions like guilt,
shame, or anger? Would you like to get better at helping yourself and others set more workable boundaries with a
greater sense of generosity and compassion?
Inspired by Brene Brown’s concept of ‘Living BIG’, this workshop, suitable for practitioners with an interest in third
wave CBTs, will focus on integrating key practical and philosophical principles into their work. It will incorporate some
didactic teaching and experiential exercises, inviting participants to consider a contextual behavioural approach to
the boundary issues that arise in the therapy room. Delegates will also have the opportunity to ask questions and/or
discuss their own cases.
Learning Objectives
Through attendance at this workshop delegates will be able to:
- Integrate some key principles of moral philosophy within a contextual behavioural approach to boundary setting
- Assess the utility of applying the aforementioned principles in their own lives, or in the lives of the people to whom
they offer services
- Undertake a compassion-focussed interventions to help themselves or others to defuse from blame and other un-
helpful stories

Keywords
ACT, Acceptance and Commitment Therapy, moral philosophy, boundaries, relationships, third wave CBT

SC19: Innovative and creative techniques in Group Schema Therapy for

Children and Adolescents
Diana Teodorescu
Romanian Institute of Schema Therapy, Romania

Abstract
This Skill Class starts from the design of the first protocol of Group Schema Therapy for children and adolescents. It
starts from the latest theories and studies and provides methods and strategies with which to build a flexible and
developmentally appropriate group program. The main focus is the development of the “ Wise and Competent Mode”,
which is the primary resource for children’s and adolescents’ emotional, cognitive and social skills and competencies.
As the stages of the protocol are presented, those types of interventions and activities that have yielded outstanding
results over the years of practice will be highlighted. The methods presented will be those specific to the ST group
protocol, with a focus on combining experiential techniques with creativity, playfulness and novelty. The innovative
elements of this skill class are: the design of the first protocol in group schema therapy for children that it is in the
validation process and unique therapeutical stories and mode cards, specially designed for this protocol.
Key learning objectives
1. ST-CA Group protocol description and the underlying studies used for it. Short description of the ongoing
study which is aimed to validate this protocol
2. Pinpointing the ST-CA objectives in group protocols with a constant focus on the Wise and the Competent
Mode in each stage of the protocol: creating a warm, protective environment, developing basic emotional
skills: awareness, expression, regulation.
3. Exploring and describing the main areas of competence reflected in the Wise and the Competent Mode and
developing them through various group techniques
4. Showcasing the innovative and creative techniques to increase the Wise and the Competent Modes, unique
therapeutical stories and mode cards, specially designed for this protocol.
5. The element of novelty and creativity lies in the integration of 12 cards with the skills and competencies chil-
dren need to develop and strengthen the Wise and Competent Mode. These skills are embodied in charac-
ters whose ingenious names allow us to maintain gender neutrality. They were created respecting all the cri-
teria behind the concepts: The Caring, The Explorer, The Strategic, The Self Guarding, The Wise, The Creative,

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The Self Reflective, The Self Driven, The Self Regulator, The Social Connector, The Self Worth Booster, The Self
Creator. These cards/characters are new, specially designed for this protocol and they are de accompanied by
unique therapeutical stories, created to enhance the power of The Wise and Competent Mode.

Keywords
Schema Therapy for children and adolescents, Group schema therapy for children and adolescents, Training Skills and
abilities, Unique mode cards and therapeutical stories

SC20: Trauma Informed Supervision: From perspectives to practices

Chetna Duggal
Tata Institute of Social Sciences, India

Abstract
Psychotherapists and counsellors work with diverse clients, including individuals and groups from disadvantaged
and marginalised communities, many of whom have experiences of trauma. Bearing witness to trauma narratives and
responding therapeutically to trauma has deep impact on therapists and can make them susceptible to professional
self-doubt, vicarious trauma and burnout. Over the years there is a recognition for the need for trauma informed su-
pervision globally. This skill class will focus on how supervisory practice can be trauma-informed. The values and prin-
ciples of trauma informed supervision will be highlighted, linkages to supervisory relationship will be drawn along
with delineating specific strategies and practices that can be incorporated in supervision when adopting a trauma
informed approach. Considerations with respect to the social identities of the supervisor and supervisee in trauma
informed supervision will be highlighted. Incorporating a trauma informed approach in supervision to promote su-
pervisee well-being and create trauma-informed systems will also be discussed. This skill lab is for both supervisors in
practice and supervisors in the making.
Key learning objectives:
a. Understand how trauma-informed principles can inform supervision
b. Learn skills in identifying and responding to trauma triggers within supervision
c. Develop a trauma informed approach in supervision to promote supervisee well-being and create trauma-informed
systems

Keywords
Trauma, trauma-informed, supervision

SC21: Crowd-sourcing acceptance: reducing shame in PTSD treatment

through targeted surveys
Emily Cooney
Otago University, New Zealand

Abstract
Background:
Bridging the gap between behaviour change, and shifts in the emotions and core beliefs that maintain complex PTSD
can be difficult and time-consuming. This is particularly challenging when the individual with PTSD believes that
thoughts that fuel shame, self-hatred, and avoidance are shared by the broader social context (López-Castro, Saraiya
et al. 2019, Seah, Dwyer and Berle 2023).
Surveys are a powerful tool in cognitive behavioural therapy for testing beliefs, normalising symptoms and experi-
ences, and generating compassionate perspectives (Murray, Kerr et al. 2022). This session focusses on the application
of principles of the prolonged exposure protocol for dialectical behaviour therapy (DBT-PE: Harned, 2022) to working
with individuals with complex PTSD. Case material and examples are used to demonstrate the use of surveys to assist
people to engage in new behaviour that amplifies reciprocal learning for both themselves, and their communities.
Key learning objectives:
Identify the impact of shame on the development, maintenance, and exacerbation of PTSD symptoms.
Describe the principles associated with the use of surveys to test beliefs related to others’ attitudes towards traumatic
experiences, including cultural and ethical considerations.
Review case material and work on practical applications of this material for addressing shame in clinical practice.
Implications:

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Designing surveys with precision to target beliefs that maintain shame and drive avoidance can assist with recovery
from disorders where the threat is related to others’ evaluations of the individual. This can be tremendously liberating
for the individual.

Keywords
PTSD, Dialectical, Shame

SC22: CBT for vaginismus

Aysegul Kervancioglu
Private Practice, Ankara, Turkey
Bengü Yücens
Pamukkale University Faculty of Medicine, Turkey
Aysegul Kart
Private Practice, Ankara, Turkey
Canan Efe
Private Practice, Ankara, Turkey

Abstract
Vaginismus is classified within sexual pain disorders and one of the most common female sexual disorders. Cogni-
tive behavioral Therapy for Sexual Disorders (CBT-SD) incorporates cognitive, behavioral, emotional, physiological,
and interpersonal factors. CBT-SD techniques include in vivo systematic desensitization; keeping a diary of thoughts,
feelings, and behaviors; psychosexual skill exercises; reality testing of cognitions; sexual rehearsal; visualization; re-
laxation training; positive psychology techniques; and meaning making. CBT for vaginismus emphasizes the couple
as an intimate sexual team who collaborate through effective communication, conflict resolution, and practice of
psychosexual skills to create a positive sexual atmosphere within which a woman can learn about her body, develop
sexual self-esteem, and fully enjoy her sexuality. Key objectives of the skill class is to teach participants how to con-
duct sessions with clients with this issue and how to use the before mentioned interventions.
Key learning objectives
Common psychological factors in vaginismus
Psycho-education for vaginismus
Cognitive restructuring for vaginismus
Relaxation and pelvic muscle training
Sensate focus/pleasuring exercises
Dilator therapy for vaginismus

Keywords
vaginismus, interventions, women

SC23: Structured Team Feedback in Family Therapy for Addicted People

Jarmila Tolimatova
Centre for Psychotherapy and Family Therapy, Addictology Clinic, 1st Faculty of Medicine, Charles University, General
University Hospital in Prague, Czech Republic

Abstract
The main aim of this skill class is to share clinical experience and to enable the participants to experience how it feels
like – a role-play of family members and to try to communicate their ideas in a structured team feedback. The key
objectives are improvement of the participant’s ability of both empathy and the ability to formulate assertive useful
feedback to activate functional ways of communication and dealing with problems. I would like to share and discuss
its usefulness not only with addicted people.
We consider addiction a part of a dysfunctional family communicational and behavioral patterns. To provide treat-
ment to addicted patients for us means also to work with the relatives, who often suffer too. The relatives of addicted
patients to some extend take part in the process of abuse of alcohol or other addictive substances and on the other
hand have partly influence in supporting the patient´s soberness.

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The therapeutic team helps to explore the relationships and roles in the family. Safe and empathic conditions may
help to share often rough experiences. It is not easy to help the addicted patients and their relatives to confront them-
selves with unfunctional cycles which lead to low performance of the family members. The acceptance and positive
regard helps family to get in touch mentally and emotionally with their weaknesses and enhance more functional
communication paths, which will enable a way of life where alcohol, drugs or other processual addiction are not
necessary.
Safe and non-judging approach is a result of a everyday practise of the therapist´s inner beliefs and the assertive
feedback to families may be the result.

Keywords
addiction, family therapy, empathetic and positive feedback

SC24: “When One Door Closes, Another Opens”: Utilizing CBT and ACT in
Children and Adolescents with Anger and Aggression Regulation Difficulties
Shimrit Telraz Cohen
Beit Berl Academic College, Israel

Abstract
Background:
This skill class introduces therapeutic techniques from two evidence-based approaches for aiding children and ado-
lescents in managing anger and aggression: Cognitive-Behavioral Therapy (CBT) and Acceptance and Commitment
Therapy (ACT). These methods are research-backed and address the emotional and behavioral facets of anger, de-
fined as an adverse emotional reaction to perceived provocations or boundary violations. While anger can motivate
action against threats and aid in communicating during conflicts, issues arise when it becomes excessive and uncon-
trolled, leads to aggression, and results in distress or dysfunction.
Children and teens struggling with anger and aggression may face social rejection and developmental challenges,
often due to heightened arousal, environmental influences, and deficient problem-solving skills. CBT techniques aim
to improve emotional regulation, problem-solving, and social skills. At the same time, ACT focuses on overcoming ex-
periential avoidance and cognitive fusion, promoting psychological flexibility through acceptance, self-compassion,
cognitive diffusion, value clarification, and committed action.
Participants in this skill class will gain a comprehensive understanding of how CBT and ACT-based interventions can
be adapted with developmental insight and utilized to regulate anger and aggression among children and adoles-
cents. They will also actively engage with each model’s techniques and learn to apply them effectively.

Learning Objectives:
By the end of the class, participants will be able to:

1. Recognize the specific emotional and behavioral expressions of anger and aggression in children and adolescents.
This objective focuses on discerning how anger manifests and affects young individuals’ lives, distinguishing between
normal emotional responses and those that lead to disruptive behaviors.
2. Develop a comprehensive understanding of how to conceptualize difficulties related to anger and aggression con-
trol within the frameworks of CBT and ACT, acknowledging the importance of environmental influences, cognitive
processes, and emotional regulation.
3. Design tailored intervention plans for children and adolescents using CBT and ACT models to address anger dysreg-
ulation. This includes creating developmentally appropriate strategies.
4. Implement effective techniques across CBT modules and the central processes of ACT to enhance psychological
flexibility and better manage anger and aggression. Effective and age-appropriate implementation of therapeutic
techniques improves the outcomes of anger and aggression treatment.

Keywords
Anger management, Child and adolescent Agression, Emotional Dysregulation, Therapeutic Techniques, CBT for Chil-
dren and Adolescents, ACT for Children and Adolescents

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SC25: Keys for integrating REBT with Logotherapy in Clinical Practice

Matti Ameli
Private practice, Calle las barcas 2, second floor, 46002 Valencia, Spain

Abstract
Logotherapy is an empirically supported meaning-centered approach to psychotherapy, which is highly compatible
with REBT. Based on research, the concept of meaning has empirical validation and presents positive correlation with
well-being, and negative correlation with anxiety and depression. Logotherapy-enhanced REBT has the potential to
offer more efficient and effective treatment plans for clients. The goal of this Skills Class is to teach participants how
to integrate both approaches throughout the therapeutic process.
Learning objectives:
• Understand the key concepts and techniques of Logotherapy
• Describe how to integrate them within the REBT framework during the therapeutic process, throughout practi-
cal examples and real case studies related to depression, despair, anxiety disorders etc.
• Discover the benefits of Logotherapy-enhanced REBT at clinical level
•
Keywords
REBT, Logotherapy, Integration, Meaning, Therapeutic Process

SC26: Socializing the patient into CBT using Socratic Questioning and a step
by step analysis and synthesis technique
Vasileios Manoulakas
GACBP, Greece
Lefteris Konstantinidis
University of West Macedonia Greece (UOWM), Greece

Abstract
Socializing and educating the client on the cognitive model and also the nature of his problem is a very important
step of treatment. For some clients, it may actually be the first time they have a good chance to understand their prob-
lems and see them through a very different and meaningful perspective. At the same time, the therapist installs hope
and, consequenty, enhances a given patient’s necessary motivation and wilful collaboration for treatment.
Quite often, during this socialization phase of therapy, cognitive therapists briefly describe the cognitive model and
recommend relevant bibliotherapy. Is this enough?
Although there are plenty of different cognitive techniques for different major or minor interventions, there is a rel-
evant paucity in techniques corresponding to the early socialization phase in CBT. Motivational techniques are also
rarely used in this early phase of treatment.
In order to achieve such a) a successful socialization into CBT, b) a patient’s motivation for therapy, and c) recruitment
of their best possible collaboration, we developed CL.I.M.A.TE. (Collaborative Interviewing in Mathematical Analogy
Technique).
CL.I.M.A.TE is a step by step analysis and synthesis procedure where a mathematical analogy is used as a vehicle for
this purpose. Socratic questioning predominates, while a deductive process leaves ample room for the aspect of col-
laborative empiricism. CL.I.M.A.TE uses a set of specific steps, is highly structured, it takes approximately 15 minutes
and it has been applied to a sample of more than 800 patients.
Objective of this mini-workshop is to help participants adopt this technique as a part of their everyday clinical prac-
tice. Appropriate revisions are also presented for difficult patients.
Since CL.I.M.A.TE does not also help patients, but it also gives the therapist some clues on the patient’s attitudes
towards their problems and therapy, preliminary results are also presented on the CL.I.M.A.TE’s predictive value for
subsequent non-compliance and early drop-outs from treatment

Keywords
Socratic questioning, Socialization into CBT

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SC27: Cognitive Behavioral Therapy for Avoidant/Restrictive

Food Intake Disorder
Hakan Öğütlü
Cognitive Behavioral Psychotherapies Association - Türkiye, Turkey

Abstract
Background
Avoidant/Restrictive Food Intake Disorder (ARFID) is a heterogeneous psychiatric disorder where individuals avoid
certain foods or food categories, leading to a diet that is limited in variety and/or overall intake. One of the most com-
mon reasons for avoidance and restriction in ARFID is an increased sensitivity to the sensory properties of food (e.g.,
taste, texture, appearance, smell). Individuals with ARFID may also avoid or restrict foods due to fears of choking, vom-
iting, or gastrointestinal pain. Often, these individuals have experienced food-related trauma and subsequently avoid
certain foods to protect against another negative experience. A lack of interest in foods or eating is also common
among individuals with ARFID, which can maintain a limited diet. Individuals with a lack of interest describe eating as
a chore, which manifests as low appetite.

Psychological therapies are prominent in the treatment of ARFID. Cognitive Behavioral Therapy for ARFID (CBT-AR)
includes three optional modules that the therapist can apply depending on the patient’s primary maintenance mech-
anism. The therapy can be administered in an individual or family-supported format depending on the patient’s age
and the severity of the eating disorder, typically spanning 20 - 30 sessions. This workshop focuses on Cognitive Behav-
ioral Therapy for ARFID (CBT-AR), an evidence-based approach addressing the complex psychopathology of ARFID to
facilitate effective treatment strategies.

Duration: 3 Hours
Key Learning Objectives:
1. Understand the diagnostic criteria and psychopathological aspects of ARFID.
2. Learn the foundational concepts and techniques of CBT-AR, including formulation and psychoeducation.
3. Apply practical skills for managing
• Fear of Negative Outcomes
• Sensory Sensitivity
• Lack of Interest in Eating or Food
4. Examine case studies to consolidate learning and enhance clinical application skills.

Keywords
ARFID (Avoidant/Restrictive Food Intake Disorder), Cognitive Behavioral Therapy, Eating Disorders, Psychoeducation,
Sensory Sensitivity

SC28: Embracing Self- Compassion:Transforming Self-Criticism in Therapy

Isabelle Leboeuf
University of lille, France

Abstract
Presenter: Dr. Isabelle Leboeuf - AFTCC
[email protected]
Introduction: The workshop will explore the evolution of the understanding of self-criticism in Cognitive Behavioral
Therapy (CBT), from the early contributions of Aaron Beck to the pioneering work of Paul Gilbert in Compassion Fo-
cused Therapy (CFT). Participants will be able to explore different techniques to enhance their understanding and
therapeutic approach to self-criticism.
The workshop will trace the historical development of the concept of self-criticism within CBT, from Aaron Beck’s cog-
nitive model to the groundbreaking insights of Paul Gilbert regarding the role of compassion in emotional healing.
Attendees will gain an understanding of the detrimental effects of self-criticism on mental health and well-being,
including its association with depression, anxiety, and low self-esteem The negative impact of self-criticism on thera-
peutic alliance and social relationships will also be explored.
Paul Gilbert’s conceptualization of the compassionate mind and its role in counteracting self-criticism, fostering
self-compassion, and promoting emotional resilience will be explained.
Participants will learn practical strategies to help clients understand and reframe self-criticism, including functional
analysis of self-criticism and compassionate imagery.

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Case examples and role-playing exercises will demonstrate how therapists can integrate CFT techniques into their
clinical practice to address self-criticism effectively.
Conclusion: The workshop will provide a comprehensive exploration of self-criticism within the context of CBT, high-
lighting the transformative potential of CFT in helping clients develop greater self-compassion and resilience in the
face of self-criticism.

Keywords
Compassion Focused Therapy; Self-criticism; Self-compassion

SC29: The third wave of CBT and beyond: Process based therapy based on
ACT, Logotherpay and Stoic philosophy
Daniel Hamiel
University, Israel

Abstract
The workshop will teach a protocol that focuses on processes beyond diagnoses and is not only a therapy but also a
basis for prevention, for education and the development of a meaning-oriented way of life. The approach is based on
ACT and combines Frankl’s logotherapy, elements from Stoic philosophy, Jewish philosophy and mind-body work.
The intervention promotes attention and regulation tools, to deal with the brain’s tendency to retreat to the comfort
zone where there is no room for unpleasant feelings and to focus on narcissistic self-affirmation. It directs to go be-
yond the self while validating oneself through “belonging” and “responsibility” to others. The intervention redirects
the brain’s automatic default, to create freedom and meaning in reactions to reality. This is done in the spirit of de-
veloping virtues and taking responsibility. A central element of the intervention is the use of mind/body work for the
purpose of connecting to the emotions and containing them. The intervention is suitable for every person and every
problem, but does not claim to solve any problem completely. It intended to be short-term therapy and helping the
person to continue it independently.
Participants will learn
1. The processes they work on in education, psychotherapy and prevention, in the spirit of Stoic philosophy
2. On the centrality of taking responsibility for others in mental health and resilience, in the spirit of Viktor Frankl’s
logotherapy.
3. A new approach and techniques for psychophysiological regulation.
4. How to use the practical Stoic philosophy to impart practical tools in education, psychotherapy and prevention
5. How to develop safe attachment with the help of assertive listening technique.

Keywords
Stoic philosophy, Reasonability in Logotherapy, Third way CBT, Practical philosophy and Psychology

SC30: Beyond verbal therapy: Applying skills for using metaphors, imagery,
drawings and sculpturing to facilitate the change process
Tammie Ronen
Tel-Aviv University, Israel
Yair Dangoor
Tel-Aviv University, Israel

Abstract
Verbal therapy is the mainstream approach to therapeutic intervention. However, traditional verbal therapy alone is
frequently insufficient to help clients overcome their difficulties. This holds true for clients whose verbal expressive-
ness is not an area of strength; for those who suffer from emotional problems that will not be changed by merely
“talking;” for those who resist therapy; for clients who are ashamed or afraid of expressing difficult events and feelings
directly into words; and for many others. Metaphors, imagery and drawings offer a crucial therapeutic solution for
such clients, particularly when relating to emotional issues at the crux of many issues, which require clients to experi-
ence, feel, share, and cope with their feelings. The skills class will present the participants with important non-verbal
techniques they can impart. They will learn how to use these techniques through role play and practice.

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Learning Objectives:
To gain skills to enable the use of imagery, mindfulness, drawings, and
sculpturing to facilitate therapeutic outcomes.

Keywords
Imagery, metaphors, relaxation, skills, non verbal therapy

SC 31: Obsession or Compulsion? Recent Developments in Treating Mental

Compulsions in OCD
Asher Straus
college of management, Israel
Hezi Be’er
Geha Mental Health Center, Israel

Abstract
Obsessive-Compulsive Disorder (OCD) is characterized by persistent intrusive thoughts (obsessions) and repetitive
behaviors or mental acts (compulsions) aimed at reducing distress. While overt compulsive behaviors are observable,
mental compulsions pose a unique challenge as they occur internally through covert thoughts and mental rituals
unseen by the therapist. Moreover, distinguishing between obsessions and mental compulsions, both existing in the
patient’s internal mental realm, can at times be confusing for client and therapist alike. However, effectively identi-
fying and addressing these covert mental compulsions is crucial for comprehensive OCD treatment and achieving a
lasting recovery.
This advanced clinical skills class will provide an in-depth examination of cutting-edge developments in the theory
and practice of identifying and treating mental compulsions within behavioral and cognitive approaches to OCD
treatment. Beginning with clarifying key conceptual distinctions between obsessions, compulsions, overt behaviors,
and mental acts, we will explore how mental compulsions experientially differ from obsessive thoughts and the piv-
otal role they play in perpetuating and intensifying the OCD cycle.
A core focus will be on enhancing clinicians’ ability to aid clients in refraining from compulsive mental activity. Com-
mon challenges and pitfalls when applying exposure and response prevention (ERP) to the internal mental world will
be discussed, with practical guidance on how to overcome these hurdles. A special exploration will be devoted to
the controllable part of thought process, outlining the challenging art of mixing acceptance and modification (e.g.
response prevention) techniques when addressing such process. Additionally, we will emphasize the important role
of the therapist in cultivating an environmental context during sessions that enhances the client’s ability to refrain
from mental compulsions and increases willingness to let go of mental rituals. Suggestions for incorporating these
techniques into client’s between-session practice at home will also be covered.
Participants can expect to leave this skills class equipped with an enhanced conceptual grasp of mental compulsions,
methods to identify them, and an arsenal of novel and advanced therapeutic strategies rooted in ERP to decisively
aid clients to overcome mental compulsive patterns. Ultimately, the goal is to provide clinicians with the necessary
skills to comprehensively address mental compulsions - a frequently overlooked yet critical component in enhancing
treatment outcomes for OCD.

Keywords
Obsessive-Compulsive Disorder; Mental Compulsions; Response Prevention

SC32: Do you know how to have fun with your anger

Karolina Vörös
Schema Therapy Center Belgrade, Serbia
Ksenija Roganović
Schema Therapy Center Belgrade, Serbia

Abstract
Anger as an emotion can be perceived differently depending on the modality of the psychotherapist. In schema
therapy anger is considered a healthy emotional response, still it is a common challenge how to work with it during a
psychotherapy session. In the clinical practice supporting assertive healthy behavior can be difficult when the client
has an overwhelming emotional response.

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Schema therapy uses the concept of “angry child mode” as an innate, universal state triggered when our emotional
needs are frustrated by the environment. However, while growing up, many of our clients learned that it’s not desir-
able to express it, so they suppress it, or express it in an excessive and hurtful way.
In our workshop, we will focus on the original, physical-emotional form of anger and to support it through playful
group schema therapy activities and DBT skills.
We want to offer the learning how to support clients to feel, experience and ventilate their anger in a fun, completely
healthy and safe way.

Keywords
anger, emotional expression, schema therapy

SC33: Integrating Behavior Therapy and Zen Practices

in Dialectical Behavior Therapy
Ursula Witteween
Dialexis Advies, Netherlands

Abstract
This workshop explores the profound fusion of Behavior Therapy and Zen practices in Dialectical Behavior Therapy
(DBT). DBT, an evidence-based treatment developed by Marsha Linehan, is designed for clients struggling with sui-
cidal behavior, self-harm, and emotional dysregulation. It combines cognitive-behavioral techniques with Zen prin-
ciples to promote emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness. Zen, rooted
in Buddhist philosophy, emphasizes mindfulness, meditation, radical acceptance, and the cultivation of present-mo-
ment awareness.
The integration of Zen principles with Cognitive Behavior Therapy in DBT is inherently synergistic. Zen meditation
serves as a type of exposure therapy, enabling individuals to observe their impulses, thoughts, and emotions without
judgment. This practice reduces both impulsive actions and avoidance behaviors that perpetuate suffering. The core
tenet of radical acceptance, pivotal in both DBT and Zen, emphasizes that acknowledging reality as it is represents a
significant form of change. This acceptance empowers clients to halt the exacerbation of their challenges, abandon
resistance, and actively engage with their life experiences, ultimately facilitating a transition from mere survival to
genuine living. Furthermore, the Zen belief that evading suffering only intensifies it resonates with DBT’s objective of
guiding clients to confront and endure distress effectively.
Participants in this workshop will engage in experiential exercises and dialogues to explore how these concepts can
be applied in clinical practice. Attendees will gain practical tools for integrating more Zen mindfulness and radical
acceptance into DBT interventions, enhancing their therapeutic repertoire. This workshop is ideal for CBT and DBT
therapists who wish to deepen their practice and support their clients’ journeys towards a life worth living.

