Cognitive Modification versus Therapeutic Support for Internalizing Distress and Positive Thinking: A Randomized Technique Evaluation Trial

It is important to evaluate not only comprehensive treatment packages, but also specific procedures to determine their contribution
to the change process. The current study examined the efficacy of cognitive modification (CM) techniques compared to supportive
therapy (ST) for university students reporting significant internalizing distress. CM consisted of three sessions of Fluency
Training (FT) to increase positive self-statements and three sessions of Thought Record (TR) training in challenging negative
thoughts. Participants (N = 57) were randomized to CM or ST and assessed at pre-, mid-, post-treatment, 1- and 3-month follow-ups.
Intent-to-treat analyses suggested that CM produced greater changes in internalizing distress and positive thinking, which
was especially apparent at midtreatment with small-to-medium differences consistently favoring CM at post-treatment and follow-up.
These data suggest that change in CM was beyond that attributable to time spent with an engaged therapist who provided a treatment
rationale, subsequent intervention and homework assignment.