Keywords
fusion, DBT, life worth living

SC34: Accepting the Horror in Full Detail: The Acceptance and Commitment
Therapy with Trauma Victims
Dragan Žuljević
Faculty of Law and Business Studies Dr Lazar Vrkatić, Serbia

Abstract
Acceptance and Commitment Therapy (ACT) is one of the therapeutic approaches that emerged from the behavioral
and cognitive traditions. As part of the so-called third wave of behavioral treatments, it uses acceptance, mindfulness,
committed action, and processes of behavioral change to promote an increase the person`s psychological flexibility
and motivate her toward a behavioral change that is more consistent with their own valued life perspectives (Hayes,
Wilson, & Strosahl , 1999). Also, ACT has recently been demonstrated as one of the preferred treatments of choice in
working with traumatized people (Harris, 2021). As in other psychological treatments in dealing with traumatic mem-
ories, the main focus of ACT in this specific context is retraumatization - bringing the person into a state of willingness
to re-face the traumatic memories in full detail, allowing oneself to re-experience the highly unpleasant emotional
response, as well as the accompanying cognitions and urges. Only with the abreaction of this emotional content, the
person is faces the opportunity to integrate the traumatic memories. By allowing the possibilities of experiencing the

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traumatic memories in a different way, the person becomes opened to the behavioral possibilities that would poten-
tially lead him to a valuable and meaningful, happy and fulfilled future.
The main goals of this workshop will be:
Introduction to the basic concepts and the ACT model
Introduction to the basic elements of trauma theory with special reference to the neurophysiology of trauma
The basic ACT protocol in working with individual traumas
Specific ACT techniques in working with intense emotional responses during the trauma reexperiencing.
The ACT approach in working with trauma compared to other approaches of cognitive and other therapeutic tradi-
tions.
Limitations of the ACT approach in working with trauma
The specifics of ACT applied to war veterans and war victims in the territory of the former Yugoslavia
Our many years of experience in working with war veterans, victims of wars in the territory of the former Yugoslavia
and their family members provided us with the opportunity to discreetly adapt the standard ACT protocols to the cul-
turally specific setting of the post-conflict area of ​​the Western Balkans. Through numerous examples and illustrations
from the practice, we will try to provide participants with specific knowledge that they could apply in their daily prac-
tice when working with this specific population, especially in the situation where they face the limited effectiveness
of traditional therapeutic approaches.

Keywords
Acceptance and Commitment Therapy, PTSD, War trauma, Retraumatization

SC35: RE&KBT i Egzistencijalizam

Vladan Beara
REBT Praxis Centar, Serbia

Abstract
Radionica se bavi mogućnostima RE i KBT-a da pomogne suočavanje sa nepromenjivim egzistencijalnim činjenicama
života i olakša njihovo prihvatanje. RE i KBT ima mogućnost da ode korak dalje u odnosu na klasičnu egzistencijalis-
tičku terapiju Irvina Yaloma, i značajno poboljša prihvatanje „neprihvatljivih“ činjenica života. Bazični egzistencijalni
konflikt po Irvinu Yalomu je u konfrontaciji između čoveka-pojedinca i egzistencijalnih datosti kao što su: smrt, sloboda
i odgovornost, egzistencijalna izolacija i besmislenost življenja. Po egzistencijalistima svi moramo umreti; svi smo slo-
bodni ali i odgovorni za sopstvene izbore; nema univerzalnog smisla niti uzvišene grandiozne tvorevine univerzuma;
nema pouzdanog vodiča za donošenje životnih odluka, nema ničeg da se oslonimo kada donosimo odluke; mi smo
sami u univerzumu i moramo da otkrijemo ili pridamo smisao životu. Iz RE i KBT perspektive pojedinac je prestravljen
susretom sa nepromenjivim egzistencijalnim činjenicama života, zato što pojedinac veruje u iracionalna uverenja da
bi svet trebao biti drugačiji; da je užasno i nepodnošljivo živeti u ovakvom svetu. Naši apsolutistički zahtevi prema re-
alitetu ukazuju na naš neurotičan i egocentričan odnos prema stvarnosti. RE i KBT ima potencijal da pomogne ljudima
da radikalno rekonstruišu svoja duboka životna uverenja i tako načine dubinsku filozofsku promenu u sebi.
RE i KBT ima mogućnost da pomogne ljudima da prihvate ono što vide kao neprihvatljivo, da prestanu da se užasavaju
oko toga, da donesu neke odluke u životu i promene svoja ponašanja. Na taj način RE i KBT može da pomogne ljudima
da prevaziđu neurotičnost i egocentričnost svoje egzistencije u svetu.

Keywords
existential therapy, givens of existence, ultimate concerns, REBT, life philosophies, egocentric relationship toward
reality, meaning

SC36: Of Skies, seas and mirrors: Discovering the Self of the Therapist through
Reflective Practice
Chetna Duggal
Tata Institute of Social Sciences, India
Poornima Bhola
National Institute of Mental Health and Neurosciences, India
Rathna Isaac
Parivathan Counselling Training and Research Center, Bangalore, India

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Abstract
As we work with our clients in the therapy room, we embark on a parallel journey of self-discovery that shapes our
personal and professional growth and development. Engaging in reflective practice, furthers the therapeutic process
and our connection with clients, and allows us to effectively integrate our theoretical orientation with our personal
beliefs and values.
This half-day workshop is an immersion into using reflective practice for ‘self-of-the-therapist’ work and is recommend-
ed for trainees with some experience in psychotherapy practice/counselling, psychotherapists in practice, teachers/
supervisors engaged in psychotherapy/counselling training using CBT and other models of therapy practice.
• Key learning objectives
1. Learn about reflect practice and how it can facilitate therapist personal and professional development
2. Use reflection as a tool to explore the ‘self-of-the-therapist’ and how it enters the therapy room and connects to
theoretical orientation
3. Engage in reflective and experiential exercises to understand the therapist ‘self-in-relation’
4. Discuss therapist positionality and reflect on the ‘self-in-context’.

Keywords
reflective practice, self-of-the-therapist

SC37: An integrated CBT treatment for psychosis: Strategies to optimize the

treatment and mistakes to avoid
Antonio Pinto
SITCC, APC,/SPC,CBT School, CEPICC, Department of Mental Health, Naples, Italy

Abstract
The therapy of psychosis, has undergone several changes in recent years.
From an initial work on skills, to the strengthening of problem-solving skills and information processing until a new
way of managing the symptoms.
Third-generation therapies and the identification of metacognitive deficits also enabled us to enhance and improve
the standard CBT approach to the treatment of this disease.
However, in clinical practice, the presence of therapeutic errors that often represent one of the causes of failure of
therapies and drop-out by patients, is still rather frequent.
There are several elements that can influence the negative course of therapy, such as:
The presence of prejudices and old theories about the nature of the pathology could be considered one of the central
errors in the treatment of schizophrenia. It should be difficult, In fact to overcome the pessimism about the outcome
of this disease if we consider it only a chronic disease characterized by a progressive deterioration of the brain struc-
tures.
The presence of other elements can still contribute to create misunderstanding and confusion in approaching this
disease as, for instance:
the greater or lesser timeliness of the intervention, the appropriate use of pharmacological therapies, the assump-
tions on which to base the therapeutic alliance, the greater or smaller sharing of the objectives to be achieved, the
target of therapeutic intervention, the possibility or not to include patients in structured and integrated protocols, the
choice of the individual or group setting, etc.
Some old strategies have also proved to be a failure to treat these patients, such as trying to change at all costs pa-
tients opinions about the content and the nature of their (delusional) ideas; it is also increasingly revealed that an
error does not take into account, before starting a personalized therapeutic program, of the presence of neurocogni-
tive and metacognitive deficits, the presence of which can have a decisive influence on the course of therapy and the
outcome of the disease itself.
Key learning objectives
To show participants the strategies and techniques to overcome issues mentioned above, to improve the therapeutic
alliance and to make the therapeutic path easier for both the patient and the therapist, to improve the efficacy of the
techniques, and to personalize the case formulation.
Implication for everyday clinical practice of CBT
Providing the participants with the elements to apply in their daily clinical practice strategies evidence based and not
to commit the usual methodological errors that too often cause dropouts or poor therapeutic efficacy.

Keywords
psychosis, treatment, pitfalls

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SC38: What really matters in (my) life? Exploring values in Acceptance and
Commitment Therapy (ACT)
Dario Lipovac
BHACBT, Bosnia and Herzegovina

Abstract
Exploring values is an integral part and one of the core processes of behavioural change in Acceptance and Commit-
ment Therapy (ACT). Values-based living gives people sense of meaning and purpose in making mindful choices in
their life, deep sense of vitality and motivation. When clients are participating in therapy process, they naturally want
to move away (“symptom reduction”) from the pain they experience (anxiety, depression, shame, guilt, anger, stress
and many more). The clinical research in ACT over the last decades is demonstrating that expanding behavioural rep-
ertoire, increasing psychological flexibility (through exposure, defusion and mindfulness) and overcoming difficult
experiences is more efficient when values are integral part of the therapy process.
At the end of this skills class participants will be able to:
• Understand the basics of the ACT model (six core ACT processes)
• Understand and describe role of values in ACT (aversive vs. appetitive stimulus/behaviour conditioning)
• Understand and describe role of values-based committed action (behaviours toward values)
• Identify core values domains in their personal experience and in their clients experience
• Outline how they can integrate values and committed actions in their own work with clients, including key ob-
stacles to values-based living
• Apply values questionnaire and experiential exercise for identifying values in their clinical work
This skills class would combine didactic large group presentation, large group mindfulness exercise, role plays in pairs
and discussion. Participants would be introduced to the ACT model (including six core ACT processes) and to the role
of values in ACT (including a values questionnaire). Participants will then fill in values questionnaire using their per-
sonal experience in order to understand how to apply it with clients. Facilitator will then lead the large group mind-
fulness exercise to get experiential contact with the concept of values in ACT, after which participants would do a role
play in pairs to practice identifying values. The skills class would end with discussion in a large group and key take-
aways. Participants would get the links to relevant literature to explore the topic further after this skills class session.
Participants with at least basic knowledge and understanding of ACT would benefit from this skills class the most.
However, participants with no previous knowledge of ACT would still benefit to get an overview and role of values in
ACT.

Keywords
ACT, values, committed action, meaning, behaviour change

SC39: The art of assertiveness: helping anger of self and other

Lidija Ristić Milojević
SRABCT, Serbia

Abstract
Unmanaged anger is recognized as a common and exhausting psychological problem among various psychiatric
populations as well as healthy individuals, and the treatment of anger and aggression has become the subject of
interest in various settings. There are challenges in self-management in situations where individuals face their own
anger, as well as the anger of others.
Assertiveness is a skill we use to express our thoughts, feelings and beliefs in a clear, direct and appropriate way, re-
specting the rights of others. Assertiveness contributes to better self-esteem and better communication in emotional
and professional relationships in healthy individuals, with evidence-based therapeutic effect in some psychiatric con-
ditions, such as anxiety disorders (particularly social phobia), substance abuse, depression, etc.
The aim of this skills class is to present how shaping the client’s personal assertiveness “art” can specifically address the
anger of self and the anger of others, focusing on both the skill to distinct assertive from aggressive/passive behavior,
and the implementation of assertive techniques. The approach focuses on cognitive restructuration and feedback
during role-play.
Training modalities
The training modalities will include didactic curriculum, case presentations, and working in small groups.
Learning objectives:
By the end of the class, participants will be able to:

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1. Help their clients recognize the anger of self (type 1 situation) and others (type 2 situation)
2. Help their clients identify and restructure cognitive distortions in both types of situations
3. Help their clients change behavior through role play in both types of situations

Keywords
anger management, assertiveness, communication

SC40: Developing Compassionate Mind - A Compassionate Mind Training

Petra Malešević
Compassionate Mind Foundation, Croatia

Abstract
Very short scientific background
Compassion Focused Therapy (CFT) have been developed to address transdiagnostic difficulties connected to high
levels of shame and self-criticism. While practising CBT, prof. Paul Gilbert noticed that although clients could some-
times generate helpful thoughts to counteract negative, self-accusatory, and attacking ones these were not helpful
and lacked genuine caring emotional textures (Gilbert, 2020). Helping people to generate a compassionate inner
voice or texture to their coping thoughts proved more difficult than anticipated, which opened up a whole journey
into what is the underlying basis of feeling of affiliation and compassion (Gilbert 2014). CFT is used today for a wide
range of mental difficulties, as it tries to develop a psychophysiological base for feelings of safeness as a counterbal-
ance to life setbacks and distress.
Compassionate Mind Training (CMT) is a combination of psychoeducation, physiological and psychological practices,
which help to develop physiological and psychological characteristics of a resilient personality, including attention
training, mindfulness, soothing rhythm breathing, and imagery. CMT practices ultimately aim to cultivate a compas-
sionate self-identity (known as the compassionate self ), linked to qualities of wisdom, strength and caring motivation,
which is then used to manage daily struggles and common difficulties (Irons, C. and Heriot-Maitland, C., 2021).
8-week group CMT showed significant increases in compassion, self-reassurance, social rank, positive emotions, and
well-being, alongside reductions in self-criticism, attachment anxiety, and distress (Irons, C. and Heriot-Maitland, C.,
2021). Even short forms of CMT have proven to be effective. McEwan and Gilbert (2016) found that after 5 min of daily
practice of CMT over a 2-week period, participants reported significant reductions in self-criticism, depression, anxi-
ety, and stress, and increases in self-compassion and self-reassurance.
Key learning objectives
• The Compassionate Mind model – the competencies of CM
• Neuroscientific lessons in CFT – ventral vagus, „tricky brain“, three emotional systems model
• Activate the ventral branch of vagal nerve and understand its connection to the Compassionate Mind
• How our mind falls into a vicious circle of unpleasant emotions
• How the combination of evolutionary psychology, attachment theory, social psychology, mindfulness and biol-
ogy connect to a profound wisdom of CFT
• Evolutionary roots of shame and self-criticism
• How to stop being self-critical and solve problems constructively by using your basic biology and „New Brain“
functions
• Why compassion is not soft but assertive and courageous
All this in a dynamic combination of interesting mini lessons and a lot of practical work.
Implications for everyday clinical practice of CBT
The elements of CFT can be implemented in the CBT treatment in the form of psychoeducation (“Tricky Brain”, “Com-
mon humanity”, etc.), various practices for more optimal ventral vagal response, chair-work for the better understand-
ing of emotional complexity, partial compassionate formulation for better understanding of defensive behaviours
and emotional shame memories, especially for the cases of high self-criticism and shame and insecure attachment
styles.

Keywords
compassion, compassionate mind training, attachment, compassion focused therapy, third wave

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SY1: Narrative Exposure Therapy: Navigating Challenges and Exploring

Perspectives/Societal Reach
Chair: Inga Schalinski
Universität der Bundeswehr Munich, Germany
Vittoria Ardino
University of Urbino and Italian Society of Traumatic Stress Studies, Italy
Inga Schalinski
Universität der Bundeswehr München, Germany
Katy Robjant
Nongovernment organization vivo international e.V., 78430 Konstanz, Germany, United Kingdom
Anselm Crombach
Universität des Saarlandes, Germany

Abstract
Narrative Exposure Therapy (NET) is an effective and internationally recommended trauma-focused treatment for
posttraumatic stress disorder (PTSD). Grounded in Testimony Therapy, NET has shown effectiveness in treating PTSD.
During psychotherapy, individuals are empowered to articulate their personal traumatic experiences, enabling them
to construct a coherent and contextualized narrative of their past, explicitly recognizing cumulative exposure to
traumatic events, childhood maltreatment, and further adversities. By finding words for the unspoken memories
of the past and reconstructing these narratives within a safe therapeutic environment, individuals can gradually
process and integrate their traumatic memories into their life story, fostering healing, dignity, and meaning-making,
while also incorporating individual resources. The first two presentations will address adaptations and challenges in
underserved cases from clinical practice
Vittoria Ardino will present a case illustrating a framework for designing, delivering, and evaluating a NET-based
early intervention protocol (NASTI) in combination with subsequent NET sessions for a woman, who has survived
complex and extreme multiple traumatic events. The woman underwent three NASTI sessions and ten NET sessions.
Data showed that NASTI enabled the woman to develop more effective coping strategies and improve emotion
regulation. Partial remission of PTSD symptoms occurred after the NET treatment.
Inga Schalinski will focus on an underserved group of individuals with psychotic disorders and PTSD. Despite the
common reports of traumatic events throughout their lives and exhibiting increased comorbidity with PTSD, they
have been overlooked in research efforts. The presentation will discuss the findings of a study involving N = 10
individuals with psychotic disorders and PTSD who received NET. Evaluation of primary of secondray outcomes were
done using a pre-post study design (registered in clinical trials: NCT03730831).
Further contributions of this symposium will focus on exploring societal reach through an integrated model of
evidence-based individual trauma treatment (NET) and trauma-informed community-based intervention (NETfacts),
aiming to improve mental health within communities and reduce ongoing violence. Environments characterized by
cumulative traumatic experiences and childhood maltreatment, along with recurring cycles of violence, are associ-
ated with profound repercussions on human capital, underscoring the need for broader awareness and intervention
efforts. Collective avoidance plays a significant role in how societies respond to trauma involving collective denial or
avoidance of acknowledging and addressing traumatic events or their consequences at a societal level.
Katy Robjant will introduce the NETfacts health system applied in the Democratic Republic of Congo, a country
affected by armed conflicts for decades. First findings of randomized control trials will be presented on individual
and societal level.
Anselm Crombach will present findings of NETfacts health system in a longitudinal cohort design involving N = 1680
individuals, we aim to assess how NETfacts is perceived by community members and if trauma-related symptoms
are reduced.
This symposium will highlight adaptations to apply NET in underserved individuals with cumulative trauma ex-
posure and trauma-related disorders, as well as presenting findings from the NETfacts health system that may be
critical to regain human capital and establish peaceful, healthy environments.

Keywords
Narrative Exposure Therapy; PTSD; cumulative trauma exposure

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Integrated Narrative Stabilization (NASTI) and Narrative Exposure Therapy:

from early intervention to clinical treatment
Vittoria Ardino
University of Urbino and Italian Society of Traumatic Stress Studies (IT), Italy

Abstract:
Background. Traumatization is a dynamic process over a continuum of increasing difficulty in managing autobi-
ographical memories; in fact, how survivors of trauma manage their autobiographical memories is associated with
posttraumatic stress responses potentially leading to a disjunction of the hot and cold memory and to an overall
decontextualization of memory. Narrative Exposure Therapy is an evidence-based treatment useful in relieving com-
plex post-traumatic symptoms with a focus on a narrative of a coherent full autobiography resulting from the re-con-
textualization of traumatic memories. NET-based early interventions could play an important role in preventing the
decontextualization of the traumatic memory from happening and to develop a narrative of the potential traumatic
events as early as possible.
Clinical scenario. The case illustrates a framework for thinking about the design, delivery and evaluation of a NET-
based early intervention protocol (NASTI) in combination with subsequent NET with a woman living in a refuge for
women victims of violence and who survived complex and extreme multiple traumatic events. The woman under-
went three NASTI sessions and ten NET sessions. Data showed that NASTI enabled the woman to develop more ef-
fective coping strategies and to improve emotion regulation alongside PTSD symptoms partial remission happened
after NET treatment.
Conclusion. The case highlighted the importance of seeing traumatization along a continuum and of strengthening
early intervention protocols in coherence with evidence-based trauma treatments.

Key words
multiple traumatic experiences; complex PTSD; emotion regulation; Narrative Exposure Therapy

Narrative Exposure Therapy for Psychosis with Comorbid PTSD: A Case Series
Exploring Efficacy in Clinical Practice
Inga Schalinski 1,2,
Susanne Breinlinger 3,4,
Brigitte Rockstroh 2,3,
Michael Odenwald 2,3
1Universität der Bundeswehr München, Department of Human Sciences (Germany)
2 Non-Governmental Organization Vivo International e.V., Konstanz (Germany)
3University of Konstanz, Department of Psychology (Germany)
4Center of Psychiatry, Reichenau, Germany

Abstract:
Introduction/Background: Individuals with schizophrenia spectrum disorders frequently report an exposome char-
acterized by childhood maltreatment as well as traumatic experiences throughout their lives, and they show an in-
creased comorbidity with post-traumatic stress disorder (PTSD). Trauma-focused treatments are effective for PTSD
symptoms; however, individuals with severe psychiatric disorders have been insufficiently considered in previous
studies. One form of trauma-focused therapy is Narrative Exposure Therapy (NET), which specifically takes the broad
exposome into account. The present case series examines trauma-related symptoms before and after treatment with
NET, as well as 6 months post-treatment, in individuals with schizophrenia spectrum disorders and comorbid PTSD.
Methods: The study was registered in clinical trials (NCT03730831). N=10 individuals with schizophrenia spectrum
disorders and comorbid PTSD were treated using NET. The primary outcomes were the diagnosis (according to DSM-
5), the severity of PTSD symptoms (PCL-5), and dissociation (Shut-D). Secondary outcomes included depression se-
verity (BDI-II; HAMD), psychotic symptoms (PANSS), suicidal tendencies (M.I.N.I. Suicidal Scale), global functioning
(WHODAS 2.0) and cognitive performance measured using a standardized test battery (MATRICS Consensus Cogni-
tive Battery, MCCB).
Results: PTSD symptoms were significantly reduced between the pre-treatment and post-treatment (Hedges’ g=2.15),
as well as at the 6-month follow-up (Hedges’ g=0.75). N=2 individuals still met the DSM-5 diagnostic criteria for PTSD
at the post-treatment time point, and n=3 at the 6-month follow-up. Dissociative symptoms decreased as well (Base-
line to post-treatment: Hedges’ g=.65; Baseline to 6-month follow-up: Hedges’g=.70). Additionally, significant effects
were observed in cognitive performance, psychotic symptoms, and depression severity.
Discussion/Conclusion: The results indicate that NET is a promising and feasible treatment option for comorbid PTSD

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in individuals with schizophrenia spectrum disorders. The exposome and PTSD should be systematically examined
in individuals with schizophrenia spectrum disorders, and trauma-focused therapy should be offered. Further large-
scale, randomized, and controlled studies are necessary to confirm these results.
Keywords: Psychosis; Severe mental illness; PTSD comorbidity; Narrative Exposure Therapy

Healing traumatised communities: Its not what you think you know
Dr Katy Robjant
vivo International

When a community goes through an experience collectively, an overall ‘shared narrative’ exists, that explains what
happened: “the time our community was attacked”. The reality, is that every individual had a different experience,
one person experienced rape, one person was abducted into an armed group, one person witnessed their loved one
being shot.
The individual narratives of what happened to each person is not shared because of trauma related psychopatholo-
gy. PTSD includes avoidance as a core symptom. Working with the individuals at an individual level, can heal trauma,
but the collective may remain unable to respond. We propose, the ‘NETfacts Health System’ whereby individuals who
have been victims of , or perpetrators of trauma are effectively treated (using NET, FORNET or KIDNET) and individuals
showing sub-clinical symptoms can process single events. Shared narratives (anonymised and de-personalised) are
shared in a group setting, in order to ensure the community can contain a shared memory of all of the parts of the
experience, reducing stigma and social exclusion and increasing caregiving to those most affected.

Keywords
Trauma, conflict, PTSD, community psychology, narrative

The importance of addressing traumatic stress on the community level

Anselm Crombach 1, 2
Amani Chibashimba2,
Ornella Irambona 3
Tobias Hecker 2, 4,
Roos van der Haer 5,
Brigitte Rockstroh 2, 3
1 Saarland University, Department of Psychology, Clinical Psychology and Psychotherapy for Children and Adoles-
cents, Saarbrücken, Germany
2 Non-Governmental Organization vivo international e.V., Konstanz, Germany
3 University of Konstanz, Department of Psychology, Clinical Psychology and Clinical Neuropsychology, Konstanz,
Germany
4 Bielefeld University, Department of Psychology, Clinical Developmental Psychopathology, Department of Psychol-
ogy, Bielefeld, Germany
5 Leiden University, International Relations at the Institute of Political Science, Leiden, The Netherlands

Abstract:
Background: With decades of armed conflict, the Democratic Republic of Congo (DRC) is an example of the detri-
mental impact of violent conflicts on mental health, social attitudes, and cultural norms within communities. Initial
research suggests that the NETfacts health system, an integrated model of evidence based individual trauma treat-
ment (Narrative Exposure Therapy) and a trauma informed community-based intervention (NETfacts), is effective in
reducing trauma-related symptoms and stigmatization of survivors and former perpetrators.

Objective: We aim at understanding how individual and collective traumatization affects social capital, i.e., social in-
teractions, social support in case of need, trust and solidarity, and collective action and cooperation, and how NET-
facts might affect this social cohesion.
Methods: In a cohort design, we conducted semi-structured interviews with one person from every household in
four villages in the eastern DRC. In total we assessed 1597 adults longitudinally. We assessed posttraumatic stress
symptoms, social capital and violence committed within the community. After the initial assessment the communities
benefitted from the NETfacts intervention and were invited to participate in 9-months-follow-up assessments. During
the follow-up assessments, we additionally conducted focus groups to understand how NETfacts is perceived by the
communities.
Results: Preliminary results suggest that PTSD symptom severity reduced improved for those receiving individual
treatment (drm= -0.88), and for those who participated only in the community interventions (drm= -0.63). Trust and
solidarity and collective action improved significantly in those who listened to prototypical narrations of survivors.

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Furthermore, qualitative data will be presented regarding the perception of NETfacts in the communities.
Conclusion: Addressing traumatic stress within a stepped-care model for individuals and on the community, level
might improve social cohesion within war-affected communities.

Keywords
Collective traumatization; Social cohesion; Stepped-care model; NETfacts health system

SY2: Exploring Interpersonal Processes in Social Anxiety and Depression

Corine Dijk
University of Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands, Netherlands
Hanieh Abeditehrani
University of Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands, Netherlands
Carmen van den Bulck
University of Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands, Netherlands

Abstract
This symposium explores the significant role of interpersonal processes in both the maintenance and treatment of
social anxiety and depression. It acknowledges the pivotal role of social interactions in psychological health and ex-
amines how these mental health conditions are influenced by, and in turn affect, interpersonal relationships.
The first presentation examines the relationship between social anxiety and empathy, highlighting a paradox due to
the heightened interpersonal distress experienced by socially anxious individuals. This research indicates that socially
anxious individuals with a colder demeanor experience less stress and have better emotional recognition. However,
their tendency to appear cold and distant may make them less likable. Conversely, warmer socially anxious individ-
uals show greater concern for others but suffer from increased stress, leading to difficulties in recognizing emotions.
These findings suggest that the degree of interpersonal engagement significantly impacts the experiences of socially
anxious individuals.
The second presentation focuses on therapeutic interventions, specifically the effectiveness of group therapies that
incorporate interpersonal processes. This part of the symposium introduces comparative studies on group cognitive
behavioral therapy (CBT) with a focus on social exposure, psychodrama that targets the enactment of interpersonal
situations, and a hybrid approach integrating both methods. These studies explore mechanisms of change such as
increased spontaneity, diminished negative social expectations, and reduced avoidance of social situations. Interest-
ingly, results suggest that these mediators of change are not as specific to the type of therapy as previously thought,
offering insights into the broad benefits of focusing on interpersonal dynamics in group therapy settings.
The final presentation uses network modeling to explore loneliness as a potential consequence of both social anxiety
and symptoms of depression, while considering various interpersonal difficulties such as emotional coldness and
inhibition. The study finds that social anxiety is closely linked to inhibition and a lack of self-assurance. In addition,
social anxiety is associated with being less securely attached, which leads to social loneliness characterized by dissat-
isfaction with both the quantity and quality of social contacts. In contrast, symptoms of depression correlate more
with emotional loneliness, which reflects a pervasive feeling of missing out.
Together, these studies emphasize the crucial role of interpersonal interactions in the causes, treatment, and effects of
social anxiety and depression. They point to the importance of addressing interpersonal factors in both understand-
ing these mental health issues and in creating effective interventions.

Keywords
Interpersonal processes, social anxiety, depression, integrative therapies, cognitive behavioral therapy, psychodrama

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SY3: Promoting Durable Remission from Depression: Towards Clinical Imple-

mentation of Preventative Cognitive Training
Chair: Kristof Hoorelbeke, Ghent University, Belgium

Kristof Hoorelbeke
Ghent University, Belgium
Patricia Mecha
Universidad Complutense de Madrid, Spain
Eivind Haga Ronold
University of Bergen, Norway
Yannick Vander Zwalmen
Ghent University, Belgium
David Demeester
Ghent University, Belgium
Ernst H.W. Koster
Ghent University, Belgium

Abstract
Maintaining stable remission remains an important challenge in the treatment of depression. In this context, evi-
dence suggests that cognitive deficits show limited response to existing treatments, placing one at increased risk for
recurrence of depression. Over the last decade, tailored experimental interventions have been developed to target
these processes (i.e., 4th wave CBT interventions), including remediation of executive functions and working memory
deficits through cognitive training. The current symposium offers an overview of the state-of-the-art in the field of
preventative cognitive training for depression, while providing direct implications for clinical case conceptualization
and implementation of preventative cognitive training in clinical practice.
For this purpose, the first presenter, Patricia Mecha (Complutense University of Madrid, Spain) will present the find-
ings of a recent study that aimed to map the relation between cognitive processes and stress resilience. This includes
a focus on cognitive processes relevant to depression such as affective attentional flexibility and its relation with
mental health outcomes while accounting for the occurrence of stressors, providing avenues for novel interventions
targeting depression vulnerability.
Next, Dr. Eivind Haga Ronold (University of Bergen, Norway) will present the results of a recent study investigating
long-term alterations in cognitive functions following preventative cognitive training for remitted depressed (RMD)
individuals. Over a two-year follow-up period, clinically meaningful effects were observed for different cognitive pro-
cesses, including executive functioning, working memory, and processing speed which were repeatedly assessed us-
ing a comprehensive neuropsychological test battery. These findings highlight the potential of preventative cognitive
training to obtain durable changes in cognitive vulnerability factors for depression.
Following up on this, Yannick Vander Zwalmen (Ghent University, Belgium) will provide an overview of recent evi-
dence for emotional transfer effects following preventative cognitive training for depression, focusing on rumination
and residual depressive symptomatology in particular. This will include the results of a recent large-scale clinical trial
focused on determining the optimal training dosage to be used when applying preventative cognitive training in
clinical practice (i.e., dose-response study; RMD individuals).
The fourth presenter, David Demeester (Ghent University, Belgium) will present findings of single-case series focusing
on the temporal unfolding of emotional transfer effects following preventative cognitive training for RMD individuals.
For this purpose, RMD individuals completed preventative cognitive training while being intensively monitored using
a comprehensive set of self-report measures and wearables. This includes a focus on (sequence of ) effects on specific
residual complaints, transdiagnostic vulnerability mechanisms and resilience to daily life stressors.
Finally, the symposium will conclude with a brief discussion moderated by Prof. dr. Ernst Koster (Ghent University,
Belgium), a CBT therapist who is an expert in cognitive vulnerability for depression and related interventions. Taken
together, this symposium focuses on an important challenge in CBT treatment of depression, namely, reaching and
maintaining stable remission. For this purpose, we propose a novel add-on preventative cognitive intervention, and
discuss challenges for its clinical implementation.

Keywords
cognitive training; depression; prevention; remission; cognitive control

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The role of attentional affective flexibility in resilience outcomes: Insights from an eye-tracking study
Patricia Mecha, Oscar Martin-Garcia, Alvaro Sanchez-Lopez
Department of Personality, Evaluation and Clinical Psychology, Complutense University of Madrid, Spain

Abstract:
The capacity for cognitive flexibility, a central component of executive functions (EFs), has been shown to be a key fac-
tor associated with the promotion of resilient responses. However, the experimental study of cognitive flexibility has
generally relied on tasks with non-affective stimuli, whose indices are based on response time. Further, most studies
analyzing resilience, have depended on measures focused on self-reported resilience trait. New approaches propose
the need to increase ecological validity through affective stimuli, as well as outcome-based measures of resilience
(i.e., the maintenance of good levels of mental health and well-being, despite the experience of stressful situations).
Therefore, the aim of this study was to analyze the relationship between affective-attentional flexibility (through
eye-tracker technology and affective stimuli) and resilience (measured as an outcome).
A total of 152 participants completed scales of mental health (i.e., DASS-21), well-being (WEMWBS); perceived stress
(i.e., PSS) and daily-life stressors checklist (LES), as well as an experimental cognitive-affective flexibility task in which
participants were asked to attend to relevant positive or negative information, depending on changes in specific
goals.
Results showed that greater performance in the flexibility task was associated with outcome resilience. First, a pattern
of inflexibility towards negative information (i.e., longer switching time toward negative stimuli) was associated with
maintaining higher resilience understood as having good levels of mental health despite the experience of stress.
Second, a pattern of general affective flexibility (i.e., greater ability to switching between both affective conditions)
was associated with the maintenance of well-being despite the experience of stress. Finally, in general, a pattern of
attentional preference towards positive information was found to be related with better resilience outcomes.
This study highlights the central role of high cognitive processes such as affective attentional flexibility in resilient
coping with stress. It also suggests a new avenue for the development of new cognitive trainings aimed at promoting
this flexibility and, consequently, improving resilience to stress.

Keywords
attentional affective flexibility; resilience; eye-tracking

How long does the cognitive improvements from working memory (WM) training last? A two-year longitudi-
nal follow-up of reliable changes in processing speed, WM and executive functions in remitted major depres-
sive disorder.
Eivind Haga Ronold (presenter), Rune Raudeberg & Åsa Hammar
University of Bergen, Norway

Objectives:
Interventions targeting cognition (e.g. computerized WM training; CWMT) in people with depression have recently
been shown to improve cognitive functions and symptoms. However, little is known about long term effects. The
presence of practice effects on the tests used for assessing cognitive function precludes interpretation of improve-
ments. Methods controlling for practice has been developed for assessing reliable change indices (RCI) in repeated
neuropsychological testing. An investigation of RCI could improve the understanding of the long-term impact of
CWMT.

Participants and methods:

Twenty participants remitted (<12 MADRS) from major depressive disorder (MDD) completed five weeks of CWMT.
The task consisted of various spatial and symbol span tasks with incremental difficulty and were performed one hour
for five days a week. There was weekly telephone contact with a trained coach before, during and after training. Partic-
ipants completed a comprehensive neuropsychological test battery pre, post (n = 20), one-year (n = 13) and two years
following CWMT (n = 10), including executive functioning (EF), WM, and processing speed (PS).

Results:
Participants showed lasting improvements on most cognitive tests. Following CWMT, and at 1- and 2-year follow up,
participants showed RCI at rates of 25%, 45% and 50% in EF; 20%, 18.18% and 20% in WM; and 30%, 36% and 30%
showed RCI in PS, respectively.

Conclusions:
Participants showed improvement in measures EF, PS and WM with most RCI for EF, which could suggest far transfer
effects compared to WM. Smaller rates of RCI in PS indicated that faster PS likely cannot explain improvement. The rel-

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atively low rate of RCI could suggest that screening for cognitive deficits is feasible when conducting CWMT studies.
RCI was apparent two years after CWMT which could indicate long term benefits of one period of intensive CWMT.

Keywords: computerized working memory training; cognitive transfer; depression

The more, the merrier? Examining a dose-response relationship of a neurocognitive training for relapse pre-
vention of depression.
Yannick Vander Zwalmen (presenter), David Demeester, Kristof Hoorelbeke, Nick Verhaeghe, Chris Baeken,
Ernst Koster
Ghent University, Belgium

Objective:
Meta-analyses have indicated that Cognitive Control Training (CCT) can be used to increase cognitive functioning
and prevent relapse of depression. However, it is currently unclear how many training sessions are required in order
to obtain both immediate and long-term effects. A large scale RCT was conducted to examine the dose-response
relationship of CCT for depressive symptomatology.

Participants and methods:

Remitted depressed individuals (n = 216) were recruited and were randomized across 6 groups: five intervention
groups, receiving either 1, 5, 10, 15 or 20 training sessions, and one waiting list control group. Cognitive performance
tasks and self-report questionnaires were used to examine cognitive and affective transfer. Outcomes were assessed
at baseline, after completing training, and at 3 and 6 month follow-up. Analyses were performed using mixed effects
models.

Results:
Preliminary analyses point to decreased depressive symptomatology with a minimum of 10 training sessions, imme-
diately after training. After correcting for multiplicity, coefficient estimates remained negative at follow-up for groups
with higher doses, but did no longer reach significance. Interestingly, (mal)adaptive emotion regulation strategies did
not show a clear improvement. Examination of training progress indicated continued improvements beyond typical
previously reported dosages. As expected, task-specific transfer was higher in the groups with higher dosages. How-
ever, all groups improved on an untrained cognitive task and no group differences occurred. The absence of cognitive
near transfer effects points to insufficient understanding in working mechanisms of CCT.

Conclusions:
CCT is a useful intervention for relapse prevention of depression with a minimum dose of 10 training sessions. How-
ever, individual differences highlight the need for future research into training moderators. Furthermore, more mech-
anistic studies are required to gain better understanding of how CCT improves cognitive and affective functioning.

Keywords:
cognitive control training; depression; prevention; dosage

Cognitive Control Training for Depression Relapse Prevention: Single-case research

David Demeester (presenter), Yannick Vander Zwalmen, Kristof Hoorelbeke, Chris Baeken, Ernst Koster
Ghent University, Belgium

Objectives:
Cognitive control training (CCT) holds promise as an intervention for preventing depression relapse. However, previ-
ous studies have not yet focused on the temporal unfolding of CCT effects. To address this, we conducted two longi-
tudinal single case studies to examine within-subject changes over time.

Participants and methods:

A single case study extended the previously discussed CCT dose-response RCT, examining the effects of an unusual
high amount of training sessions (n = 55) over the course of one year. The second study employs an experience sam-
pling methodology with a multiple baseline across participants design (n = 6), to investigate the effectiveness of CCT.
The second study specifically focuses on individuals exhibiting subclinical depressive symptoms, particularly those
who also experience cognitive complaints associated with depression. A daily smartphone-based questionnaire is
used to assess depressive symptomatology and stressors. Preliminary results will be discussed.

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Results:
In the first study, results show a decrease in depressive symptoms following CCT, but with too few data points to make
statements about unfolding effects. Emotion regulation strategies and indicators of rumination did not show clear
evidence of CCT effects. Interestingly, training progression continued after typical amounts of dosages, indicating fur-
ther increase in cognitive functioning may be possible. Qualitative assessments indicate the need for clear feedback
mechanisms during and following training.

Conclusions:
The two studies provide a more comprehensive understanding of the participants’ depressive symptomatology and
the temporal unfolding of effects of CCT.

Keywords:
cognitive control training; depression; prevention; single-case

SY4: Inhibitory learning during exposure: From lab to clinic

Chair: Lotte Stemerding
University of Amsterdam & Rianne de Kleine, Leiden University
Convenor/organizer: Lotte Stemerding
University of Amsterdam, Netherlands
Lotte Stemerding
University of Amsterdam, Netherlands
Rianne de Kleine
Leiden University, Netherlands
Anne Willems
KU Leuven, Belgium
Marike Kooistra
Leiden University, Netherlands

Abstract
Exposure therapy is a powerful intervention to mitigate the unwanted and irrational fear responses that characterise
a variety of anxiety disorders. One important working mechanism of exposure therapy is extinction learning. Fear
extinction is an active learning processes during which a patient is confronted with a feared situation or stimulus
(e.g., giving a presentation) and learns that the feared outcome (e.g., fainting) does not actually occur. In recent years,
the inhibitory retrieval model (Craske et al., 2008, 2014, 2022) has outlined the conditions under which this type
of learning, called inhibitory learning, is believed to most effectively take place, resulting in better treatment out-
comes. Grounded in experimental work and learning theory, the model has identified potential key components
of a successful exposure session, such as within-session distress variability and maximising (violations of ) outcome
expectancies. These insights have been highly influential in shaping clinical practise and the design of exposure ses-
sions. However, important questions about their precise application remain unanswered: What expectations should
be violated during exposure? How can we best measure and manipulate expectancy violations? What characteristics
of an exposure session improve inhibitory learning and directly relate to better treatment outcomes? In this sym-
posium, we delve deeper into the conditions that could strengthen inhibitory learning during fear extinction and
exposure. We combine insights from lab to clinic with the goal to better understand how exposure treatments can
be most optimally designed. First, dr. Anne Willems (KU Leuven) will present the results of an fMRI experiment that
investigates how expectancy violations, resulting from threat omissions, are processed in the brain using a new-
ly developed experimental paradigm. In this study, she links neural threat omission processing to the pleasurable
emotional experience of relief. Then, dr. Lotte Stemerding (University of Amsterdam) will present the results of two
experimental fear-conditioning studies in which expectancy violations were manipulated during extinction learning,
aiming to understand whether increasing the magnitude and awareness of expectancy violations results in improved
long-term extinction learning. Next, Marike Kooistra (Leiden University) will present data from a clinical study in PTSD
patients. She investigated whether an exposure intervention that specifically focussed on violating expectations out-
performed an intervention in which expectancy violations were not actively attended to. Last, dr. Rianne de Kleine
(Leiden University) will present work on the relationship between distress variance and exposure effectiveness, inves-
tigating whether within-session and average distress variance can predict next session PTSD symptom decline, as well
as overall treatment outcomes. We will conclude the session with a discussion about the presented work and possible
clinical implications, during which we aim to illustrate how our findings can help to guide clinicians in the effective
application of exposure for fear-based disorders.

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Keywords
Exposure therapy, anxiety disorders, extinction learning, inhibitory learning, PTSD

Omissions of threat trigger subjective relief and prediction error-like fMRI responses in the human reward and
salience systems
Anne Willems, Lukas Van Oudenhove, Bram Vervliet
KU Leuven, Belgium

Abstract
We experience a pleasurable relief when an imminent threat is unexpectedly averted. These violations of threat ex-
pectancy have been said to be crucial for the learning of safety during exposure therapy. Yet, how exactly omissions
of threat are processed by the human brain, and how this gives rise to the pleasurable feeling of relief remains unclear.
To answer these questions, 31 healthy volunteers performed the previously validated Expectancy Violation Assess-
ment (EVA) task within an MRI scanner. On each trial, participants were presented with probability and intensity in-
structions of an upcoming electrical stimulation to the wrist, time-locked by a countdown clock. Most trials, however,
did not contain the electrical stimulation and therefore constituted a violation of threat expectancies. We measured
ratings of relief-pleasantness, omission-induced fMRI responses and changes in skin conductivity during all omitted
stimulations. Based on the contemporary fear extinction literature, we predicted that unexpected omissions of the
stimulation would elicit reward prediction error-like activations in the Nucleus Accumbens (NAC), Ventral Tegmental
Area/Substantia Nigra (VTA/SN), ventromedial Prefrontal Cortex (vmPFC) and Ventral Putamen (VP); meaning that the
signal would increase as a function of instructed probability and intensity; but that completely predicted outcomes
(0% and 100% trials) would elicit equivalent fMRI activation. Additionally, we predicted that these activations would
be related to subjective relief.
We found that unexpected omissions of threat elicited greater fMRI activations than fully expected omissions in the
VTA/SN and VP. However, none of the regions univocally satisfied the prediction error requirements. Still, we found that
VTA/SN activity increased with increasing intensity and at trend-level probability (p=.055) of the expected-but-omit-
ted stimulation; and that the activity of both VTA/SN and VP was positively related to subjective relief-pleasantness
on a trial-by-trial level.
Together, our findings provide additional support for an overlap in the neural processing of absent threat and rewards
in humans.

Keywords
prediction error; expectancy violation; fMRI; relief; reward

Manipulating expectancy violations to strengthen the efficacy of human fear extinction

Lotte Stemerding, Vanessa van Ast, Merel Kindt, University of Amsterdam, Netherlands

Recent theoretical and clinical articles have emphasized a role for expectancy violations in improving the effective-
ness of exposure therapy. Expectancy violations are critical to extinction learning and strengthening these violations
has been suggested to improve the formation and retention of extinction memories, which should result in lasting
symptom reductions after treatment. However, more detailed mechanistic insights in this process are needed to bet-
ter inform clinical interventions. In two separate fear-conditioning experiments, we investigated whether stronger
expectancy violations (Exp1) or fostering awareness of expectancy violations (Exp2) during extinction could reduce
the subsequent return of fear. We measured fear potentiated startle (FPS) and skin conductance responses (SCR) as
physiological indices of fear, and US expectancy ratings to assess our manipulations. While we successfully created
stronger expectancy violations in Exp1, we found no evidence that these stronger violations reduced the return of
fear at test. Interestingly, fostering awareness of violations (Exp2) reduced differential SCRs, but not FPS responses.
These findings provide novel insights into the effect of US expectancies on fear extinction in the lab, but they also
illustrate the complexity of capturing clinically relevant processes of change with fear-conditioning studies.

Keywords
Fear extinction, Expectancy violations, Inhibitory learning

Expectancy violations in exposure treatment for PTSD

Marike Kooistra, Leiden University, Netherlands

It has been proposed that maximizing expectancy violation enhances the efficacy of exposure therapy. The clinical
utility of expectancy violation remains unclear and it has not yet been studied in PTSD. During this talk, we will pres-
ent findings from our study investigating whether an explicit focus on expectancy violation during exposure leads
to greater symptom reduction in the first session. Adult treatment-seeking patients with PTSD (N = 60) received one
90-minute exposure session and were randomly allocated to either a expectancy violation condition or a control con-
dition in which no attention to expectancies was paid. Assessments took place directly before the exposure session

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and one week later. Outcomes were change in subjective and physiological fear responses during a personalized
script-driven imagery task, and PTSD symptoms. Our analyses showed no significant differences in symptom reduc-
tion between the two conditions. However, both groups experienced a general decrease in fear responses and PTSD
symptoms over time. Notably, those in the expectancy violation condition exhibited a greater reduction in threat
appraisal, which appeared to mediate symptom reduction. Our findings will be discussed and interpreted within the
framework of inhibitory learning theory. Clinical implications—e.g., does expectancy violation enhance treatment?—
will be explored, along with insights into designing exposure sessions and directions for future work.

Keywords
Exposure treatment, PTSD, Expectancy violations, inhibitory learning

Vary it up? The relationship between distress variability and symptom decline during exposure therapy for
PTSD
Rianne A. de Kleine, Marike J. Kooistra, Chris M. Hoeboer, Danielle A.C. Oprel, Maartje Schoorl, Willem van der
Does, Agnes van Minnen, Leiden University, Netherlands

Background: The Inhibitory Learning Theory (ILT) suggests that variability in distress levels during therapy sessions
may facilitate extinction learning, potentially improving the effectiveness of exposure therapy. In this talk, we will
present findings of a study (Kooistra et al., 2024) set-up to examine whether variability in distress during sessions
predicts a decrease in PTSD symptoms by the next session in patients undergoing prolonged exposure (PE) therapy.
Methods: Eighty-six PTSD patients participated in 14 to 16 sessions of PE therapy. We used dynamic panel models to
analyze the temporal (i.e., within-person) relationship between in-session distress variability and subsequent PTSD
symptom reduction. Additionally, we examined the averaged (i.e., between-person) relationship between distress
variability and PTSD symptom improvement.
Results: Temporal analysis indicated that variability in distress during sessions did not predict subsequent improve-
ments in PTSD symptoms. However, averaged analysis revealed that greater distress variability was associated with
symptom improvement.
Conclusions: Distress variability can fluctuate even in the absence of distress reduction. Our findings indicate that
in-session distress variability does not necessarily lead to symptom reduction during PE therapy. However, when
averaged across participants, higher distress variability was associated with better treatment outcomes, suggesting
that individuals with more variable distress patterns across sessions may respond more positively to treatment. The
operationalization of distress variability (by us and in earlier work) differed from its theoretical conceptualization and
distress reduction and variability are difficult to disentangle. Further research is needed to understand the impact of
distress variability during exposure therapy and to inform clinical practice.

Key words
Exposure treatment, PTSD, Distress variability, Inhibitory learning

SY5: Romantic obsessions, unrealistic beliefs, and insightless cognitions

Gregoris Simos
University of Macedonia, Greece

Abstract
Romantic relationships can be a significant source of emotional distress when accompanied by obsessive thoughts
and unrealistic beliefs. Cognitive insight into these problems is crucial for effective clinical interventions. This sym-
posium presents findings from a comprehensive study examining the interplay of romantic obsessions, unrealistic
relationship beliefs, and cognitive insight. This research aims to elucidate patterns that could enhance therapeutic
approaches for individuals experiencing relationship-centered psychological difficulties. Our symposium is based on
preliminary findings of an ongoing research. Study participants were assessed using a battery of established psy-
chometric tools.For the assessment of romantic obsessions, we employed the Relationship Obsessive Compulsive
Inventory (ROCI), which provides a broad measure of relationship-centered obsessive-compulsive symptoms; the
Partner-Related Obsessive-Compulsive Symptoms Inventory (PROCSI), which offers a more detailed look at how these
symptoms manifest specifically in the context of specific qualities of a partner; the Obsessive Beliefs Questionnaire
(OBQ21), aimed at identifying underlying cognitive styles associated with obsessive-compulsive behavior; and the
Obsessive Compulsive Inventory-Revised (OCI-R), which assesses obsessive-compulsive symptoms across various
domains. To evaluate the presence and extent of unrealistic and distorted relationship beliefs, we used the Relation-

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ship Belief Inventory (RBI); cognitive insight was assessed through the Brown Assessment of Beliefs Scale (BABS), an
instrument for assessing delusionality in a few psychiatric disorders, and the Beck Insight Scale (BIS), which measures
cognitive processes involved in patients’ re-evaluation of their anomalous experiences and of their specific misinter-
pretations. Due to the multiplicity of measures and their corresponding subscales (127 “clinical” variables), as well as
the numerous correlational relationships, we opted to examine and interpret our data in three parts of unique and
conceptually related combination of measures and variables. Our preliminary analyses revealed complex interrela-
tions among romantic obsessions, unrealistic beliefs, and cognitive insight; there were several statistically significant,
although mainly low, correlations among variables. High scores on the ROCI and PROCSI correlated significantly with
stronger endorsement of dysfunctional beliefs on the RBI, suggesting a robust link between obsessive symptoms and
unrealistic/irrational beliefs about romantic relationships, beliefs that are unanimously related to relationship dissatis-
faction and maladjustment. Higher scores on the OBQ and OCI-R were associated with lower cognitive insight scores
on the BABS and BIS, indicating that more pervasive obsessive beliefs and related appraisals correlate with poorer
insight into these beliefs’ unrealistic nature. Obsessing about the romantic relationship per se (ROCI) was related to a
good enough insight (BIS), while obsessing about the partner’s specific qualities (PROCSI) related to less insight (BIS)
and more “overvalued“ characteristics (BABS). In total, our findings suggest that romantic obsessions and unrealistic
beliefs in relationships are strongly interconnected and negatively impact individuals’ emotional well-being. The in-
verse relationship between the severity of obsessive-compulsive symptoms and cognitive insight emphasizes the
importance of insight-oriented therapeutic interventions. These interventions could focus on enhancing self-aware-
ness regarding the nature and impact of one’s thoughts and beliefs, thereby potentially mitigating the severity of ob-
sessive-compulsive symptoms and the adherence to unrealistic relationship beliefs. Presenters: Nota Zerva, Aggeliki
Louloumari, and Grigoris Gkiouzelis

Keywords
relationship, obsessive-compulsive, beliefs, insight

SY6: Interventions for youth internalizing problems

across settings – lessons for the future
Chair: Krister W Fjermestad, University of Oslo, Norway

Krister Fjermestad
University of Oslo, Norway
Pål Teigland Lystrup
University of Bergen, Norway
Jo Magne Ingul
Norwegian University of Science and Techonology, Norway
Toril Skumsnes
Innlandet Hospital Trust, Norway
Annika Sannes
Akershus University Hospital, Norway
Kristin Martinsen
University of Oslo, Norway
Einar Heiervang
Innlandet Hospital Trust, Norway

Abstract
This multi-disciplinary symposium comprises five presentations on interventions for youth internalizing disorders
across three settings (schools, clinics, online) with data on effects and implementation. The overarching aim is to
present the state-of-the-art on what works for whom in which format and service tier, and to discuss how this knowl-
edge can be used to optimize and individualize interventions. The background is the need to prevent the increase in
youth internalizing problems, by outreach within the resources of school and health services. The symposium covers
prevention and treatment for anxiety and depression based on quantitative, qualitative, and meta-analytic data. Pre-
sentation 1 covers a school-based indicated-preventive group-CBT intervention for anxiety and depression. This is the
Long term outcomes from school-based indicated prevention for anxiety in adolescents study (LIST-LTFU) with 302
youths (mean age 14 years). Results using latent growth curve models showed reduced internalizing symptoms and
increased health-related quality of life that were maintained at 1-year follow-up. Presentation 2 is focused on Back-

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2School (B2S), a transdiagnostic modular CBT-based intervention for youth with school attendance problems. The
B2S intervention starts with assessment of each individual case resulting in a case formulation and an intervention.
We present user experiences based on qualitative interviews with 16 participating families (children aged 6-16 years)
and teachers. Presentation 3 moves to the clinic and examines social anxiety disorder and behavioral inhibition as pre-
dictors of 4-year post outcomes among 179 youth aged 8-15 years with anxiety disorders in a randomized controlled
trail of individual versus group CBT. The results showed both differential and overlapping contribution of behavioral
inhibition and social anxiety for long-term outcomes. Presentation 4 covers meta-analytic findings on the barriers
and facilitators to the implementation of internet-delivered therapist-guided interventions in child and adolescent
mental health services. Results from an AI-assisted systematic review identified facilitators and barriers related to the
local organizational implementation infrastructure, leadership, staff turnover, staff engagement, therapists’ attitudes,
and program flexibility. Presentation 5 covers the factorial trial ECHO study (N = 633, mean age 11 years) developing
new strategies and leverage digital innovations to enhance the access, acceptability, and utilization of such inter-
ventions are presented. The effects of three delivery conditions of a CBT program for youth anxiety and depression
prevention are presented: blended delivery versus face-to-face, limited versus extended parent involvement, and
with versus without therapist feedback elements. The five presentations will be followed by an overarching discus-
sion led by Professor Einar Heiervang, who has decades of experience with running effectiveness and efficacy trials
for youth internalizing disorders. Heiervang will highlight how the presented efforts can be optimized for improving
the care provided to anxious and depressed children. The questions to be discussed include: How can we know when
to intervene early, in what setting, with what dosage, to prevent the need for resource-demanding clinic treatment?
What are the benefits and obstacles to delivering interventions online, and what stakeholders should be involved at
what time? The discussion will end with a set key learning points for clinicians and researchers on how to enhance
intervention efforts.

Keywords
children; adolescents; interventions; school-based interventions; anxiety; depression; e-therapy

Health-related quality of life after a school-based indicated-preventive intervention for anxiety in adolescents
Pål Teigland Lystrup, University of Bergen, Norway

Abstract: Health-related quality of life (HRQOL) adds important information on the quality and usefulness of inter-
ventions. It has previously not been examined in school-based indicated prevention for anxiety in youth. We sought
to determine whether a randomized controlled trial of a cognitive behavioral therapy (CBT) intervention for anxious
youth (N = 302; mean age 14) increased HRQOL. Additionally, we examined whether changes and pre-treatment
levels in anxiety and depression symptoms predicted changes and end levels of HRQOL. This was done using la-
tent growth curve modeling. Results showed that the intervention increased levels of HRQOL and that the levels of
HRQOL were sustained at 1-year follow-up, independent of the timing of change. Pre-treatment levels and changes
in symptoms of anxiety and depression were predictive of the changes and end levels in HRQOL. The results indicate
an additional beneficial effect of the school-based indicated-preventive intervention beyond reduction in symptoms
of anxiety and depression, warranting broader implementation in schools and making it a potential first-line of inter-
vention for youth with anxiety

Keywords
Anxiety, youth, school-based intervention quality of life

Back2School in a Norwegian setting. Feasibility and preliminary results

Jo Magne Ingul, Norwegian Unviversity of Science and Technology, Norway

Abstract: Introduction: School attendance is important to promote inclusion and opportunities for development for
all youth, both socially and academically. Prolonged or frequent absence is a serious risk factor for school dropout,
future unemployment and economic deprivation, poor mental health, loneliness, and social isolation. Back2School
(B2S) is a transdiagnostic modular intervention based on CBT for youth showing school attendance problems. Origi-
nally developed and tested both in a feasibility study and RCT in Denmark, the intervention has now been adapted for
Norwegian conditions and tested in a pilot study. Method: 8 B2S teams were formed and trained in the intervention.
N= 14 youth were recruited by the teams, assessed and the intervention was delivered weekly over 11 weeks. The B2S
intervention starts with assessment of child, family and school issues related to each individual cases. Based on this,
a case formulation and plan of intervention is formed and implemented. Results: Results will be presented describing
adaptations done in Norway, and results from qualitative interviews with participating parents and teachers, and
characteristics of the youth and their development during the intervention.

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Discussion: Results will be presented and discussed focusing on the feasibility of the intervention in a Norwegian
setting, including potential changes that need to be implemented before a large-scale RCT is launched.

Key words
children, anxiety, school refusal

Predicting Outcomes of Youth Cognitive Behavioral Therapy: Investigating Behavioral Inhibition and Social
Anxiety Disorder as predictors
Toril Skumsnes, Innlandet Hospital Trust, Norway

Abstract: Introduction: Behavioral inhibition predisposes an individual toward anxiety disorders, particularly to so-
cial anxiety disorder, and is a suggested predictor of treatment outcomes among anxious children. Social anxiety
disorder and behavioral inhibition share common features and are related both theoretically and empirically. This
study investigated whether behavioral inhibition and social anxiety disorder are unique or merely overlapping pre-
dictors of treatment outcome among youth with anxiety disorders. Method: Parent reports on the behavioral inhi-
bition questionnaire and a diagnosis of social anxiety disorder were used to predict treatment outcomes in terms of
symptoms levels, diagnostic recovery, and clinical severity in a 4-year perspective among 179 youth aged 8-15 with
anxiety disorders in a randomized controlled trail of individual versus group cognitive behavioral therapy. Results: In
the symposium the results will be presented and discussed focusing on differential and overlapping contribution of
behavioral inhibition and social anxiety as predictors of outcomes in relation to outcomes measures and assessment
points. Conclusion: CBT adaptations for youth anxiety disorders might be indicated.

Key words
Children, temperament, anxiety, CBT

Barriers and facilitators to the implementation of internet-delivered therapist-guided psychotherapy (e-ther-

apy) in child and adolescent mental health services
Annika Sannes, Akershus University Hospital, Norway

Abstract: The increasing number of young people being referred to mental health services today highlights the ur-
gent need for effective modes of delivering evidence-based treatment that can reach more young people and utilize
limited clinical resources more efficiently. Internet-delivered therapist- guided psychotherapy (e-therapy) has shown
promising results in terms of efficacy, fidelity, acceptability and cost-effectiveness. What are the barriers and facilita-
tors to the implementation of internet-delivered therapist-guided psychotherapy (e-therapy) in child and adolescent
mental health services (CAMHS)? Results from a AI-assisted systematic review and Bayesian meta-analysis will answer
this question by identifying and synthesizing existing research on what barriers and facilitators influence effective
implementation e-therapy in CAMHS. The systematic review includes quantitative, qualitative and mixed method
empirical studies. The findings are tabulated and categorized using the Consolidated Framework for Implementation
Research (CFIR) (Damschroder, Widerquist & Lowery, 2022).

Key words
Children, Anxiety, E-therapy, Meta-analysis

Optimizing and Innovating: Enhancing Access and Acceptability of Evidence-Based Interventions for of Anx-
ious and Depressed Children
Kristin Martinsen, University of Oslo, Norway

Abstract: Introduction: The pervasive impact of elevated internalizing symptoms, such as anxiety and depression, on
children’s daily functioning is well-documented, serving as a precursor to more serious disorders. Despite the recogni-
tion that early intervention is critical, challenges persist in early detection and treatment of such symptoms, partially
because they may not be readily apparent to the adults in a child’s environment. Consequently, children often do
not receive timely assistance While schools have become a pivotal environment for the identification and support
of at-risk children, the actual application of effective interventions is surprisingly limited Addressing these gaps, this
presentation will discuss innovative strategies and digital advancements to improve access, acceptability, and usage
of interventions to enhance care for anxious and depressed children. This presentation aims to discuss the strate-
gies employed and the results obtained from the ECHO factorial study to identify effective methods for broadening
intervention reach. Methods: The ECHO factorial trial included 633 children with a mean age of eleven. The study’s
primary objective was to examine the impact of different delivery conditions for interventions designed to address
elevated internalizing symptoms. The three delivery conditions assessed in the study included: blended delivery com-

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pared to a traditional faceto-face approach, varying levels of parental involvement (limited versus extended), and
the presence or absence of therapist feedback. Results: The findings of the ECHO factorial study provide valuable
data on the effectiveness of each delivery condition. The presentation will delve into specific outcomes related to
each intervention approach, discussing how the results may impact the implementation of the intervention in the
services. Conclusion: The ECHO factorial study offers valuable insights into optimal intervention delivery methods for
ameliorating internalizing symptoms in children. These results have implications for the design and implementation
of future preventive efforts and interventions in school-based settings. Discussion: This part of the presentation will
explore the broader implications of the study’s findings, considering factors such as the relevance of parental involve-
ment and the potential advantages of blended delivery and therapist feedback for interventions delivered in schools.
The discussion will consider these results in the context of enhancing access to and utilization of effective interven-
tions for children with elevated internalizing symptoms. Learning Objectives: Participants will gain insights into the
effectiveness of various intervention delivery methods, the role of parental involvement, and the value of therapist
feedback in the early detection and management of internalizing symptoms in children. The presentation aims to
foster a deeper understanding of how best to utilize school-based services for preventive efforts and intervention to
mitigate the risks associated with internalizing symptoms in children.

Key words
Anxiety, Depression, Children

SY7: Empowering Relationships: Strategies for Engaging Significant Others in

Psychotherapy
Convenor & Chair: Johanna Boettcher

Presenter:
1) Anders Hammarberg
Karolinska Institute, Stockholm, Sweden
2) Hannelore Tandt
University Hospital Gent, Belgium
3) Brígida Caiado
University of Coimbra, Portugal
4) Johanna Boettcher
Psychologische Hochschule Berlin, Germany

“They [the patients] come into treatment, they come here after often years and years of difficulty. But, you know, we
have the same number of years of difficulty as they do, but we don‘t have the help.” Spouse of an alcohol-dependent
person (DeCevita et al., 2000, p.141).
Mental disorders are associated with high personal costs and suffering. They also pose a serious burden to the social
network of the afflicted person. Partners, parents, and children deal with often chronic conditions, they take over tasks
and responsibilities, put their own needs second, and get emotionally entangled in the symptomatic expressions of
the mental disorder. This is associated with a decrease in well-being and a heightened risk for mental health problems.
Mental disorders evolve in a social context; they are maintained, alleviated, and reinforced by the people around the
patient. While social support in general is a protective factor and in many studies a predictor of better outcomes, stud-
ies have also identified several social risk factors. Enabling behaviors, expressions of criticism and negative emotions,
overprotection, and supporting avoidance are among the identified behaviors associated with the maintenance or
exacerbation of mental health problems.
Recognizing the potential and need of significant others, many cognitive-behavioral approaches have been devel-
oped to address significant others in psychotherapy. Most work has been conducted in the field of addiction and
within child and adolescent populations.
However, other patient and relative groups have been addressed, including depressive, obsessive-compulsive, and
stress-related disorders. Studies showed that involving significant others can lead to better outcomes for the pa-
tients, better relationship quality, and improved well-being for the significant others. Approaches differ substantially,
ranging from providing psychoeducation to the significant other in a single session to comprehensive multimodal
programs targeting relationship processes as well as the significant other’s mental health.
The current symposium aims at providing an overview of different approaches to involving significant others in psy-
chotherapy. It will give insights into programs’ aims, target groups, efficacy, and practical application. It will also shed
light on different outcomes and discuss and evaluate mechanisms of change. In the first presentation, Anders Ham-

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marberg will report on involving significant others in the treatment of substance use disorders. He will find answers to
the questions of how involving significant others can improve intervention uptake, can lead to drug use reductions,
and improved quality of life for the significant other. The second presentation will move to a different patient group
and a different setting. Hannelore Tandt will report on the multi-family group therapy that her team evaluates for
patients with obsessive-compulsive disorder. She will present qualitative data on patients’ and relatives’ subjective
experiences and perceived mechanisms of change. The third presentation will also focus on mechanisms of change,
choosing a quantitative design, and addressing children with emotional disorders and their parents. Brígida Caiado
will report on how a transdiagnostic program improves emotional parenting behaviors such as parental overprotec-
tion. The last presentation also reports on a transdiagnostic approach.
Johanna Boettcher will show first data on the uptake and impact of a module on involving significant others in a
blended care intervention for patients in outpatient psychotherapy.

Taken together, the symposium aims to demonstrate the breadth of approaches to including significant others in
therapy while highlighting commonalities between them and identifying key learnings for implementation and re-
search.

Keywords
significant others, relatives, couples

Involving significant others in the treatment of substance use disorders

Anders Hammarberg
Karolinska Institutet, Karolinska Institute, Stockholm, Sweden

Abstract
Significant others (SOs) of individuals with substance use disorders (SUD), including alcohol use disorders (AUD), face
increased risks of both psychological and somatic ill-health. These risks stem from factors such as financial issues, ex-
cessive worry, stigma, and being blamed by others for causing the substance use. Despite these challenges, support
programs for SOs are rarely integrated into the regular healthcare system or specialized addiction treatment. There-
fore, there is a need for support programs for SOs that simultaneously increase the willingness of the affected family
member (AFM) to enter treatment.

In a series of randomized controlled trials and studies using qualitative research methodology, we have investigated
the efficacy of support programs for SOs of AFMs suffering from SUD. We have employed novel approaches, including
digital interventions and group-format programs. Additionally, we have included various categories of SOs, such as
parents of young adults with SUD and partners of individuals with AUD.

In most of our studies, we have utilized enhanced versions of the Community Reinforcement Approach and Family
Training (CRAFT). CRAFT is a manualized support program based on the principles of cognitive behavioral therapy
(CBT) and motivational interviewing (MI). SOs participating in CRAFT practice strategies to change their behavior
with three main goals: (1) to improve their own quality of life; (2) to decrease substance use in their AFM; and (3) to
promote help-seeking behavior in their AFM.

Our study results indicate that providing structured support to SOs can benefit both the SOs and the AFM. Over-
all, our studies have shown increased rates of treatment seeking among AFMs, decreased use of alcohol and other
substances, and improvements in the psychological health of SOs. In these respects, CRAFT delivered in various for-
mats has proven superior to wait-list control conditions. However, compared to active comparators, CRAFT has not
demonstrated superiority. Our qualitative studies have been informative in explaining these results. Factors such as
family cohesion, the development of communication skills, easy access to treatment, and therapist involvement were
expressed as helpful by SOs.

Keywords
Significant others; Affected family members; Support programs; Community Reinforcement Approach and Family
Training (CRAFT); Cognitive Behavioral Therapy; Substance Use Disorders; Alcohol Use Disorders

Hannelore Tandt
(University Hospital Ghent)

A multi-family therapy (MFT) for adult obsessive-compulsive outpatients and their family members targeting
family accommodation: treatment protocol and therapeutic processes.

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Hannelore Tandt, Lemke Leyman, Chris Baeken, Christine Purdon and Gilbert Lemmens Dept. of Psychiatry, Ghent
University Hospital and Dept. of Head and Skin- Psychiatry, Ghent University Family accommodation is an important
maintaining factor in OCD symptoms as it interferes with exposure and response prevention (ERP).
As a result, a multi-family group intervention targeting FA has been developed. It consists of 12 weekly sessions with a
duration of 90 minutes. All sessions are structured in a similar way: a go-round, psychoeducation section about OCD,
ERP and FA, an ERP exercise, a group discussion and a homework task. Sixteen patients and 15 family members have
been interviewed after their MFT participation. Preliminary qualitative analysis revealed beneficial effects of the MFT
on OCD symptoms of the patients and FA of the family members.
Furthermore, both patients and family members reported increased insight and knowledge about OCD and FA by the
psychoeducation and new coping strategies in dealing with OCD and FA by the ERP exercises. Additionally, patients
and family members noted the value of learning from each other’s stories and experiences.
MFT is a beneficial option in the treatment of OCD patients and their family members.
Effects of the Unified Protocol for Children (UP-C) in reducing Emotional Parenting
Behaviours: Results of a randomized controlled trial

Presenting author:
Brígida Caiado,
[email protected]

Abstract
The Unified Protocol for Children (UP-C) is a transdiagnostic cognitive-behavioral 15-session group intervention de-
signed for children with emotional disorders (i.e., anxiety and/or mood disorders) and their parents. UP-C aims to
reduce child symptomatology by targeting childhood and parenting transdiagnostic mechanisms, including emo-
tional parenting behaviors such as parental overprotection, criticism, inconsistency, modeling of intense emotions,
and avoidance.
Through a randomized controlled study (RCT), we aim to assess UP-C&#39;s efficacy in reducing the four targeted
emotional parenting behaviors compared to an active control group without parental involvement (a psychoeduca-
tional intervention; “The ABCs of Emotions”).
A total of 153 parents (88.2% mothers) of children aged 6-13 years with emotional disorders were randomly assigned
to either the UP-C group (n = 77) or the control group (n = 76). Self- report questionnaires assessing the four target-
ed emotional parenting behaviors were completed at pre-treatment, mid-treatment, post-treatment, and a 3-month
follow-up.
Linear Mixed Models (LMM) were employed to analyze interaction effects between time and group, with child illness
severity and parental psychopathology as fixed effects.
Results of the present study support the UP-C&#39;s efficacy in reducing emotional parenting behaviors, particu-
larly parental overprotection. This study highlights the importance of addressing emotional parenting behaviors in
child-directed interventions for emotional disorders and supports UP-C&#39;s efficacy in this domain.

Key-words
Unified Protocol for Children, Emotional Parenting Behaviors, Overprotection,
Parenting, Emotional Disorders

Presentation 4 Significant others of patients in routine outpatient therapy

Presenting author:
Prof. Dr. Boettcher Johanna, Psychologische Hochschule Berlin
E-mail: [email protected]

Co-authors:
Duddeck Laura, Psychologische Hochschule Berlin
E-Mail: [email protected]

Fenski Friederike, Psychologische Hochschule Berlin

E-Mail: [email protected]

Behr Solveig, Freie Universitaet Berlin

E-mail: [email protected]

Prof. Dr. Knaevelsrud Christine, Freie Universitaet Berlin

E-Mail: [email protected]

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Dr. Schaeuffele Carmen, Freie Universitaet Berlin

E-Mail: [email protected]

Background: Mental disorders pose a major challenge not only to patients but also to their
significant others (SOs). Data on significant others of patients in routine care is very scarce.
In this secondary analysis of a randomized controlled trial we examine significant others of
patients undergoing routine outpatient psychotherapy.
Method: N=62 significant others filled in questionnaires at the beginning of therapy,
evaluating their mental health and the perceived burden by the patients‘ mental disorder.
After six months, we analysed whether SOs‘ health improved and the burden decreased. A
subset of significant others received access to a website with information and exercises for
SOs and the patients. SOs were asked for their feedback on this website.
Results &amp; discussion: Data analysis is still ongoing. Preliminary results will be presented,
compared to previous studies, and discussed in relation to their clinical implications.

Keywords
significant others, outpatient therapy, burden

SY8: New developments in the understanding and management of OCD

Gideon Anholt
Ben-Gurion University of the Negev, Israel
Reuven Dar
Tel-Aviv University, Israel
Assaf Soref
Tel-Aviv University, Israel
Noam Sarna
Tel Aviv University, Israel
Yuval Geiger
Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel

Abstract
The proposed symposium consists of presentations of selected research on OCD from the labs of two expert OCD
researchers: Prof. Reuven Dar from Tel-Aviv University and Prof. Gideon E. Anholt from Ben-Gurion University. These re-
searchers are also Co-Editors-in-Chief of the Journal of Behavior Therapy and Experimental Psychiatry. From Prof, Dar’s
Lab, two researchers will present their work: (1) Noam Sarna, a Ph.D. student that will present a novel meta-memory
experiment that dissociates between general metamemory deficiencies and a specific difficulty to rely on the com-
pleteness of one’s own memory (“I would have remembered this word if it had been presented before”). The experi-
ment uses computational models of metacognition, grounded in Signal Detection Theory to allow for the measure-
ment of the alignment between memory confidence and accuracy independent of biases, and (2) Dr. Assaf Soref will
present experimental research concerning the overshadowing effect (i.e., putting complex visual stimuli into words
exerts an adverse effect on memory accuracy for these stimuli). 183 participants with high vs. low obsessive-compul-
sive (OC) symptoms were randomized into a verbalization task vs. a control condition. Results demonstrate the occur-
rence of the overshadowing effect in low OC participants (replicating earlier results with similar tasks). However, high
OC participants did not exhibit this effect. These results seem to reflect an effort of OC individuals to maintain a high
sense of control through excessive reliance on controlled processes, and a reluctance to shift into processes that are
run by themselves (i.e., automatic). These results have important implications for the understanding and treatment of
OCD. From Prof. Anholt, two researchers will present: (1) Yuval Geiger, a Ph.D. student will present results of a natural-
istic 6-year follow up OCD study using a large patient sample from the Netherlands OCD association (NOCDA) study.
Results suggest that most patients do not remit despite receiving evidence-based treatment. Furthermore, results
demonstrate that using multiple follow-up measurement for the course of OCD reduces OCD recovery estimates,
probably resulting in more realistic measures of OCD course in comparison with studies using a singly follow-up
measurement. These results have important implications for the long-term management of OCD, and (2) a second
presenter from Prof. Anholt’s lab will present another NOCDA-related study investigating the rates and correlates of
loneliness in OCD. Loneliness has been extensively studied in other psychopathologies and has shown to increase
risk for mental and physical disorders and mortality, above and beyond depressive symptoms. Results demonstrate
the high prevalence of loneliness in OCD patients. Furthermore, loneliness was found to be associated both with

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depressive as well as OCD symptoms. Though increased loneliness is more strongly related to depressive rather than
OCD symptoms, the high prevalence of loneliness in OCD suggests that this phenomenon should be assessed and
addressed in the treatment of OCD patients.

Keywords
obsessive-compulsive disorder, experimental psychopathology

Elucidating Meta-Memory in OCD

Noam Sarna1*, Reuven Dar1 and Matan Mazor2
1
School of Psychological Sciences, Tel Aviv University
2
Department of Experimental Psychology, University of Oxford
*Address all correspondence to Noam Sarna, School of Psychological Sciences, Tel Aviv University, Tel Aviv,
Israel 69978.
Email Address: [email protected]

Abstract
Early models of OCD suggested that recurring doubts, such as “Did I lock the door?” might be related to a core-mem-
ory issue. However, subsequent models have challenged this idea, indicating that while memory problems exist,
they are overshadowed by under-confidence, shifting the focus towards metacognitive failure rather than a pure
memory deficit. Although numerous clinical studies have documented the under-confidence observed in OCD, it is
not sufficient to deduce that OCD is associated with a core metacognitive problem. This is because under-confidence
is a subjective measure, prone to biases, such as a personal tendency to report low confidence. More recent compu-
tational models of metacognition, grounded in Signal Detection Theory, allow to measure the alignment between
confidence and accuracy independent of such biases. To our knowledge, these models have not yet been employed
to investigate meta-memory in OCD. To harness these advanced computational models while maintaining clinical rel-
evance in memory tasks, we have developed a meta-memory experiment that achieves both objectives. By contrast-
ing confidence in the presence and absence of memories, we dissociate between general metamemory deficiencies
and a specific difficulty to rely on the completeness of one’s own memory ( “I would have remembered this word if it
had been presented before”), more closely mirroring the clinical manifestations of doubt (“How can I know I haven’t
run someone over without noticing?”). In this talk, I will argue for the integration of newly developed metacognitive
computational models into OCD meta-memory research and will present initial results from a meta-memory task.

Cognitive Control in Action: Obsessive-Compulsive Tendencies Shape Information Processing and Recogni-
tion Accuracy
Assaf Soref; Bella Dubinchik; Reuven Dar
School of Psychological Sciences, Tel Aviv University, Israel

Introduction: Putting complex visual stimuli into words was found to have an adverse, overshadowing effect, on
memory accuracy for these stimuli (Schooler &amp; Engstler-Schooler, 1990). This effect is considered to be the result
of a processing shift between the way information was encoded and the way it was retrieved. As recognition typically
involves automatic processing, encoding information using explicit processing such as verbalization interferes with
memory performance. The present study was motivated by recent evidence that people with OCD tend to prefer
controlled and focused processing in acquiring and retrieving information (e.g., Soref et al., 2018). This evidence leads
to the prediction that for obsessive- compulsive (OC) individuals, both coding and retrieval of stimulus information
would involve controlled processing, so that verbalizing would not constitute a processing shift for these
individuals. The goal of the study was to examine the hypothesis that verbalization will be less disruptive in individ-
uals with high OC tendencies in comparison to individuals with low OC tendencies, as it matches their spontaneous
style of information processing.
Method: 183 participants participated in the study which was presented via an Israeli internet panel. Following the
procedure described by Schooler and Engstler-Schooler (1990), participants viewed a short video of a bank robbery
and were instructed to pay close attention to it, and then participated in a 20-min unrelated Sudoku task. They were
then randomly assigned to one of two experimental conditions – a verbalization condition, in which participants
were asked to write a detailed description of the robber; and a control condition, in which they listed states and state
capitals. Subsequently, all participants viewed a lineup image depicting eight people and asked to select the one who
was in the bank robbery video. Finally, participants completed a measure of obsessive-compulsive symptoms.
Results: As predicted, verbalization impaired recognition accuracy in participants with low OC tendencies, indicating
an overshadowing effect, but did not affect the performance of high OC participants.
Discussion: Current findings add to growing body of research from various cognitive tasks, suggesting a distinct pro-
cessing style in OC individuals. This processing style may reflect an effort of OC individual to maintain high sense of

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control through excessive reliance on controlled processes, and a reluctance to shift into processes that run by them-
selves (i.e., automatic).
Conclusions: OC individuals tend to rely on controlled strategies in processing stimuli that are typically processed
using automatic, non-verbal strategies. Taken as a whole, these findings may have important implications for under-
standing and treating OC symptoms.

References
Schooler, J. W., &amp; Engstler-Schooler, T. Y. (1990). Verbal overshadowing of visual memories: Some things are better
left unsaid. Cognitive psychology, 22(1), 36-71.

Soref, A., Liberman, N., Abramovitch, A., &amp; Dar, R. (2018). Explicit instructions facilitate performance of OCD par-
ticipants but impair performance of non-OCD participants on a serial reaction time task. Journal of anxiety disorders,
55, 56-62.

Long-term remission rates and trajectory predictors in obsessive-compulsive disorder: Findings from a six-
year naturalistic longitudinal cohort study
Geigera, Y., van Oppenb, P., Visserc, H., Eikelenboomb, M., van den Heuveld, O. A., d Anholta, G. E.
a
Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
b
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health research insti-
tute and GGZ inGeest Specialized Mental Health Care, the Netherlands
c
Innova Research Centre, Mental Health Care Institute GGZ Centraal, Ermelo, the Netherlands
d
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy and Neurosci-
ences, Amsterdam Neuroscience, the Netherlands

* Corresponding author: Geiger Yuval

Tel: (972)-52-5971954
e-mail: [email protected]
Address: Department of Psychology, Ben-Gurion University, David Ben Gurion Blvd 1, Be’er Sheva
Introduction: This naturalistic study, utilizing data from the Netherlands Obsessive-Compulsive Disorder Association
(NOCDA) cohort, investigated the long-term remission rates and predictors of different trajectories of obsessive-com-
pulsive disorder (OCD) within a clinical population.
Methods: A sample of 213 participants was classified into three illness trajectories: “Chronic,” “Episodic, ”and “Remit-
ted-OCD.” Long-term remission rates were calculated based on three follow-up measurements over a 6-year period.
A multinomial logistic regression model, incorporating five selected predictors with high explanatory power and one
covariate, was employed to analyze OCD trajectory outcomes.
Results: The long-term full remission rates, calculated from all the measurements combined (14%), were significantly
lower than what was observed in earlier studies and when compared to assessments at each individual follow-up
(∼30%). Moreover, high baseline symptom severity and early age of onset were identified as significant risk factors for
a chronic course of OCD, while male sex and younger age predicted a more favorable trajectory. Notably, the likeli-
hood of an episodic course remained high even without identified risk factors
Discussion: Results suggest that long-term remission rates may be lower than previously reported. Consequently, em-
ploying multiple assessment points in longitudinal studies is necessary for valid estimation of long-term full remission
rates. The results emphasize the importance of personalized clinical care and ongoing monitoring and maintenance
for most OCD cases.

Loneliness in OCD and its determinants

Adi Friedman-Ezra a, Karin Keydar-Cohen a, Patricia van Oppen b, Merijn Eikelenboom b, Koen Schruers c, Gideon E.
Anholt a
a
Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
b
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Insti-
tute and GGZ inGeest Specialized Mental Health Care, the Netherlands
c
Department of Psychiatry and Research School for Mental Health and Neuroscience, Maastricht University, Mon-
driaan Mental Health Center, Maastricht, the Netherlands
Abstract
Obsessive-compulsive disorder (OCD) is a psychiatric condition characterized by intrusive thoughts and repetitive
behaviors, affecting approximately 1.3 % of the population. Loneliness has serious consequences for future health
outcomes. Although it has been extensively studied in depression, its prevalence in obsessive-compulsive disorder
(OCD) has hardly been investigated. The current study sought to examine the association between loneliness and
OCD, through an exploratory investigation of their demographic and clinical correlates. This cross-sectional study uti-
lized data from the Netherlands Obsessive-Compulsive Disorder Association (NOCDA) study, designed to investigate

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determinants, course, and consequences of OCD in a large clinical sample. In this data base, a cohort of 363 OCD adult
patients underwent assessment for loneliness severity, OCD symptomatology, comorbid conditions, and demograph-
ic variables. Findings reveal a high prevalence of loneliness among OCD patients, with nearly three-quarters (73.6 %)
experiencing elevated levels. Loneliness was associated with greater depression severity and specific demographic
factors such as gender, age, and education level. However, the relationship between OCD severity and loneliness was
explained by depression severity. Clinical and theoretical implications are discussed as well as limitations and direc-
tions for future research.

Long-term remission rates and trajectory predictors in obsessive-compulsive disorder: Findings from a six-
year naturalistic longitudinal cohort study
Friedman-Ezra 1, Adi., Keydar-Cohen 1, K., van Oppen 2, P., Eikelenboom 2, M., Schruers 3, K., & Anholt1, G. E.
1
Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
2
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Insti-
tute and GGZ inGeest Specialized Mental Health Care, the Netherlands.
3
Department of Psychiatry and Research School for Mental Health and Neuroscience, Maastricht University, Mon-
driaan Mental Health Center, Maastricht, the Netherlands.
* Corresponding author: Anholt Gideon
Tel: (972)-548102858
e-mail: [email protected]
Address: Department of Psychology, Ben-Gurion University, David Ben Gurion Blvd 1, Be’er Sheva
Introduction: Obsessive-compulsive disorder (OCD) is a psychiatric condition characterized by intrusive thoughts and
repetitive behaviors, affecting approximately 1.3 % of the population. Loneliness has serious consequences for future
health outcomes. Although it has been extensively studied in depression, its prevalence in obsessive-compulsive
disorder (OCD) has hardly been investigated.
Methods: The current study sought to examine the association between loneliness and OCD, through an exploratory
investigation of their demographic and clinical correlates. This cross-sectional study utilized data from the Nether-
lands Obsessive-Compulsive Disorder Association (NOCDA) study, designed to investigate determinants, course, and
consequences of OCD in a large clinical sample.
Results: In this data base, a cohort of 363 OCD adult patients underwent assessment for loneliness severity, OCD
symptomatology, comorbid conditions, and demographic variables. Findings reveal a high prevalence of loneliness
among OCD patients, with nearly three-quarters (73.6 %) experiencing elevated levels. Loneliness was associated
with greater depression severity and specific demographic factors such as gender, age, and education level. However,
the relationship between OCD severity and loneliness was explained by depression severity.
Discussion: Clinical and theoretical implications will be discussed and limitations and directions for future research
will be discussed.

SY9: Innovations in Imagery-Based Interventions

in Cognitive Behavioral Therapy
Elad Zlotnick
The Hebrew University of Jerusalem, Israel
Hila Sorka
The Hebrew University of Jerusalem, Israel
Iris Engelhard
Utrecht University, Netherlands
Simon Blackwell
Clinical Psychology and Experimental Psychopathology, Georg-Elias-Mueller-Institute of Psychology, University of
Göttingen, Germany
Snir Barzilay
The Hebrew University of Jerusalem, Israel
Jonathan D. Huppert
The Hebrew University of Jerusalem, Israel

Abstract
Imagery-based interventions represent a burgeoning field in cognitive behavioral therapy, with diverse applications
and innovative approaches emerging rapidly. The importance of understanding the applications and underlying
mechanisms of these interventions is central to their effective integration into clinical practice. This symposium will

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present four cutting-edge studies that illustrate the breadth and depth of this field, focusing on the clinical implica-
tions and therapeutic outcomes of different imagery-based interventions.
1. Hila Sorka: Transdiagnostic Online Imagery Rescripting
Hila Sorka will discuss a novel self-guided online imagery rescripting intervention, which has been applied trans-
diagnostically with two types of intervening agents: the current self vs. a supportive other. Results from a one-year
follow-up demonstrate sustained improvements in pathological anxiety (OASIS), daily function (WSAS), self-schema
(BCSS), and specific symptoms. Notably, the follow-up results indicate a significant advantage for interventions using
the ‘self’ as the intervening agent over those using a ‘supportive other.’ This presentation will delve into the potential
mechanisms that may contribute to these differential effects and their implications for clinical practice.
2. Simon Blackwell: Cognitive Training and Imagery
Simon Blackwell will present a comparative study on a computerized cognitive training intervention designed to in-
fluence mood and cognitive biases. Participants listened to audio scripts that progressed from ambiguous to positive
conclusions, with the goal of training them to automatically envision positive outcomes in ambiguous real-life scenar-
ios. This intervention was compared to a control task that involved mental arithmetic, targeting the same population
of depressed individuals. Blackwell’s presentation will focus on the comparative efficacy of these interventions and
their potential as tools for managing depression.
3. Iris Engelhard: Dealing with Anticipatory Anxiety Through Imagery-Based Interventions
Iris Engelhard will discuss her experimental research on the effects of imagery-based interventions on anticipatory
anxiety, employing two distinct subject groups: musicians with performance anxiety and students participating in
the Social Trier Test. Her study explores how imagery techniques can be used to manage and mitigate the anticipatory
anxiety that these groups experience in high-stress scenarios. Engelhard’s presentation will provide insights into the
mechanisms by which imagery interventions can alter anxiety responses and enhance coping strategies in diverse
settings.
4. Elad Zlotnick: Self-Administered Written Exposure Therapy
Elad Zlotnick will introduce a self-administered written exposure therapy aimed at addressing transdiagnostic anxiety
disorders. His study evaluates the efficacy of this intervention and explores the therapeutic differences that emerge
when focusing on future versus past aspects of anxiety. Zlotnick’s findings contribute to a deeper understanding of
how temporal focus in exposure therapy can influence therapeutic outcomes and provide valuable insights into op-
timizing treatment strategies for anxiety.
This symposium promises to advance our knowledge of imagery-based interventions, demonstrating their utility in a
wide range of clinical contexts and paving the way for further innovations in the field of cognitive behavioral therapy.
Attendees will gain a comprehensive overview of the latest research developments and their practical applications in
improving mental health outcomes.

Keywords
Imagery, ICBT, online

SY10: How to make help based on CBT for anxious children and young people
easily available
Chair: Thomas Bjerregaard Bertelsen, Phd, Norway
Convenor/organizer: Åshild Tellefsen Håland, Professor, Norway

Åshild Tellefsen Håland

university in agder, Norway
Lene Holmen Berg
Kristiansand kommune, Norway
Thomas Bjerregaard Bertelsen
Sørlandet sykehus, Norway

Abstract
Despite the overwhelming evidence for the effectiveness of cognitive behavioral therapy (CBT) in treating youths
with anxiety it still remains difficult to access for youth. The level of proficiency in CBT among teachers and health
workers is underwhelming. A significant issue is the inappropriate accomodation of anxiety by teachers, whereby
they assist students in avoiding rather than encouraging them to confront things that they find fearful.
The primary objective of this symposium is to exchange experiences on disseminating knowledge about CBT to en-
able teachers, parents, and healthcare professionals to offer optimal assistance and support to anxious youths. This

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symposium will focus on the collaborative efforts of parents, schools, and public health nurses in assisting anxious
youths outside specialized clinics. We will discuss our utilization of an online intervention for anxiety (https://e-RISK.
no) and a group-based low-threshold intervention (Mini-RISK) to enhance the accessibility of cognitive behavioral
therapy (CBT) for a wide range of individuals.

How to implement a low-threshold intervention in all schools in a municipality.

Lene Holmen Berg, Kristiansand kommune, Norway
The primary goal of this presentation is to discuss the experiences of implementing a low-threshold intervention
named Mini-RISK for anxious youths in all 45 schools within a municipality. The intervention we have developed is
named Mini-RISK and involves a high degree of parental and school involvement. Mini-RISK takes place within the
school setting and is led by a school teacher and a public health nurse. This lecture will also focus on how the profi-
ciency in leading the Mini-RISK group has also enhanced the competence in CBT in general among school teachers.

Strategies for effectively managing anxious students in schools

Thomas Bjerregaard Bertelsen, Sørlandet sykehus, Norway
We have conducted a pioneering study examining the degree and nature of accomodations that teachers pro-
vide to students with anxiety, such as those who are reluctant to engage in activities like public speaking or
physical education. The findings indicate that teachers primarily assist students in avoiding tasks that they are
afraid of, rather than aiding them in gradually mastering such skills. The findings of this study will be presented.
We will also share experiences of system-level changes that could reduce inappropriate school accommodations.

How to disseminate knowledge about CBT to youths, teachers and mental health workers through an online
intervention.
Åshild Tellefsen Håland, University in Agder, Norway
e-RISK (2023), is a free online intervention developed by the Department for Child and Adolescent Mental Health at
Sørlandet Hospital in Norway to help anxious youths. E-RISK has modules for adolescents aged 12 to 18 and modules
tailored for parents and teachers. E-RISK has gained significant popularity in Norway, attracting around 70,000 uniqe
users since May 2023. e-RISK has multiple applications, including self-help, assisted self-help, competence enhance-
ment for teachers and parents, and as part of therapy in group or individual settings. In the presentation we will dis-
cuss and share our experiences regarding the diverse applications of e-RISK.

Keywords
cbt anxiety schoolaccomodation dissemination online treatment low-threshold groups

SY11: Cognitive processes and predictors of treatment efficacy

for social anxiety
Rivkah Ginat-Frolich
The Hebrew University of Jerusalem, Israel
Jonathan D. Huppert
The Hebrew University of Jerusalem, Israel
Ulrich Stangier
Institut für Psychologie der Goethe-Universität Frankfurt, Germany
Jan Schittenhelm
Institut für Psychologie der Goethe-Universität Frankfurt, Germany
Cem Yilmaz
Institut für Psychologie der Goethe-Universität Frankfurt, Germany
Wolf-Gero Lange
Radboud University Nijmegen, The Netherlands, Netherlands
Zohar Klein
Bar Ilan University, Ramat Gan, Israel
Eva Gilboa-Schechtman
Bar Ilan University, Ramat Gan, Israel

Abstract
Social Anxiety Disorder (SAD) negatively impacts individuals’ social functioning and quality of life. Although several
first-line cognitive behavioral therapies (CBT) are effective in reducing social anxiety (SA), on average only approx-

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imately one in two individuals with SAD experience clinically significant change. It is therefore essential to better
understand the role of maintaining processes in SA as well as the mechanisms of change involved in interventions so
as to improve treatment outcomes. To this end this symposium presents findings from a group of basic and applied
studies. The first two studies examine three important maintaining processes in SA: information processing biases,
negative self-referential processes, and approach/avoidance behaviors. Zohar Klein, Reut Zabag, Einat Levy-Gigi, and
Eva Gilboa-Shechtman will present a study examining learning and updating in processing social feedback using an
online self-referential learning paradigm in a sample of 653 adults. SA symptoms are predicted to be associated with
enhanced learning of negative feedback, and both SA and depression severity are hypothesized to exhibit aberrant
positive updating (i.e., worse learning of positive feedback) following an initial negative feedback phase. Thereafter,
Wolfe-Gero Lange will present a study examining approach/avoidance behaviors using a VR social interaction para-
digm. Approach speed and interpersonal distance, eye gaze, and HR variability are assessed, with participants higher
in SA predicted to exhibit less approach behaviors and more avoidance behaviors than participants with lower levels
of SA. Next, a series of treatment studies will be presented. Rivkah Ginat-Frolich, Sascha B. Duken, Elske Salemnik and
Jonathan Huppert will present a study assessing dynamic changes in interpretation bias as predictors of SA symptom
change during treatment. Individuals suffering from social anxiety disorder (SAD) received 20 sessions of cognitive
behavioral therapy (CBT). Changes in three measures of interpretation bias (online, strategic, and self-appraisal/of-
fline), each administered at multiple time points during treatment, will be examined as predictors of SA symptom
change. Jan Schittenhelm and Ulrich Stangier will then present an RCT study with 160 patients with SAD examining
smartphone-based self-help as compared to a therapist-assisted app. Follow-up assessments will be included. Ulrich
Stangier, Jan Schittenhelm, and Cem Yilmaz will then present findings from a randomized-controlled trial, where cog-
nitive therapy including behavioral experiments was compared to cognitive therapy focusing on self-esteem in 68
patients with SAD. Although no significant differences were observed in primary outcome measures, results indicate
that using behavioral experiments increases the efficacy of cognitive therapy. Thereafter, using data from the same
RCT, Cem Yilmaz and Ulrich Stangier will discuss mediators and moderators of treatment outcomes. Weekly assess-
ment of symptoms, differential predictors of outcomes in behavioral experiments vs. cognitive restructuring, and
learning styles will be examined. These analyses will contribute to further understanding mechanisms of change in
the treatment of SAD and potentially relevant criteria to the tailoring of treatment to patient characteristics. Together,
the presented studies can guide future research attempting to further elucidate the underpinnings of maintaining
processes and mechanisms of change in SA.

Keywords
social anxiety disorder; maintaining processes; mechanisms of change; basic research; applied research

SY12: Novel developments in the field of internet-based interventions

Convenor: Noëmi Seewer, University of Bern; Fabrikstrasse 8, 3012 Bern, Switzerland, [email protected]
Chair and Discussant: Thomas Berger, University of Bern
Noëmi Seewer
University of Bern
Victoria Aminoff
University of Linköping
Laura Bielinski
University of Bern
Rodrigo Lopes
University of Bern

Abstract

The efficacy and effectiveness of internet-based interventions for people with mental health disorders have been
demonstrated in numerous studies. This symposium will highlight new and innovative developments in this rapid-
ly advancing field. It will demonstrate how low-threshold internet-based interventions can alleviate psychological
distress under challenging conditions, and foster our understanding of how internet-based interventions can be op-
timised by investigating mechanisms of change. It will elucidate how such interventions can be applied to transdi-
agnostic phenomena and shed light on the chances and challenges in specific, understudied treatment populations
and settings.
In the first talk, Victoria Aminoff will present the CoronaCope project, which investigated whether internet-based
cognitive behavioural therapy is effective in reducing psychological symptoms related to the coronavirus pandemic.

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In the second talk, Rodrigo Lopes will show the potential mediating role of five proposed mechanisms of change
(namely, increased understanding of SAD, reduction in dysfunctional social beliefs, reduction of self-focused atten-
tion, reduction of avoidance of social situations, and reduction of reliance on safety behaviours) in alleviating social
anxiety disorder (SAD) symptoms following participation in an internet-based cognitive behavioural program for SAD.
Internet-based interventions are not limited to a disorder-specific approach; they have also been developed and
studied for transdiagnostic phenomena. In this context, Noëmi Seewer will elaborate in the third talk on whether an
internet-based self-help program for loneliness—with and without human support—can lead to a long-term reduc-
tion in feelings of loneliness.
Finally, Laura Bielinski will present qualitative and quantitative results from a randomised controlled pilot trial inves-
tigating an internet-based emotion regulation intervention as an add-on to acute psychiatric inpatient treatment.
The symposium will conclude with a discussion chaired by Gerhard Andersson.
Overall, the symposium will improve our understanding of developments in the area of internet-based interventions,
providing a deep-dive into four different areas of application. The goal of the symposium is to foster a discussion on
both chances and challenges in these different areas and how they might advance our general understanding of the
field of internet-based interventions for people with mental health problems.

Keywords
internet-based, intervention, rct, emotion regulation, psychological distress, social anxiety, loneliness

CoronaCope: Internet-based cognitive behavioral therapy during the COVID-19 pandemic

Victoria Aminoff, Malin Sellén, Elise Sörliden, Mikael Ludvigsson, Matilda Berg, Gerhard Andersson, Johanna
Bobeck, Sofia Bobeck
Linköping University, Sweden

Abstract
Introduction: Psychological symptoms have been observed to increase during the COVID-19 pandemic in both in-
fected and non-infected individuals. Considering this, and acknowledging that the COVID-19 pandemic will not be
the last, it is crucial to explore ways to address the psychological impact. The CoronaCope project aimed to assess the
effects of individually tailored internet-based cognitive behavioral therapy (ICBT) on COVID-19-related psychological
symptoms.
Aim: After a pilot RCT, showing that ICBT had effects compared to a wait-list control condition, a full RCT was con-
ducted. 76 participants were recruited and randomized to either a treatment or control group. The treatment group
received eight individually tailored modules over eight weeks, with weekly guidance from a therapist. A qualitative
study was also conducted, interviewing participants from the pilot study about their experiences with the ICBT.
Results: Controlling for pre-treatment measurements, post-treatment differences favored the treatment group in
terms of depression symptoms, insomnia, and anger. These improvements persisted at one-year follow-up. No signif-
icant differences were observed in quality of life, anxiety, post-traumatic stress symptoms, or stress. Thematic analysis
of interviews revealed four main themes, for instance, “Treatment effects equal work”.
Conclusion: The ICBT appears promising in effectively addressing some psychological symptoms related to the
COVID-19 pandemic. These results, observed during the pandemic, suggest that ICBT can help alleviate symptoms in
such crises.

Keywords
Internet-based cognitive behavioral therapy, COVID-19, Individually tailored, Psychological treatment

Mechanisms mediating efficacy of treatment components of social anxiety disorder: a factorial mediation
analysis on knowledge of SAD, dysfunctional social cognitions, self-focused attention, avoidance of social sit-
uations, and use of safety behaviors
Rodrigo Lopes1, Javier Fernández-Álvarez2, Dajana Šipka1, Thomas Berger1
1
Universität Bern, Switzerland
2
Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellon de la Plana, Spain

Abstract
BACKGROUND: Although evidence-based psychological treatments for Social Anxiety Disorder (SAD) exist, there is
room for improvement and a lack of understanding about how they work. The goal of this presentation is to examine
the mediational role of five hypothesized mechanisms of change (i.e., knowledge of SAD gain, decrease of dysfunc-
tional social cognitions, decrease of self-focused attention, decrease of avoidance of social situations, and decrease in
the use of safety behaviors) in reducing symptoms of SAD after undergoing an internet-based CBT program.
METHODS: In this factorial trial, 464 participants diagnosed with SAD received a self-guided internet-based pro-
gram called Shyne for 8 weeks with minimal guidance. The program is composed of four typical CBT components for

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treating SAD (psychoeducation, cognitive restructuring, attention training, and exposure). These components were
combined in sixteen conditions, allowing us to compare the effects of each component (n=232) against its absence
(n=232). Mediation path analysis using bootstrapping to estimate indirect effects and their confidence intervals were
used.
RESULTS: All hypothesized mechanisms, except self-focused attention, were significantly associated with SAD reduc-
tion. Specifically, knowledge gain mediated the effects of psychoeducation, and a decrease in safety behaviors me-
diated the effects of exposure. Contrary to expectations, cognitive restructuring was not mediated by dysfunctional
social cognitions, attention training was not mediated by self-focused attention, and exposure was not mediated
by avoidance of social situations. Exploratory analyses indicated that cognitive restructuring, attention training, and
exposure modestly increased knowledge of SAD, exposure reduced SAD by decreasing social cognitions, and psycho-
education reduced SAD by decreasing avoidance.
DISCUSSION: These findings suggest that while certain CBT components directly target specific mechanisms, other
components may exert broader, overlapping effects on various psychological processes. More research to understand
the specific pathways of the CBT components is needed for optimizing this intervention.

Keywords
social anxiety disorder, cognitive behavioral therapy, internet-based CBT, factorial design, mediation analysis

Short- and long-term effects of an internet-based cognitive behavioural self-help intervention for loneliness –
Results of a randomised controlled trial
Noëmi Seewer1, Andrej Skoko1, Anton Käll2, Gerhard Andersson2, Thomas Berger1, Tobias Krieger1
1
Universität Bern, Switzerland
2
Linköping University, Sweden

Abstract
Background: Chronic loneliness is prevalent in the general population and clinical practice. It is associated with poor
physical and mental health. Nonetheless, there remains a dearth of high-quality studies offering evidence on ef-
fective interventions for targeting loneliness. From a theoretical and empirical perspective, interventions targeting
maladaptive social cognitions are among the most effective interventions for loneliness. Due to the stigma associated
with loneliness, low-threshold interventions like internet-based cognitive behavioural interventions (ICBT) present a
promising avenue for delivering effective interventions. Recent studies on guided ICBT for loneliness yielded promis-
ing results, though the precise impact of human contact through guidance on loneliness reduction remains unclear.
Moreover, the long-term effects of ICBT on loneliness have only been investigated in a few studies. Furthermore,
whether the longer-term effects differ between people who received human guidance during the program and those
who did not is still being determined.
Aims: The primary objective of this study is to evaluate the efficacy of an internet-based cognitive behavioural inter-
vention administered with human guidance or automated messages. The study further aims to investigate the long-
term effects on loneliness in both intervention groups.
Methods: In total, 243 adults with increased loneliness scores from the general population in German-speaking coun-
tries were randomly assigned to either a 10-week ICBT (SOLUS-D) with human guidance or automated messages or to
a waitlist control group. Outcome measures were assessed at baseline and 10 weeks (post-treatment). Participants in
both intervention groups further completed assessments at 12 months after randomisation. The 9-item UCLA Lone-
liness Scale was the primary outcome. Among others, depressive symptoms, social anxiety, and social network size
were assessed as secondary outcomes. Continuous outcome measures were analysed using mixed effects models.
Results: The results on the intervention’s efficacy (at the end of treatment) and long-term effects 12 months after
randomisation will be presented.
Conclusion and Implications: The results of the current study will expand knowledge about effective interventions for
loneliness. Furthermore, they will provide valuable insights into the long-term effects of an internet-based cognitive
behavioural intervention for loneliness with human guidance or automated messages.

Keywords
Loneliness, efficacy, long-term effects, guidance, automated message, RCT, ICBT

Experiences with an internet-based emotion regulation intervention in acute psychiatric inpatient care
Laura Bielinski1, Gwendolyn Wälchli1, Anna Lange1, Elianne Von Känel1, Lena Demel1, Christoph Nissen2, Franz
Moggi1, Thomas Berger1
1
University of Bern, Switzerland
2
Geneva University Hospitals, Switzerland

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Abstract
Background: Trials investigating internet-based interventions in acute psychiatric inpatient settings are rare. When
such innovative treatments are explored, it’s crucial to capture the experiences of those involved. The insights from
acute inpatient ward healthcare workers and from the patients involved in the intervention are invaluable for assess-
ing the feasibility of the treatment. Aim: This presentations aims to delineate findings pertaining to healthcare worker
and patient experiences with an internet-based emotion regulation intervention added to acute inpatient psychiatric
treatment. Methods: A randomized controlled pilot trial recruited 60 adult patients from an acute psychiatric inpa-
tient setting, randomly assigning them to either treatment as usual (TAU) or TAU plus access to an internet-based
emotion regulation intervention. Outcomes were measured at baseline, four weeks, eight weeks, and post-discharge.
The primary outcome was symptom severity, evaluated using the Brief Symptom Inventory. Secondary outcomes
included emotion regulation parameters and various feasibility factors such as satisfaction with the internet-based
intervention and the system usability of the internet-based intervention. Semi-structured interviews were also con-
ducted with 20 healthcare workers from the participating wards. For more details, the study protocol for the trial can
be consulted (Bielinski, Wälchli, et al., 2023). Results: The qualitative data from interviews with healthcare workers and
quantitative data on patient satisfaction, usage, and usability of the internet-based intervention will be presented.
Conclusion: This presentation will enhance understanding of healthcare worker and patient experiences with an in-
ternet-based intervention in acute psychiatric inpatient care. The potential opportunities and challenges for future
implementation of internet-based interventions in this treatment setting will be discussed.

Keywords
blended treatment; emotion regulation; internet-based intervention; acute psychiatric treatment

Schema Therapy and Imagery Rescripting: Applicability Across Formats and Disorders
Chairs: Simon Blackwell, Clinical Psychology and Experimental Psychopathology, Georg-Elias-Mueller - Institute of
Psychology, University of Göttingen, Germany
Convenor/organizer: Sophie Rameckers, Department of Clinical Psychology, University of Amsterdam, the Nether-
lands

Sophie Rameckers, University of Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands,
Netherlands
Astrid Baljé, University of Leiden, Netherlands
Christofer Taylor, Department of Psychology, Faculty of Science, The University of Sheffield and Community Mental
Health Team, Pennine Care NHS Foundation Trust, United Kingdom
Simon Blackwell, Clinical Psychology and Experimental Psychopathology, Georg-Elias-Mueller-Institute of Psycholo-
gy, University of Göttingen, Germany

Abstract
This symposium aims to discuss the effectiveness of Schema Therapy (ST) across different formats for various disor-
ders, while also discussing the applicability of Imagery Rescripting (ImRs) in the treatment of psychosis. ST is an evi-
dence-based treatment for personality disorders and complex mental health problems. However, the effectiveness
of ST for other mental health diagnoses and comorbidities needs to be further studied.
ST can be offered in different formats, namely group, individual and combined formats. While it is thought that a
group format may be more effective (e.g., increased cost-effectiveness), it leaves less room for individual attention. A
recent trial by Arntz et al. (2022) on borderline personality disorder (BPD) concluded that a combined individual and
group ST format was more effective than group ST. This raises the question which factors can elucidate the differential
effectiveness of different ST formats.
One ST technique that is also offered as a stand-alone treatment is ImRs. ImRs is a promising intervention for disorders
related to aversive memories, such as posttraumatic stress disorder. However, more studies are needed to examine its
effectiveness and applicability for other disorders, including psychosis.
The first presentation (Baljé) will discuss the effectiveness of group ST compared to group cognitive behavioral treat-
ment (GCBT) for patients with social anxiety disorder (SAD) and comorbid avoidant personality disorder (AVPD). Al-
though SAD is often comorbid with AVPD, (clinical) consensus regarding the preferred treatment remains elusive. The
focus of ST on childhood origins and on acquiring more adaptive coping styles might make ST particularly effective
for patients who suffer from both diagnoses. This presentation will give insight into whether group ST is a more effec-
tive treatment compared to GCBT.
The second presentation (Rameckers) will discuss the moderating effect of exposure to childhood trauma (CT) and
dissociation on the effectiveness of combined individual and group ST compared to predominantly group ST and
treatment-as-usual for BPD. BPD has strong links with CT and dissociation. When patients are exposed to severe CT
and experience dissociation, individual sessions offer trauma processing and more opportunities to effectively deal

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with dissociation. The findings of this study will give insight into whether these two factors explain why ST with a
larger individual component may be more effective than a predominantly group format.
The third presentation (Taylor) will discuss two studies in which the acceptability of a six-session online imagery ther-
apy for psychosis (iMAPS) was examined using a clinical cases series design. Moreover, the iMAPS treatment of the
second study was also focused on attachment style. The findings from these studies give insight into the acceptability
of adapting the ImRs protocol to the treatment of psychosis and delivering the iMAPS intervention online. This will be
discussed in terms of changes in intrusions, core schemas, and psychotic symptoms.
Presenters: 1) Astrid Baljé, PsyQ and University of Leiden (NL); 2) Sophie Rameckers, Phd (convenor/chair), University
of Amsterdam (NL); 3) Chris Taylor, PhD, University of Sheffield and Community Mental Health Team, Pennine Care
NHS Foundation Trust (GB). Discussant: Simon Blackwell, PhD, University of Göttingen (DE).

Keywords
Schema therapy, imagery rescripting, borderline personality disorder, psychosis, avoidant personality disorder

Group schema therapy versus group cognitive behavioral therapy for patients with social anxiety disorder
and comorbid avoidant personality disorder: Results of an RCT in clinical practice
Astrid Baljé, Department of Anxiety Disorders, PsyQ / Institute of Psychology, University of Leiden, Netherlands

Abstract
Social anxiety disorder (SAD) and avoidant personality disorder (AVPD) are often comorbid. For patients with SAD, the
most common psychological treatment is cognitive behavioral therapy (CBT). For patients with comorbid SAD and
AVPD, there is no consensus in clinical practice about which treatment is indicated, and guidelines are scarce. Sche-
ma Therapy (ST) evolved as one of the major current treatments for patients with personality disorders and chronic
mental health problems. Personality disorders, including AVPD, are characterized by negative and sometimes trau-
matizing childhood experiences resulting in maladaptive coping strategies that still influence patients’ daily life. The
focus of ST on childhood origins and on acquiring more adaptive coping styles might make this therapy particularly
effective for patients who suffer from comorbid SAD and AVPD.
In the current study, we adjusted the ST mode model group treatment for borderline personality disorder, developed
by Farrell and Shaw, to a 30-session semi-open group schema therapy (GST) for patients with comorbid SAD and
AVPD. We compared this treatment to a semi-open group CBT (GCBT), based on Heimberg’s GCBT protocol for pa-
tients with SAD, which was extended to 30 sessions.
We conducted the first randomized controlled trial comparing GST and GCBT in an outpatient population (n=154)
with both SAD and AVPD. Both interventions were compared on SAD symptoms (Liebowitz Social Anxiety Scale) and
manifestations of AVPD (Avoidant Personality Disorder Severity Index). Intention-to-treat analysis showed no signifi-
cant differences between treatments at 3 months post-treatment and one-year follow-up regarding SAD symptoms
and manifestations of AVPD. Both modalities led to significant and substantial improvements. Significantly more pa-
tients completed GST. GST and GCBT are valuable treatments for SAD with comorbid AVPD. The higher treatment
retention in GST indicates that GST is more acceptable than GCBT.
Reference:
Baljé, A. E., Greeven, A., Deen, M., van Giezen, A. E., Arntz, A., & Spinhoven, P. (2024). Group schema therapy versus group
cognitive behavioral therapy for patients with social anxiety disorder and comorbid avoidant personality disorder: A
randomized controlled trial. Journal of Anxiety Disorders, 104, 102860. https://doi.org/10.1016/j.janxdis.2024.102860

Keywords
Social anxiety disorder, Avoidant personality disorder, Randomized controlled trial, Schema therapy, Cognitive behav-
ioral therapy, Personality disorder

Are Childhood Trauma and Dissociation Differentially Related to Treatment Outcomes? An Examination of Dif-
ferent Schema Therapy Formats
Sophie Rameckers, Arnoud Arntz, Arnold Van Emmerik
University of Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands, Netherlands

Abstract
One promising and effective treatment for borderline personality disorder (BPD) is Schema therapy (ST). ST can be
offered in different formats, such as predominantly group (PGST), combined individual and group (IGST), or individual
formats. PGST is thought to be more time and cost-efficient, and effective, in part due to processes in the group, so-
cial support from peers, and more efficient treatment planning. However, a smaller individual component leaves less
room for the processing childhood traumas (CT) and effectively addressing dissociation during treatment. Given the
strong links between CT, dissociation and BPD, patients who have been exposed to higher levels of CT and experience

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more dissociation may benefit more from a ST format with a stronger individual component.
To examine this question, we studied whether CT and baseline dissociation moderated treatment outcomes (i.e., BPD
symptom severity and treatment retention) of IGST, PGST, and optimal treatment as usual (TAU). We also explored the
same question for individual CT types (i.e., sexual, physical, and emotional abuse, and emotional and physical neglect)
and the subjective distress related to CT. Moreover, we also examined the relationships between dissociation, CT and
BPD severity at baseline. We hypothesized that a higher and more severe exposure to CT and dissociation would be
related to relatively higher changes in BPD symptom severity over time and treatment retention for IGST compared
to PGST and TAU. The present study is a secondary analysis of a multicenter randomized controlled trial comparing
different ST formats for BPD (Arntz et al., 2022; Wetzelaer et al., 2014). Participants received two years of IGST (n = 123),
PGST (n = 125), or TAU (n = 246). The Borderline Personality Disorder Severity Index-IV was used to assess treatment
effectiveness, and we assessed treatment retention per quarter. We analyzed the data with linear regressions, gamma
regressions and survival analyses, similar to the analyses of the main study.
Surprisingly, exposure to CT was not related to BPD severity at baseline, whereas baseline dissociation was positively
related BPD severity, indicating that patients who experienced more dissociation also experienced more severe BPD
symptoms. During the symposium, the moderating effects of CT and dissociation on BPD symptom severity improve-
ment and treatment retention per quarter will be discussed. One limitation of this study is that the heterogeneity of
the TAU group was high (i.e., different types of treatments), which complicates the interpretation of the comparisons
to this treatment category. In addition, while we studied IGST, future should also compare IGST to individual ST. Lastly,
this study can have important clinical implications, as the findings may be useful in explaining the superiority of IGST
over predominantly group formats and TAU in case of high exposure to CT and dissociation.

Keywords
Schema Therapy formats, Borderline personality disorder, childhood trauma, dissociation

New developments in iMAgery focused therapy for PSychosis (iMAPS)

Christopher D. J. Taylor, ClinPsyD, PhD

Department of Psychology, Faculty of Science, The University of Sheffield and Research and Innovation, Pennine Care
NHS Foundation Trust

This presentation will outline recent work on imagery focused therapies for psychosis from two new studies. In iMAPS
Telehealth, a clinical case series of five patients with psychosis were offered six sessions of an imagery focused therapy
for psychosis (iMAPS) online via video calls to test the acceptability of delivering the intervention online. All five pa-
tients attended all six sessions with improvements on intrusive images, core schema and psychotic symptoms (Cairns,
Kelly & Taylor, 2023). In a second case series, the iMAPS approach was adapted to include a focus on attachment style
in the formulation and use of a “felt security” technique in addition to wider iMAPS therapy protocol. Eight patients
attended six offered sessions, with improvements in images, schemas and psychotic symptoms (Airey, Berry & Taylor,
2023). The results will be discussed in relation to the wider literature.

Keywords
psychosis, imagery, schema, CBT, schizophrenia

(if needed) ) Airey, N. D., Berry, K., & Taylor, C. D. J. (2023). Attachment-focused iMAgery therapy for PSychosis (A-iMAPS):
A case series targeting psychosis-related trauma. British Journal of Clinical Psychology, 62(3), 621-641. https://doi.org/
https:// doi.org/10.1111/bjc.12433 Cairns, A. J. J., Kelly, J., & Taylor, C. D. J. (2023). Assessing the delivering of iMAg-
ery-focused therapy for PSychosis (iMAPS) via telehealth. Psychology and Psychotherapy: Theory, Research and Prac-
tice, 96(3), 678-696. https://doi.org/ https://doi.org/10.1111/papt.12463)

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SY14: Threat learning: How basic science can inform clinical practice
Rivkah Ginat-Frolich
The Hebrew University of Jerusalem, Israel
Jonathan D. Huppert
The Hebrew University of Jerusalem, Israel
Tomer Shechner
The University of Haifa, Haifa, Israel, Israel
Gil Shner
The University of Haifa, Haifa, Israel, Israel
Iris Engelhard
Utrecht University, Netherlands

Abstract
Threat conditioning paradigms provide a way to assess mechanisms related to fear and anxiety. Examining these
mechanisms across development provides important insight into how fear is learned and maintained. One such
mechanism, fear (over)generalization, whereby fear generalizes from threat to safety stimuli, is a defining feature of
anxiety disorders. Consequently, better understanding both fear generalization and additional mechanisms involved
in threat learning can lead to the refinement of clinical treatment. In this symposium, recent research using threat
conditioning paradigms will be presented. The first two presentations will examine threat learning through a de-
velopmental lens. In the first presentation, Gil Shner, Rany Abend, Nadav Barak, Ido Shitrit, and Tomer Shechner will
present a study examining threat acquisition and extinction in a community sample of 65 adults and 63 adolescents
using electroencephalogram (EEG). Developmental differences that emerged in both late positive potential (LPP) and
theta activity, particularly during threat extinction, will be presented. In the second presentation, Tomer Shechner,
Yael Skversky-Blocq, Yoni Fishman, and Oded Cohen will present a series of three studies that used a novel observa-
tional threat learning paradigm in a sample of children, adolescents, and adults. Developmental differences in threat
learning stages, differences between observational and direct threat extinction, and the clinical relevance of these
differences will be discussed. The last two presentations will examine different aspects of fear generalization: one
from a mechanistic perspective and one as a predictor for symptom change. In the third presentation, Iris Engelhard
will present a study on the effect of intrusive memories on fear generalization. In a sample of healthy adults, triggering
involuntary memories in the presence of a safe stimulus following threat conditioning led to increased distress and
threat expectancy towards the safe stimulus. Clinical implications, such as targeting involuntary memory of threat in
anxiety disorders possibly enhancing the effects of exposure-based treatment, will be outlined. Finally, in the fourth
presentation Rivkah Ginat-Frolich, Baraa Kabha, Noa Broder, Snir Barzilay, Elad Zlotnick, and Jonathan Huppert will
present a study that looked at threat learning in sample of adults with high anxiety sensitivity. Individuals who exhibit
low fear generalization are predicted to exhibit a greater decrease in anxiety sensitivity, as compared to participants
with greater fear generalization, following a one session intervention. The symposium concludes with a discussion of
the importance of examining threat learning across developmental studies and the clinical relevance of using threat
conditioning paradigms. Suggestions for future directions will be presented.

Keywords:
threat learning; anxiety disorders; fear generalization; developmental differences

SY15: Unraveling the Mechanisms of Change in Transdiagnostic Cognitive-

Behavioral Therapy: Insights from the Unified Protocol
Convenor & Chair: Johanna Boettcher, Psychologische Hochschule Berlin
Presenter:
Bogdan Tulbure
West University of Timisoara, Romania
Brigida Caiado
University of Coimbra
Johanna Boettcher
Psychologische Hochschule Berlin, Germany

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Transdiagnostic cognitive-behavioral treatments address the problem of “rampant comorbidity and pervasive hetero-
geneity” (Dalgleish et al., 2020, p. 186) of mental disorders. Meta-analyses have demonstrated the efficacy of various
transdiagnostic approaches. But what makes these treatments work? Studying processes of change in transdiagnos-
tic treatments offers the opportunity to inform our knowledge of treatments across the borders of specific disorders.
It thus contributes to our understanding of which elements of cognitive-behavior therapy are crucial for most indi-
viduals and which are of specific value to only a subset of individuals. However, examining processes of change is
challenging. Quantitative approaches struggle with sample sizes, timing, and the entanglement of symptoms and
processes. Qualitative results, on the other hand, are often hard to integrate into the quantitative evidence. These
difficulties are exacerbated by the lack of consistency of studied processes. The various (transdiagnostic) approaches
all differ in the assumed, targeted mechanisms which makes the interpretation of results across studies nearly im-
possible. Focusing on a single, transdiagnostic approach and studying mechanisms of change from different angles
seems like a promising approach to deepen our understanding of the key processes of symptom improvement. In the
current symposium, we therefore combine three studies of mechanisms of change for the same treatment program,
the Unified Protocol (UP). The UP is a transdiagnostic approach that has demonstrated efficacy in the treatment of
emotional disorders in adults, adolescents, and children. More importantly for this context, the UP clearly outlined
the assumed mechanisms of symptom improvement, including cognitive flexibility, mindfulness, and emotion avoid-
ance. The current symposium will examine these mechanisms in different settings and populations, applying quanti-
tative and qualitative measures. In the first presentation, Bogdan Tulbure (West University of Timisoara) will focus on
experiential avoidance in a study on an Internet-based version of the UP. He will depict fine-grained weekly changes
in mechanism and symptoms and answer the question if reductions in experiential avoidance drive symptomatic
change. In the second talk, Brigida Caiado (University of Coimbra) will broaden the focus and report on a study where
all assumed mechanisms of the UP were assessed. She will describe changes in distress intolerance, experiential avoid-
ance, and cognitive errors in children with emotional disorders, receiving the UP. In the third presentation, Johanna
Boettcher (Psychologische Hochschule Berlin) will shift the focus to qualitative methods and will report on Client
Change Interviews conducted with participants of an Internet-based version of the UP. She will outline how patients’
experiences of change processes match and extend the UP’s hypothesized processes.
Throughout the symposium, we will critically discuss the value of this line of research and its potential to enhance our
knowledge of psychotherapeutic processes and our understanding of mental disorders.

Keywords
Transdiagnostic, Unified Protocol, mechanisms, processes of change

The impact of the Unified Protocol for Children (UP-C) on Transdiagnostic

Mechanisms

AUTHORS

Symposium title
U Unraveling the Mechanisms of Change in Transdiagnostic Cognitive-Behavioral Therapy:
Insights from the Unified Protocol
Presentation title:
Exploring the role of experiential avoidance as a change mechanism in a transdiagnostic treatment for anxiety and
depression

Bogdan Tudor Tulbure, Ph.D.

Ștefan Marian, Ph.D.
Department of Psychology, West University of Timisoara, Romania

Lately transdiagnostic treatments addressing a broad spectrum of mood and anxiety disorders started to accumu-
late efficacy evidence, but fewer efforts have been directed toward understanding the underlying mechanisms that
lead to symptom reduction. To cover that gap, we decided to examine whether experiential avoidance represents
a potential change mechanism candidate for the transdiagnostic intervention program proposed by Barlow at all.
(2011). A shorter version (i.e., nine session) of the Unified Protocol was delivered online in Romania as part of a larger
Randomized Control Trial (RCT). During the program (i.e., weeks 1, 3, 5, 7, 9) participants were invited to report their
anxiety and depression symptoms, and their level of distress aversion (i.e., part of the experiential avoidance concept).
Participants were also assessed before the intervention, immediately after it, and six months later (Follow Up - FU). A
multilevel approach to test the mediation effect of distress aversion on the effect of intervention on anxiety, depres-
sion, and negative affect was used. The mediation effects were tested by first fitting two sets of multilevel models

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for each outcome. The first set of models included Group, Time and their interaction as fixed effects, and a random
intercept for participant. In the second set of models, we also included the mediator as a fixed effect predictor and a
random slope for the mediator. Mixed effect models were computed using the lme4 package version 1.1-35.4 (Bates
et al., 2015) in R version 4.4.1 (R Core Team, 2024). Results of the mixed effects models indicated a significant time
by group interaction for all outcome variables and the mediator, except ODSIS. This indicated that decrease in these
variables across time was significantly higher in the treatment group as compared to the control. The second set of
models indicated that distress aversion was a significant predictor for all outcome variables. Results of the mediation
analyses indicated a partial mediation effect of distress aversion on the effect of time on all outcome variables in the
Treatment group. Particularly, distress aversion mediated 23% of the effect of the intervention on anxiety, 26% of the
effect on depression, and 32% of the effect on negative affect. Given the importance assigned to mechanisms of ac-
tion in treatment outcome research, the obtained results will be interpreted in light of the existing data, contributing
to the growing evidence regarding the possible role of distress aversion as a transdiagnostic change mechanisms.

Brígida Caiado
[email protected]

Abstract:
The Unified Protocol for Children (UP-C), a 15-session cognitive-behavioral group intervention for children with emo-
tional disorders and their parents, aims to reduce the children’s anxiety and/or depression by addressing shared un-
derlying mechanisms. This study aims to assess UP-C&#39;s efficacy in reducing transdiagnostic mechanisms such
as negative affect, distress intolerance, cognitive errors, behavioral avoidance and experiential avoidance, compared
to an active control group (a psychoeducational intervention) through a randomized controlled trial. A total of 153
Portuguese children (6-13 years; 58.8% girls), diagnosed with at least one emotional disorder (82.4% with an anxiety
disorder; 9.8% with an anxiety related disorder; 7.8% with depression), were randomly assigned to either the experi-
mental group (n = 77) or control group (n = 76). Self-report questionnaires were administered at baseline, mid-treat-
ment, post-treatment, and a 3-month follow-up to evaluate the targeted mechanisms. Mixed models were used for
data analysis.

Key words
Unified Protocol for Children, Transdiagnostic Mechanisms, Emotional Disorders

Symposium: Unraveling the Mechanisms of Change in Transdiagnostic Cognitive-Behavioral

Therapy: Insights from the Unified Protocol

Presentation 3 of the symposium

Presenting Author:
Title: Prof. Dr.
Name: Johanna
Surname: Boettcher
Affiliation: Psychologische Hochschule Berlin
E-Mail: [email protected]
Co-author:
Title: Dr.
Name: Carmen
Surname: Schaeuffele
Affiliation: Freie Universitaet Berlin
E-Mail: [email protected]

Title: What do patients make of the UP? Exploring mechanisms of change in qualitative interviews
Background: Qualitative investigations that openly explore changes and facilitators of changes from the patient’s
perspective might offer valuable insights on important impacts of the Unified Protocol and their change mechanisms.
Objective: Our aim for this study was to extend findings from qualitative process research to the Internet-based set-
ting and shed light on possible differences between treatment responders and non-responders. In exploring the pa-
tients’ perspective on the intervention, we were interested to understand (1) which changes responders and non-re-
sponders experienced, and (2) which aspects of the intervention they found helpful or hindering in facilitating those
changes.
Method: We interviewed 21 patients that showed response or non-response to treatment using the Change Interview
Schedule following a 10-week Internet-based intervention based on the Unified Protocol. Interviews were analyzed
using qualitative content analysis.

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Results: Both responders and non-responders reported positive changes. Most frequently they reported increased
positive affect (81%). Interviewees reported that they experienced few negative effects following treatments. Both
groups reported helpful aspects of treatment, with guidance mentioned most frequently (85,7%). Mainly, aspects of
the specific framework were perceived as hindering (e.g., lack of personalization) (66.7%).
Conclusion: Overall, patients reported mostly positive impacts, even if they did not respond to treatment on quan-
titative questionnaires. In terms of change mechanisms, our results highlighted that what patients find helpful or
hindering is highly individual.

Keywords
qualitative change interview, Unified Protocol, Internet-based, transdiagnostic

SY16: Treatment model and beyond: adherence and flexibility in application

of dialectical behavior therapy (DBT)
Dmitrii Pushkarev
BE Company Training (Serbia), Serbia
Magdalena Skuza
Centrum Zdrowia Psychicznego HarmonJa, Poland
Kseniya Syrokvashina
Nonaffiliated researcher, Russian Federation
Fragiskos Gonidakis
National and Kapodistrian University of Athens, Greece

Abstract
This 90-minute symposium is for experienced DBT therapists, as well as for the professionals interested in DBT. The
symposium will focus on the scope of DBT model and elements of treatment in different settings and with different
client populations. Magdalena Skuza (Poland) will cover how standard DBT model can be expanded for use with
families in her presentation “DBT transactional model and systemic therapy - family therapy or therapy with family -
dialectical synthesis”. Ksenija Syrokvashina (Russia, Serbia) in her presentation “Expanding treatment targets in DBT”
will discuss how DBT treatment targets can be adapted to embrace new client populations. Dmitrii Pushkarev (Russia,
Serbia) in the presentation “Burnout in DBT therapists and team survival” will talk about how team adherence/non-ad-
herence to the DBT treatment model affects the burnout of therapists and their willingness to continue practicing
DBT in the longterm. Magdalena Skuza (Poland) in her presentation “Comprehensive DBT program vs DBT-informed
treatment: is it possible to use DBT principles, skills, and strategies outside of DBT comprehensive program?” will pro-
vide an overview of current research data on integrating elements of DBT into other CBT treatments.

Keywords
DBT, dialectical behavior therapy, comprehensive DBT, treatment model, family therapy, treatment targets, burnout

SY18: Challenges in Assessment and Conceptualization of Rumination as a

Transdiagnostic Risk Factor
Chair: Kristof Hoorelbeke, Ghent University, Belgium

Kristof Hoorelbeke
Ghent University, Belgium
Ana Mar Pacheco Romero
Universidad Complutense de Madrid, Spain
Laura Mertens
Ghent University, Belgium
Yorgo Hoebeke
UCLouvain, Belgium

Abstract
Rigid use of emotion regulation strategies has shown to place one at increased risk for the development of internal-
izing disorders. In this context, one emotion regulation strategy that is considered to be particularly debilitating and

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difficult to treat is rumination. The current symposium provides an integration and empirical test of central premises
of influential models of rumination, while focusing on implications for clinical case conceptualization and treatment.
We particularly focus on (assessment of ) specific aspects of rumination and how these may constitute cognitive vul-
nerability for internalizing complaints, or be implicated in resilience.
The first presenter, Prof. dr. Kristof Hoorelbeke (Ghent University, Belgium), will focus on how central factors from
influential self-regulatory (e.g., effortful control, promotion goal focus, goal discrepancy) and metacognitive models
(e.g., positive/negative beliefs about rumination, self-consciousness, need for control) contribute to rumination and
its detrimental effects (e.g., depressive symptomatology). He will present network analyses conducted in the context
of a large-scale cross-sectional study, as well as focus on temporal dynamics between these constructs based on in-
tensive time-series data collected in a second sample at risk for depression.
While the first presentation focuses on how depressive rumination and related factors contribute to the development
and maintenance of depression, Ana Mar Pacheco Romero (Complutense University of Madrid, Spain) will focus on
the development of positive affect and related responses, and how these may contribute to resilience rather than
depression (e.g., anhedonia). She will rely on intensive time-series data to model specific mechanisms underlying
affective responses to (un)pleasant experiences, with a main focus on anticipated pleasure and the use of positive
rumination versus dampening of positive affect in daily life. This includes a focus on temporal sequences, patterns of
co-occurring activity, and how these relate to individual differences in positive affect in daily life.
The third presenter, Laura Mertens (Ghent University, Belgium), will extend the focus of this symposium to the context
of post-traumatic stress, exploring how different forms of rumination may place one at risk for developing post-trau-
matic stress complaints, while also providing opportunities for post-traumatic growth to occur. Extending the frame-
work provided in the first presentation, this includes a focus on the role of different forms of event-related- (e.g.,
intrusive, deliberate rumination) and depressive rumination, while accounting for central metacognitive and self-reg-
ulatory factors.
Finally, dr. Yorgo Hoebeke (Université Catholique de Louvain, Belgium) will focus on existing challenges in the as-
sessment of rumination in clinical practice. dr. Hoebeke will present a recently developed tool that allows to assess
rumination as a multifaceted construct in daily life. In this context, using intensive time-series data, he will explore
the clinical utility of novel indices of emotion regulation dynamics for the prediction of depressive-, stress-related and
anxiety complaints.
Taken together, this symposium provides an overview and empirical test of key theories of rumination, while pro-
viding guidelines for its assessment within clinical case conceptualization. In addition, across the different studies
potential targets for intervention are identified.

Keywords
rumination; assessment; depression; anxiety; trauma; ambulatory assessment

Multiple Paths to Rumination: A Network Analytical Approach

1. Prof. Kristof Hoorelbeke - Ghent University, Belgium
2. Dr. Gerly Tamm - Ghent University, Belgium
3. Prof. Ernst H.W. Koster - Ghent University, Belgium

Abstract
This presentation will explore central elements from self-regulatory and metacognitive models of repetitive negative
thinking, and how these contribute to rumination as a key depression vulnerability factor. By integrating concepts
from self-regulation, such as effortful control, promotion goal focus, and goal discrepancy, with metacognitive factors
like beliefs about rumination, self-consciousness, and the need for control, the study provides a comprehensive un-
derstanding of rumination. The findings are based on network analyses from two cross-sectional studies, elucidating
the complex interrelations among these factors. Additionally, the presentation will delve into the temporal dynamics
of these constructs using intensive time-series data from a sample at risk for depression. In particular, we will explore
how different (meta)cognitive factors contribute to rumination and are affected by rumination over time, as well
as model patterns of co-occurring activity. This approach highlights how fluctuations in self-regulation and meta-
cognitive processes influence the occurrence and persistence of rumination in daily life. By mapping these intricate
relationships, this research offers valuable insights into the mechanisms underlying rumination and its role in exacer-
bating depressive symptomatology.

Keywords
rumination; assessment; depression; network analysis; ambulatory assessment

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Unraveling Ecological Positive Affect Dynamics and their Mechanisms: Predictive Patterns and Interactions in
Daily Life
Ms. Ana Mar Pacheco Romero, Universidad Complutense de Madrid, Spain
Prof. Carmelo Vázquez, Universidad Complutense de Madrid, Spain
Prof. Alvaro Sanchez-Lopez, Universidad Complutense de Madrid, Spain
Prof. Kristof Hoorelbeke, Ghent University, Belgium

Abstract
Diminished positive affect is related to anhedonia, a hallmark symptom of multiple internalizing disorders, which has
been associated to a higher chronicity of symptomatology, and poorer treatment response. The reduced effectivity
of current treatments to treat anhedonia evinces a lack of understanding on the mechanisms underlying diminished
positive affect, which could shed light into new clinical models with a stronger translational value. Using a ten day
(six times a day) experience sampling design to evaluate 130 undergraduate students, in this study we examined
the dynamic interactions between positive affect, appraisal of pleasant events, activation of pro-hedonic goals, an-
ticipated pleasure, use of positive rumination and dampening, and social desirability. Using a Vector AutoRegressive
(VAR) approach to combine ESM and network analyses we modelled the temporal (i.e., predictive) and contempora-
neous (i.e., co-ocurring) association among these variables, represented as nodes in the network of factors related to
diminished positive affect. Anticipated pleasure (i.e., how good I think future events will make me feel) occupied a
central role in the temporal network by positively predicting positive affect and all other variables, apart from the use
of dampening, and negatively predicting pro-hedonic goals (i.e., how good I wanted to feel). Higher positive affect
also subsequently predicted experiencing more pleasant events, higher social satisfaction and use of positive rumi-
nation. Interestingly, pro-hedonic goals were negatively predicted by both anticipated pleasure and positive affect,
suggesting that when individuals feel good, they do not necessarily choose to feel better some hours later in time.
Dampening was only predictive of positive rumination, which emphasizes the co-ocurring nature of positive regula-
tory strategies. Furthermore, all nodes within this temporal network showed a positive autocorrelation, meaning that
individuals were likely to perpetuate each positive affective process from one moment in time to the next. As for the
contemporaneous network, analyses showed a simmilar connectivity among the nodes as in the temporal network.
However, pro-hedonic goals in this network were positively associated to positive rumination and dampening, mean-
ing that emotional goals seem to shape emotion regulation in shorter-lasting and co-ocurring processes rather than
longer lasting processes. Furthermore, anticipated pleasure was also contemporaneously negatively associated to
dampening use, evincing its protective role against the use of strategies aimed at diminishing positive affect. Overall,
differences in individual patterns of positive affect in daily life seem to be mostly explained by future oriented hedonic
responses rather than the activation of pro-hedonic goals or the use of specific emotion regulation strategies. Thus,
future studies should assess these ecological processes in various symptomatological complaints to better under-
stand how differential patterns of positive affective change may contribute to perpetuate anhedonia.

Keywords
anhedonia, positive affect, positive rumination, dampening, pro-hedonic goals, anticipated pleasure

Forms of Repetitive Negative Thinking Differentially Relate to Posttraumatic Stress Versus Growth Following
Trauma Exposure.
Ms. Laura Mertens, Prof. Kristof Hoorelbeke
Ghent University, Belgium

Abstract:
Background. Posttraumatic stress disorder (PTSD) is a highly invalidating disorder, with a lifetime prevalence of 3.9%.
Little is known about the involvement of cognitive processes in the development and maintenance of PTSD. In line
with cognitive models of PTSD, such as the cognitive model by Ehlers and Clark (2000) and the metacognitive model
of Wells (2000), recent findings suggest that repetitive negative thinking (RNT) may play a crucial role in PTSD symp-
tom development. This presentation will focus on the role of different forms of RNT and related factors (e.g., metacog-
nition, effortful control), and how these uniquely relate to PTSD symptom severity versus growth following exposure
to a traumatic event.
Methods. To examine the unique interrelations among these variables, we conducted network analysis on cross-sec-
tional data collected from two general population samples consisting of individuals meeting Criterion A for PTSD (for
each sample N approximates 350). Different forms of RNT, positive and negative beliefs about RNT, need for control,
effortful control, posttraumatic growth and symptom severity were included in the analyses.
Results. The obtained network models suggest a central role for depressive rumination, deliberate rumination and
negative beliefs about RNT. Each form of RNT showed unique associations with PTSD symptom severity. The rela-
tionship between deliberate rumination and posttraumatic growth appeared to be the strongest among the edges
included in the model.

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Conclusions. Although cross-sectional, our findings suggest that RNT may serve as a central risk factor in the develop-
ment of PTSD. Whereas each form of RNT was linked to increased PTSD symptom severity, deliberate rumination also
showed strong associations with posttraumatic growth, suggesting the more adaptive nature of this thinking style.
Effortful control was negatively associated with rumination, which could possibly serve as a protective factor. Lastly,
metacognitions also seemed to play an important role, particularly negative beliefs about RNT.

Keywords:
repetitive negative thinking; rumination; posttraumatic stress; growth

The Assessment of Rumination as a Multifaceted Construct in Daily Life and The Clinical Utility of Novel Mea-
sures of Emotion Regulation Dynamics
Yorgo Hoebeke, Annelise Blanchard, Alba Contreras, Alexandre Heeren
Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium

Abstract:
Research indicates that rumination can be viewed as a dynamic process that fluctuates over time, within hours and
days. An increasing number of intensive longitudinal studies on rumination are accordingly being conducted and
published using experiencing sampling methodology (ESM), a technique with measurements in daily life. Yet, this
literature suffers from a profound caveat: rumination has so far been conceptualized and measured as a unitary con-
struct in these ESM studies. This is unfortunate since such a unitary view contrasts with prominent contemporary
models that regard rumination as a multifaceted construct, wherein the key features are not interchangeable and
should therefore be measured separately. Therefore, we developed and validated an ESM protocol to assess rumina-
tion as a multifaceted construct, measuring five features of rumination. To this end, forty participants answered five
rumination items four times daily over two weeks, with self-report questionnaires at the end. In this presentation,
we will present this assessment tool but also explore the clinical utility of indices derived from this time-series data.
Indeed, while statistical tools from affective dynamics have been largely applied to elucidate the temporal dynamics
of affect, it has seldom been used in rumination research. Therefore, we examine the predictive value for depressive
and anxiety symptoms of moment-to-moment variability and inertia of rumination features, comparing them against
person-level means, standard deviations, and trait rumination. Overall, this presentation will underscore the value of
considering the dynamic and multifaceted nature of rumination and the combined insights trait rumination and tem-
poral measures of rumination features can offer in understanding depression and anxiety symptomatology.

Keywords:
rumination; depression vulnerability; assessment; experience sampling methodology

SY19: Exploring the Complexities of Suicidal Ideation and Behavior:

Prediction and Effective Interventions
Birgit Wagner
Medical School Berlin, Germany
Heide Glaesmer
University of Leipzig, Germany
Anja Gysin-Maillart
University Hospital of Berne, Switzerland

Abstract
Considering the high number of more than 700,000 deaths by suicide worldwide (World Health Organization, 2019)
and an estimated lifetime prevalence of 3-33% for suicidal ideation and 2.7% for suicide attempts (Borges et al., 2012),
predicting suicidal ideation and behavior is essential to inform suicide prevention (Jobes & Joiner, 2019; Jobes et al.,
2024).
In the first talk, Heide Glaesmer will give an overview of theoretical models and recent empirical evidence on the pre-
diction of suicidal ideation and behavior. The presentation will include core findings from three prospective studies
(Ambass, PRESS, APOS) on the prediction of suicidal ideation and behavior.
In the second presentation, Anja Gysin-Maillart, will present results of the Attempted Suicide Short Intervention
Program (ASSIP). ASSIP has demonstrated remarkable efficacy in reducing the risk of recurrent suicide attempts by
approximately 80% within 24 months. The therapy consists of three to four sessions and aims to promote a compre-
hensive understanding of individual patterns leading to suicidal behavior. It includes identifying vulnerabilities, trig-

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gering factors, warning signs, and developing a personal crisis plan. The establishment of an early therapeutic alliance
is central to ASSIP, which is maintained through follow-up correspondence over a period of two years.
The third talk by Birgit Wagner will present the results of a randomized controlled trial of an online-group intervention
for individuals bereaved by suicide. The intervention consisted of 12 weekly modules based on cognitive-behavioral
methods and took place as a webinar in a group format. The primary outcomes measured were depression and sui-
cidal ideation and behavior, while secondary outcomes included symptoms of prolonged grief, PTSD, post-traumatic
cognitions, hopelessness, and grief-specific symptoms. The results showed that symptoms of posttraumatic avoid-
ance improved significantly in the intervention group compared to the waitlist control group. Psychopathological
symptoms also decreased significantly from baseline to 6-months follow-up in the intervention group. Factors such
as higher scores of depression, grief, suicide ideation, and posttraumatic stress symptoms at baseline were found to
impact the effectiveness of the intervention. Overall, these studies and interventions contribute to the understanding
and prevention of suicidal thoughts and behaviors, providing valuable insights for future research and clinical prac-
tice.

Keywords
Suicidal behavior, suicidal ideation, intervention, postvention, bereavement, grief

SY20: Activating Strengths in CBT: Outcomes,

processes and an intervention model
Chair: Ulrike Willutzki, University Witten/Herdecke, Germany
Convenor/organizer: Ulrike Willutzki, University Witten/Herdecke, Germany

Anton-Rupert Laireiter
Paris-Lodron University Salzburg, Austria
Louisa Jagmetti
University of Zurich, Department of Clinical Psychology and Psychotherapyresearch
Ulrike Willutzki
Witten/Herdecke University, Germany

Abstract
For quite some time strengths-oriented approaches have been developed in CBT (e.g. Padesky & Mooney, Beck et
al., , and since 2014 a SIG Positive CBT has been established in EABCT. A recent review and meta-analysis stresses the
unique contributions that on strengths oriented interventions seem to contribute to psychotherapy outcomes (Flück-
iger et al., 2023). Yet, respective approaches and techniques are underdeveloped. The symposium provides insights
into different research areas.
The first presentation by ANTON-RUPERT LAIREITER (University of Salzburg, Austria) will give an overview about stud-
ies utilizing positive intervention programs that focus on the activation of so-called character strengths in an individ-
ual as well as group setting with patients, using both a ftf- and an online-approach. Three studies that all achieved
moderate to strong effects in reducing depressive/anxiety/stress symptoms, as well as moderate to strong improve-
ment in well-being/flourishing/quality of life will be discussed in detail. Taking also many meta-analytically compiled
findings into account, short- and long-terms outcomes will be considered; moreover research gaps will be adressed.
The second presentation by MARIE DRÜGE, Louisa Jagmetti, Elena Gruss, Nicolas Martel & Birgit Watzke (Zurich Uni-
versity, Switzerland) will look at how patients experience strengths-based aspects of psychotherapy in their everyday
life. Inter-session processes (ISP) describe the internalization and processing of therapy outside of the actual therapy
sessions (thoughts, memories, feelings and fantasies during the intervals between therapy sessions related to ther-
apy/the therapist). Strength-based methods (SBM) might interact with ISP. In this exploratory study, respective ISP
were recorded in eleven patients using qualitative event sampling methods over a period of 14 days by means of
voice messages. In semi-structured interviews, the experiences of the voice messages were deepened. Qualitative
content analysis was used to identify categories. Results: ISP proved to be very diverse both inter- and intra-individu-
ally. The diversity and the inter- and intra-individual variance of these processes illustrate their potential importance
for the therapeutic process, but at the same time make systematic recording difficult.
The third paper by ULRIKE WILLUTZKI Ulrike Willutzki, Luise Busse, Merle Benning, Jan Schürmann-Vengels, Wolfgang
Wöller & Christoph Flückiger (Witten/Herdecke University, Germany) will look at how resource activation unfolds in
the patient-therapist interaction at a micro-process level. By using the task-analytical model of Greenberg (2007), pa-
tient processes of change that occur in resolving specific types of affective-cognitive problems, in this case resource
activation, are delineated. Resource activation was specified as a process that allows patients to access their strengths

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as well as coping strategies with challenging life tasks. A rational model was explicated and evaluated in interviews
with seven experts. An observational schema was explicated and used for videoanalysis of successful and unsuccess-
ful resource activation episodes. While the model structure was confirmed by most experts additional features were
stressed. In the video analysis interrater reliability was suboptimal. The task-analytical model of resource activation
shows promise for an explicit model of how the process of resource activation unfolds (marker of a respective epi-
sode, therapeutic interventions as well as task resolution by patients’ experiencing cognitive-emotional contact with
their resources).

Keywords
strengths-oriented CBT

Positive psychotherapy
In its relatively young tradition, positive psychology has already produced many clinically relevant approaches and
interventions. One of these is positive psychotherapy, developed by Seligman and Rashid in the early 2000s, which
is a multimodal program of applying various positive psychology-based interventions and which attempts to treat
mental disorders without the use of traditional psychotherapeutic methods. A very important component is the acti-
vation and focus of the so-called character strengths. In the author’s working group, various studies have been carried
out to evaluate PPT for mental disorders in individual and group settings as well as online and in the classic ftf mode.
The article provides a brief overview of these studies and applications and then discusses the results of three studies
in group and individual settings, all of which achieved moderate to strong effects in reducing depressive, anxiety and
stress symptoms, as well as them contributed to a moderate to strong improvement in well-being and flourishing as
well as quality of life. In one study, comparable improvements were achieved using a strengths-related short inter-
vention on a sample of preclinical patients. Stabilities over several months to years were demonstrated in all studies.
Overall, these studies, together with many meta-analytically compiled findings, show that positive psychological in-
terventions represent a legitimate alternative to conventional disorder-related and cross-disorder clinical procedures
for the treatment of mental disorders. However, their scope should be examined beyond affective disorders, such as
substance addictions, psychotic disorders, eating disorders and, in particular, personality disorders.

“How do patients experience strength-based aspects of psychotherapy in their everyday life?” - A qualitative
event-sampling and interview study on strength-based aspects in intersession processes from the patients’
perspective
Background: The transfer to everyday life is one of the challenges of psychotherapy. Inter-session processes (ISP)
describe the internalization and processing of therapy outside of the actual therapy sessions and include thoughts,
memories, feelings and fantasies that occur during the intervals between the actual therapy sessions and relate to
the therapy or the therapist. Strength-based methods (SBM), which can be delivered through strength-based instruc-
tions of the therapist or/and as the therapists’ responsiveness to the patient self-directed strength in the therapy
room and/or as strength-based homework, might interact with ISP. However, most existing studies either focus on
individual processes, which are assessed by questionnaires, or explore the patient perspective retrospectively. But
which strength-based aspects will patients use, reflect or internalize as ISP spontaneously? Method: In the present
exploratory study, ISP were recorded in eleven patients using qualitative event sampling methods over a period of
14 days once or several times a day by means of voice messages. In final semi-structured interviews, the experiences
of the voice messages were deepened and specified. Qualitative content analysis was used to identify categories.
Results: ISP proved to be very diverse both inter- and intra-individually. Various categories could be identified, in-
cluding skills, strength-based homework and diary/notes, talking to third parties about therapy or therapist, remem-
bering strength-based aspects of therapy or specific sessions. Discussion: Patients can recognize ISP and experience
strength-based aspects especially recognize specific strategies and skills. The diversity and the inter- and intra-indi-
vidual variance of these processes illustrate their potential importance for the therapeutic process, but at the same
time they make systematic recording difficult, as they can also be related to significant life events. Further research is
needed to identify patterns of helpful strength-based ISP.

Resource-Activation in Psychotherapy – a Task-Analytical Approach

Introduction: Resource or strengths activation is a transdiagnostic/transtheoretical change mechanism relevant in
cognitive-behavioral, psychodynamic (Munder et al., 2019), systemic (De Shazer, 1988) and also positive psychology
approaches. Micro-processes of how resource activation unfolds in the patient-therapist interaction have not yet
been analysed in detail.
Resource activation can be regarded as a specific task as described by Greenberg (2007): Client processes of change
that occur in resolving specific types of affective-cognitive problems, in this case resource activation, are to be delin-

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eated. The paper focuses on the discovery phase of the respective task analysis, leading to a first rational-empirical
model.
Method: Resource activation was specified as a process that allows patients to access their strengths as well as coping
strategies with challenging constellations. Based on prior experience a rational model was explicated and evaluated
in interviews with seven experts from different theoretical orientations. An observational schema was explicated and
used for the videoanalysis of four successful resource activation episodes by eight raters.
Results: While the model structure was confirmed by most experts additional features were stressed. In the video
analysis interrater reliability was suboptimal.
Discussion: The task-analytical model of resource activation will be presented. It shows promise for an explicit model
of how the process of resource activation unfolds (marker of a respective episode, therapeutic interventions as well as
task resolution by patients’ experiencing cognitive-emotional contact with their resources).
References:
de Shazer, S. (1988). Clues; Investigating Solutions in Brief Therapy. Norton.
Greenberg, L. S. (2007). A guide to conducting a task analysis of psychotherapeutic change. Psychotherapy Research,
17(1), 15-30.
Munder, T., Karcher, A., Yadikar, Ö., Szeles, T., & Gumz, A. (2019). Focusing on Patients’ existing Resources and Strengths
in Cognitive-Behavioral Therapy and Psychodynamic Therapy: A Systematic Review and Meta-Analysis. Zeitschrift für
Psychosomatische Medizin und Psychotherapie, 65(2), 144–161. https://doi.org/10.13109/zptm.2019.65.2.144

SY21: The interface between clients and mental health services: Exploring
new social digital realities
Chair: Jeannette Brodbeck, University of Applied Sciences and Arts Northwestern Switzerland, Switzerland

Sofia Jacinto
University of Applied Sciences and Arts Northwestern Switzerland, Switzerland
Lina Stallmann
University of Applied Sciences and Arts Northwestern Switzerland, Switzerland
João Niza Braga
Católica Lisbon School of Business and Economics, Portugal
Jeannette Brodbeck
University of Applied Sciences and Arts Northwestern Switzerland, Switzerland

Abstract
Great efforts have been invested into developing digital tools that provide e-health interventions, create new forms
of interaction with clients and explore virtual contexts as exposure and training grounds. The working alliance be-
tween client and digital intervention (e.g., mobile self-help interventions, online therapy, gamified virtual training
programs) seems to play an important part in clients’ engagement and adherence (e.g., Bijkerk et al., 2022, Cavanagh,
2010; Salaznik et al., 2021) and in intervention outcomes (e.g., Berger, 2017; Nordgren et al., 2013) – similar to face-
to-face therapy. Avatars guide clients through their health journey (e.g., Brodbeck, Jacinto et al., 2022), apps reward
personal achievements with points (e.g., Brown et al., 2016) and counselling services are offered online and via direct
messaging.
But what are the processes underlying this alliance within the given interface? And are we paying enough attention
to what might sometimes be a lower-threshold substitute for personal interaction, but could also be bringing in un-
explored socio-emotional factors and enrichment? The characteristics of user interfaces and virtual content that drive
engagement are an especially potent topic for the expansion of clinical intervention and learning experiences in the
virtual world.
This symposium presents four research projects exploring and evaluating different methods and strategies of online
and virtual interventions to simulate the feedback and interaction of traditional interactive contexts. Particularly, it
provides a theoretical understanding and new evidence on how the online/digital social reality can instigate thera-
peutic change, adding to the transition of mental health care to a new reality that is also digital.
Paper 1 presents two experimental studies in the context of a virtual-reality school environment, with both typical-
ly developing and autistic youth experiencing emotional scenarios and subsequent offers of support by a virtual
character. The socio-emotional impact of computer-controlled characters adds to current assessment and practice
options for people with social difficulties.
Paper 2, in three experimental studies, explores how psychological distance (Trope et al., 2007), induced by the online
context and the social identification of clients with therapists, affect judgments about the healthcare service and

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professional recommendations, and how the online context reduces the need for social identification (Hogg, 2003).
Paper 3, in two experimental studies, under the lens of causal attribution theory (Plaks et. Al., 2009; Weiner, 1988),
investigates how comparison with others and external rewards, such as gamification (Fleming, et al., 2017), increase
intentions to use a mental e-health intervention and self-efficacy for emotion regulation.
Paper 4 focusses on a randomized control trial to test the efficacy of a CBT self-help app intervention to support
emotion regulation and adaptative social functioning of emergent adults with adverse childhood experiences. This
research explores how guidance through regular personalized feedback and options for user’s self-reflection and
feedback on the app can increase engagement with the program.

Keywords
web-based intervention; e-health; working alliance; human-machine interaction; virtual reality; emotion regulation;
gamification; social identity

Virtual social emotion regulation – How virtual, how social and how emotional is a virtual-reality experiment
designed for typically developing and autistic youth?
Lina Stallmann, University of Fribourg, Switzerland
Andrea Samson, UniDistance Suisse, Switzerland

Abstract
Social (or interpersonal) emotion regulation is the process of regulating one’s own or another person’s emotional
experience through social interaction. Despite being largely overlooked in research until recent years, it is integral
to our daily lives and an important source of support when self-regulation fails (Marroquin, 2011, Reeck et al., 2016).
This makes the topic especially poignant for individuals with both difficulty regulating their emotions and less access
to social support, like individuals on the autism spectrum who are more likely to experience trouble understanding
social cues and overstimulation in social settings (Cai et al., 2018).
To investigate the use of virtual reality (VR) for the assessment and training of social emotion regulation, we devel-
oped and evaluated a novel VR paradigm in a virtual school environment: First Day at School, a story arc with two
distinct scenarios designed to elicit negative emotional reactions and provide a fellow student, a virtual agent, to
offer emotional support to the participant. Self-report and psychophysiological data of 50 participants (25 typically
developing, 25 autistic) between the ages of 9 and 20 was collected and preliminary data showed overall presence
in and acceptance of the virtual world, in addition to social and emotional relevance of the scenarios and characters
for both groups. Together with the current developments in online communities for and by individuals on the autism
spectrum, the potential of VR for low-threshold, high-realism social practice situations opens up promising routes and
opportunities for people who might otherwise more quickly be left alone in their daily regulation challenges.

Keywords
human-machine interaction; virtual reality; emotion regulation; gamification; social support; autism spectrum disor-
der

Remote care as social distance: The effects of psychological distance of online contexts and social identity on
help-seeking intentions
João Niza Braga1, Olivia O’dwyer1, Sofia Jacinto2
1
Católica Lisbon School of Business and Economics
2
University of Applied Sciences and Arts Northwestern Switzerland, Switzerland

Abstract
The emergence of internet-based mental health services increased access of vulnerable populations to health care
services. However, the online context may have compromised the relationship between clients and therapists, which
promoted the development of online solutions that try to integrate human contact. The present research explores
how the psychological distance imposed by the online context may reduce social asymmetries between clients and
therapists (Trope et al., 2007). Specifically, it is expected that the online context will reduce the impact of social iden-
tification (Hogg, 2003) between the client and the therapist in clients’ trust, perceived empathy and legitimacy of the
therapist’s recommendations. This hypothesis is tested in three experimental studies that manipulate whether the
contact with the healthcare provider takes place online or in-person. Study 1 shows that in online contexts clients
show lower trust in the healthcare professional than in in-person contexts. Study 2 shows that among POC women,
this effect interacts with the doctor’s identity as POC or White person, demonstrating a significant effect of social iden-
tification when the contact is in-person but not when it is online. Study 3 shows that when the healthcare provider
is a POC woman, social proximity, trust and positive attitudes towards the healthcare provider are higher for offline
contexts and for non-white participants. Interestingly, non-white participants show higher social proximity offline but
do not show higher trust or more positive attitudes for offline over online services. On the contrary, white participants

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show higher social proximity, trust and more positive attitudes for an offline than for an online service. Priming partici-
pants’ ethnic identity leads to more positive attitudes towards the POC healthcare provider among white participants,
but not for non-white participants. Implications for training of good practices on inclusivity in blended therapies are
discussed.

Keywords
working alliance; culture & identity; internet-based; psychological distance; e-health; social identity

Gamification in self-help: The impact of extrinsic rewards in perceived usefulness of internet-based self-help
interventions
Sofia Jacinto1, João Niza Braga2, Carolina Barros2
1
University of Applied Sciences and Arts Northwestern Switzerland, Switzerland
2
Católica Lisbon School of Business and Economics, Portugal

Abstract
Most self-help and mental health online interventions face significant reduction of its use within few weeks. To over-
come this issue, several mental healthcare apps have been using gamification as a strategy to encourage their clients
to have a regular use (Fleming, et al., 2017). However, evidence on the benefits and processes of gamification is scarce,
especially for psychological well-being. In this research, we explore whether the type of feedback: external (points) vs.
internal (emotional validation) impact gamification success. We further explore social (vs. self ) comparison (study 1)
and reward time-frame (immediate vs. late) (study 2) as potential moderators. Two experimental studies, presenting
fictitious scenarios, test the hypothesis that gamification using extrinsic feedback, such as points, lead to lower per-
ceived usefulness and adherence to an app focused on reducing daily anxiety than intrinsic feedback, such emotional
validation, when social comparison is facilitated (study 1) and when health rewards are framed as immediate effects
(study 2). In both studies the type of reward did not significantly impact motivation to use app, its perceived efficacy
and individuals’ perceived control. However, in study 1 it was found that when the feedback provides emotional val-
idation, social comparison leads to higher intrinsic motivation, self-efficacy and perceived control than self compari-
son, however, no effect of social comparison was observed for external feedback. In study 2, late-rewards gamification
and validation lead to the same level of perceived control. However, for short-term rewards, emotional validation
feedback leads to higher levels of perceived control than external feedback. The effects of the reward system of a
gamified mental healthcare service are discussed in terms client’s attributional beliefs, including the beliefs that traits,
symptoms and mental health conditions are controllable and malleable (not stable) (Plaks et. al., 2009; Weiner, 1988).
Implications for monitoring of clients’ progress and self-check are discussed.

Keywords
Change process; internet-based; web-based intervention; gamification; causal attribution; beliefs

Chances and challenges in the development and deployment of the FACE self-help app for young adults with
adverse childhood experiences
Jeannette Brodbeck, Sofia Jacinto, Neela Vetsch, Lina Stallmann
University of Applied Sciences and Arts Northwestern Switzerland, Switzerland

Abstract
Adverse childhood experiences (ACE), different forms of caregiver and peer maltreatment and household and com-
munity dysfunction, can have a lasting impact on an individual’s health and wellbeing throughout adulthood (e.g.,
Norman et al., 2012). Focusing on emerging adults with a history of ACE offers a window of opportunity for secondary
prevention and a better understanding of the processes underlying their social and emotional regulation.
To meet this goal, an internet-based intervention was developed, informed by the FACE epidemiological longitudi-
nal study (Brodbeck et al., 2022) and using an iterative co-design structure. The FACE guided self-help app aims to
increase well-being and strengthen resilience through CBT-based content and exercises organized in two thematic
blocks, emotion regulation and social information processing. By September 2024, 150 young adults reporting ACE
participated in a randomised controlled trial intervention (RCT) to evaluate the app’s efficacy. During the intervention,
participants also received weekly feedback and support by their personal e-guides via a chat function.
In a two arms design, the RCT compared outcomes of the active and the waiting list arms, with participants complet-
ing self-report measures on psychosocial variables and technology satisfaction before, during and after the interven-
tion and in a 3-month follow-up. Preliminary results indicate significant improvement in well-being and resilience. At
the same time, overall usage data showed varying patterns of engagement, including a drop in app activity from the
first to the second intervention block. These results encourage the potential of self-help online interventions to target
the early development of psychosocial outcomes, but also further elucidate the difficulties in balancing their chances

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and challenges. Aspects of the app’s logic and interface that have been developed to encourage participants’ engage-
ment and those to be developed towards a more tailored intervention in the future will be discussed.

Keywords
web-based intervention; e-health; emotion regulation; resilience; adverse childhood experiences; early intervention;
secondary prevention

SY22: Transforming Futures: Innovations and New Approaches in Childhood

and Adolescent Anxiety Interventions
Chair: Dr. L.J. Vreeke – Leiden University, Assistant Professor Developmental and Educational Psychology, The
Netherlands
Convenor/organizer: Dr. L.J. Vreeke – Leiden University, Assistant Professor Developmental and Educational Psy-
chology, The Netherlands

Leonie Vreeke
Leiden University, Netherlands
Nina Komrij
Leiden University, Netherlands
Annelieke Hagen
Leiden University, Netherlands
Sara Velthuizen
Leiden University, Netherlands
Robin Zimmermann
Ruhr-Universität Bochum, Germany

Abstract
Childhood and adolescent anxiety disorders represent a significant public health concern, with long-term implica-
tions for mental health and overall well-being. This symposium brings together five scientist-practitioners and aca-
demic researchers from Leiden University in the Netherlands and Bochum University in Germany to discuss their latest
findings and innovative approaches in early intervention for anxiety disorders among young populations. The focus
is on early intervention, disorder-specific strategies, and the integration of blended therapy formats, which combine
traditional face-to-face therapy with digital tools. Based on data from a variety of large Randomized Controlled Trials
(RCTs) as well as an international multicenter study, our presentations aim to provide attendees with cutting-edge
research and practical strategies to improve mental health outcomes for young people.
Early intervention is critical in addressing anxiety disorders in children and adolescents. Timely and effective interven-
tion can mitigate the progression of these disorders, reduce the risk of comorbid conditions, and improve long-term
outcomes. The presenters will discuss various early intervention strategies that have shown promise in their research,
emphasizing the necessity of addressing anxiety symptoms before they escalate into severe consequences and fur-
ther comorbidities. The symposium will also highlight the critical role of parent involvement in the treatment of child-
hood anxiety disorders. Engaging parents in the therapeutic process can enhance treatment outcomes by providing
children with a supportive home environment that reinforces therapeutic gains, and supports children in continuing
to practice their learned skills outside of the clinic.
Tailoring interventions to specific anxiety disorders can enhance treatment efficacy. The symposium will explore dis-
order-specific approaches, including cognitive-behavioral therapy (CBT) tailored for specific phobia and social anxi-
ety disorder. These targeted interventions are designed to address the unique features and underlying mechanisms
of each disorder with a prominent focus on graded exposure, not only as it is done in regular care with weekly sessions
but also delivered as a One-Session Treatment (OST), a three-hour session of exposure, providing more precise and
effective treatment options. Blended therapy formats, which combine traditional in-person therapy with digital tools,
offer a flexible and accessible approach to treating anxiety disorders. Researchers from both institutions will present
their work on supplementing standard therapeutic practices with online therapy modules and mobile apps. These
blended formats not only increase accessibility for families who may face barriers to in-person therapy but also allow
for continuous support and engagement outside of traditional therapy sessions.
This symposium underscores the importance of early, disorder-specific interventions and the potential of blended
therapy formats in addressing childhood and youth anxiety disorders. By incorporating parent involvement and lever-
aging digital tools, these innovative approaches offer promising avenues for improving the mental health outcomes
of young people. Attendees will gain insights into contemporary research and practical strategies for preventing and

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intervening in anxiety disorders, ultimately contributing to the development of more effective and comprehensive
mental health services for children and adolescents.

Keywords
Childhood anxiety disorders; early intervention; disorder-specific interventions; blended therapy; parent involve-
ment; exposure; cognitive-behavioral therapy

Preventing the development of anxiety disorders in inhibited toddlers: Implementation of a live, online tar-
geted group-based parenting program
N.L. Komrij, MSc. (1),
dr. M.P. Kösters (2),
dr. F. Scheper (3),
M.F.S. Soppe (1),
dr. L.J. Vreeke (1)

1 Department of Developmental and Educational Psychology, Leiden University, Institute of Psychology, Leiden, The
Netherlands.
2 Public Health Service Amsterdam, department of Healthy Living, Amsterdam. The Netherlands.
3 MOC ‘t Kabouterhuis, department of Infant Mental Health, Amsterdam, The Netherlands

Abstract:
Anxiety disorders in childhood are highly prevalent and frequently go untreated, underscoring the need for early
prevention. Targeted, group-based parenting show promise in preventing anxiety in young children but are often
difficult to implement sustainably within regular services. Online interventions are considered to be more accessible,
though few have focused on preventing internalizing disorders. Therefore, we investigated the implementation of
a live, online targeted group-based parenting program aiming to prevent the development of anxiety disorders in
anxiety-prone toddlers in the Netherlands using an effectiveness-implementation hybrid design.
Our program was based on the Dutch version of the Australian Cool Little Kids intervention: a 6-session training for
parents of inhibited children aged 3-6 years, in which a group parents of 6-8 children learned about (coping with)
their child’s inhibited behavior. We collaborated with various societal organizations for executing the intervention
and incorporated existing participant recruitment strategies, allowing us to study the intervention in its real-life cir-
cumstances. Implementation was evaluated through questionnaires completed by parents and therapists as well as
observations of the intervention sessions.
The preliminary implementation outcomes, such as reach, fidelity, and satisfaction will be presented, alongside the
challenges and implications. These findings provide insights into the feasibility and potential benefits of implement-
ing live, online interventions, informing future research and guiding mental health services.

Keywords:
anxiety, early prevention, parents, implementation

Advancing Early Intervention: Tailoring and Expanding Strategies for Anxiety in Toddlers
Dr. Leonie Vreeke, Leiden University, Faculty of Social Sciences, Wassenaarseweg 52, 2333 AK Leiden, The Nether-
lands

Abstract
At this moment, we are in the final stages of data collection of a large scaled Randomized Controlled Trial, in which
Dutch parents with inhibited children are invited to a preventive intervention for children, based on the Dutch version
of the Australian Cool Little Kids intervention (CLK). The CLK intervention is designed for young children (aged 3-6
years) who are anxiety-prone but do not yet meet the criteria of an anxiety disorder.
However, in the screening and in the contacts we have with clinical mental health care services we noticed that there
is a large group of children who already meet the criteria of an anxiety disorder, for whom a more intensive, individu-
alized program would be needed. At the same time, there are also anxiety-prone children who possibly could benefit
from lighter care such as a parental webinar with psychoeducation and online knowledge clips. This could also be
suited for parents who are less motivated, unable to participate due to their busy schedules, or are less likely to par-
ticipate in a group intervention. In such cases, a first one-off webinar could be a viable solution and could help lower
the threshold for participation in subsequent steps of the intervention. Nonetheless, a tailored treatment program in
early childhood for anxiety-prone children does not exist yet in The Netherlands.
This talk will discuss new treatments to address the needs of all these groups.

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Key words
Anxiety, children, preventive intervention, parent training.

Combining Therapy and Research Part 1: Practical Insights into One-Session Treatment for Childhood Pho-
bias
Annelieke Hagen, Leiden University, Faculty of Social Sciences, Wassenaarseweg 52, 2333 AK Leiden, The Nether-
lands

Abstract
Despite the high prevalence and impact of specific phobias, few affected children receive treatment. Moreover, stan-
dard CBT is not effective for everyone. A more intensive intervention and effective implementation of strategies may
enhance treatment outcomes. One such intensive approach is the One-Session Treatment (OST).
This talk will outline the OST protocol for specific phobias. The core of the protocol is a three-hour exposure session
during which the phobia is addressed step-by-step, working towards the child’s goal, such as undergoing an injection
or visiting a friend with a dog. This session is preceded by a comprehensive cognitive-behavioral analysis, during
which the therapist and child identify the catastrophic thoughts associated with the feared situation, and it is fol-
lowed by a period of home practice.
We will share practical tips for treating phobias using the OST protocol and discuss current research, specifically the
Kids Beat Anxiety (KiBA) study. In this study, all patients receive OST, with half practicing with the KiBA app (see
also ‘Combining Therapy and Research Part 2’) and half following the regular treatment protocol during the practice
period. Since the results of the effectiveness study will not yet be available, this talk will focus on the integration of
therapeutic and research methods. We will explore how certain research methods can be applied in clinical practice
and discuss challenges and tips for treating phobias.

Key words
Anxiety, youth, exposure, One-Session Treatment

Combining Therapy and Research Part 2: Theoretical Foundation and Practical Application of Effective Home
Exposure Exercises Supported by a Novel mHealth App
Robin Zimmermann, Germany, Mental Health Research and Treatment Center (FBZ)

Abstract:
In Cognitive Behavioral Therapy (CBT) for anxiety disorders, practicing newly acquired skills in different contexts
is considered essential. Therefore, homework during and after treatment is often integrated into CBT protocols to
strengthen the newly learned skills and facilitate generalization. Despite its importance, practicing at home can be
challenging due to factors such as, low motivation, time constraints, and insufficient self-guidance. To overcome
these challenges and optimize treatment outcomes, we studied theoretical considerations in the literature regarding
effective homework. Utilizing this knowledge, we developed a homework program aimed at improving adherence
and treatment outcomes by addressing some of these challenges.
As part of a multicenter randomized controlled trial (RCT) for the treatment of childhood specific phobias (Kids Beat
Anxiety study; KiBA), we developed an app (KiBA app) to support self-guided exposure homework. In this talk we
will outline the theoretical foundation of effective CBT homework for childhood anxiety and address key elements
for successful implementation of homework, following the literature review of Klein and colleagues (2024). We will
demonstrate how the KiBA app incorporates these elements using video clips and screenshots of the app to illustrate
its practical application within a clinical context.
While the KibA project is nearing completion, effectiveness results concerning the KiBA app will not be available at
the time of the conference. Nevertheless, this talk will offer practical insights into leveraging technology to augment
CBT-based homework programs for childhood anxiety disorders.
The presentation will also reflect on lessons learned during the project, discussing encountered challenges and the
strategies devised to address them. Practical insights and clinical tips derived from ongoing experiences with the
KiBA project will be shared, focusing on overcoming barriers to home exposure, and enhancing adherence to therapy
homework.

Keywords:
anxiety, youth, homework, home exposure, app

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Early Intervention Group Cognitive Behavioral Therapy for Socially Anxious Adolescents
Sara L.M. Velthuizen, Leiden University, Faculty of Social Sciences, Wassenaarseweg 52, 2333 AK Leiden, The Neth-
erlands

Abstract
Social anxiety disorder (SAD) is a persistent yet under-treated disorder with low remission rates. Given that adoles-
cence is the most common period for the onset of SAD, it is crucial to intervene at this developmental phase. We
implemented an evidence-based, social anxiety disorder-specific intervention for adolescents (ages 11-17) who have
developed SAD but have not yet sought treatment. By recruiting via schools, we aimed for an early intervention
approach. We offered 12 weeks of group CBT in the form of the Skills for Academic and Social Success program. The
program places much focus on cognitive restructuring, in vivo exposure exercises, and social skills training. We also
offered access to a supplemental blended element (mHealth) with a CBT-focus. We found significant improvement
with large effects in clinician-rated social anxiety disorder, with combined remission rates from clinical interviews
with adolescents and parents (ADIS-C/P) of 59%. We also found improvements in generalized anxiety disorder; and in
self-reported measures including depression, public speaking anxiety, cognitions, and self-perception. Effects were
maintained at follow-up with combined remission rates of 73%. Moderation analysis of the mHealth platform sug-
gested that it was used more frequently by treatment-resistant users. Our findings highlight the potential benefits of
early intervention programs, as well as the important role schools can play in the detection process.

Key words
Social anxiety disorder, adolescents, CBT, group, early intervention

SY23: What makes a good cognitive behavioral therapist? Current research on

therapist effects, measurement of therapeutic
competences and training methods
Chair: Tatjana Paunov
University of Potsdam, Germany

Tatjana Paunov
University of Potsdam, Germany
Kim de Jong
Leiden University, Netherlands
Klara Eisert
University of Potsdam, Germany
Jasmin Ghalib, University of Potsdam, Germany
Sven Alfonsson, Karolinska Institutet, Sweden
Dan Sacks, Ben-Gurion University of the Negev, Israel

Abstract
The symposium will present current research on therapist effects and CBT training including a variety of perspec-
tives, i.e., patients, trainees and meta-analytic results.
Which therapist characteristics contribute to greater treatment success? What makes CBT training effective? What
have we accomplished so far and what to we need to refine in the new age of CBT? Clearly, many questions regard-
ing desireable therapist behaviors and proper training to enhance cognitive-behavioral competences are still unan-
swered. This symposium gives an overview regarding the status quo and offers a deeper look into current research
themes, methods and challenges in the field.
Sven Alfonsson (Karolinska Institute, Sweden) will present results of a scoping review focusing on therapist effects, i.e.,
the variance in treatment outcomes explained by individual therapist factors. Although the results are heterogenous,
they still indicate a potential effect of therapists’ interpersonal characteristics on treatment outcomes. In line with this,
Jasmin Ghalib (University of Potsdam, Germany) will present results from a study dealing with adverse therapist be-
haviors, their relationship to therapy failure and learning experiences from patients’ perspectives. Both studies allow
conclusions that can help guideline future psychotherapist training. In the context of recognizing the influence of
one’s own behavior on the therapeutic process, the ability for self-reflection plays a major role. This skill is analysed in
a study presented by Klara Eisert (University of Potsdam, Germany). Within the framework of a university seminar, the
impact of structured self-reflection on students’ alliance skills was investigated. The study results allow conclusions

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regarding the chances and limitations of implementing self-reflection as a training method in a university setting.
Besides the individual evaluation of one’s own competences, the reliable measurement of therapeutic skills is central.
Tatjana Paunov (University of Potsdam, Germany) will present a newly developed instrument focusing on the assess-
ment of procedural knowledge in psychology students. The instrument asks participants to apply their clinical knowl-
edge on video-based case vignettes. First results indicate excellent reliability and item characteristics. Similarly, Dan
Sacks (Ben-Gurion University, Israel) will present an assessment method for procedural knowledge using linguistic
measures of speech disfluency as a proxy for cognitive fluency on a psychotherapy performance tasks. He will discuss
the potential implications skill acquisition research could have on the way we train future therapists.
Kim de Jong (Leiden University, Netherlands) will moderate the symposium as a discussant.

Keywords
training, competence, self-reflection, learning, therapist effects

Learning the ropes: Reliable assessment of procedural knowledge in clinical psychology

Authors: Tatjana Paunov, Florian Weck & Franziska Kühne; University of Potsdam

Objective: Research on the acquisition of psychotherapeutic skills attributes an important role to procedural knowl-
edge. However, suitable instruments for its assessment are still lacking. This study describes the development and
evaluation of a video-based instrument for the assessment of procedural knowledge and skills in clinical psychology
(Pro CliPs Task).
Method: The Pro CliPs Task consists of four short videos of patient presentations and eight open-ended questions
about diagnosis, case conceptualization and solutions to therapy-related problems. Seven disorder-specific case vi-
gnettes (e.g. depression, OCD) were created and recorded with trained simulated patients. In an online survey, psy-
chology students (N=66) completed the Pro CliPs Task and rated its general usability as well as the authenticity of the
video-based case vignettes. Item statistics as well as the reliability of the coding system were then assessed.
Results: The usability of the Pro CliPs Task was rated as good. All case vignettes were rated as highly authentic (M=2.25;
range 0-3). Item statistics such as item difficulty (.20< Pi<.80) were good. Interrater agreement on the coding system
for the open-ended questions was excellent (ICCs>.95).
Discussion: The results are discussed in terms of their significance for psychotherapy training, research and practice.
Advantages and disadvantages of the task format and possible areas of application are also presented.

Keywords
psychotherapy training, psychotherapy research, skills acquisition

What effect does self-reflection have on students‘ alliance skills? – A randomized controlled trial
Klara Eisert & Ulrike Maass; University of Potdam

Theoretical background: The therapeutic relationship is one of the most important factors influencing the success
of psychotherapy. Accordingly, training psychotherapy students in alliance skills is a central aim of education. At the
same time, time and human resources are usually limited in the university context, which means that not all students
and their skills can be addressed individually. Consequently, there is a need for effective training methods that stu-
dents can use on their own, independently of teachers or supervisors. This project aims to contribute to this by inves-
tigating the influence of self-reflection on the development of a sustainable therapeutic relationship.
Research question: The project investigates whether self-reflection based on video is more effective in developing
alliance skills than self-reflection based on memory alone. It also investigates what the typical topics of self-reflection
are.
Methods: As part of a seminar on therapeutic relationships, N = 34 psychology students (M.Sc.) were randomly as-
signed to four weeks of training with either video-based structured self-reflection or memory-based structured
self-reflection. The training consisted of peer role-plays followed by written reflections on one’s own behaviour. Be-
fore and after the training (pre- and post-assessment), all students completed an initial interview with a standardized
patient. Independent and trained raters evaluated participants’ interpersonal skills. In addition, self-assessments of
the students’ competences were measured during the training. The written self-reflections were analysed using qual-
itative methods.
Results: A repeated measures ANOVA to compare the development of interpersonal skills from pre- to post-assess-
ment in the two study groups did not yield significant results. Analysis of students’ self-reported competences during
the training revealed a significant interaction effect: Students in the memory-based self-reflection group rated their
skills significantly higher than students in the video-based self-reflection group during the first two training sessions
(F(2.21, 62) = 3.75, p < .05*, η2 = 0.07). Qualitative analysis of the written self-reflections showed that students focused
mainly on the positive aspects of their behaviour.

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Conclusion: The study provides new insights into the opportunities and limitations of implementing self-reflection as
a training method. Possibilities for improving the use of self-reflection in university teaching as well as limitations of
the study are discussed.

It was my therapist’s fault: Patients’ perception of treatment failures as a result of adverse therapeutic behav-
iors and impaired learning experiences
Jasmin Ghalib - University of Potsdam
Sven Alfonsson - Karolinska Institutet
Ulrike Maaß - University of Potsdam

Theoretical background: Up to 50% of patients benefit insufficiently from psychotherapy, discontinue treatment pre-
maturely or are dissatisfied with it. A lack of learning experiences in the course of treatment seems to impair the
success of therapy. In previous studies, the causes of early termination and low response rates were often attributed
to patient variables. However, some research indicates that therapist variables also contribute significantly to patient
dropout. Furthermore, insufficient therapeutic competencies appear to hinder patients’ acquisition and application
of helpful skills. In order to improve the effectiveness of psychotherapies and promote successful learning processes
of patients, it is important