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
а) Бихевиористичка терапија -- Апстракти
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: olivera@congrexpo.co.rs
W: www.congrexpo.co.rs

Publisher
Serbian Association for Cognitive and Behavioural Therapies
Skenderbegova 3, 11000 Belgrade, Serbia
Mail: tanjavgvozden@gmail.com; Website: www.ukbt.org.rs

Co-publisher
Serbian Association of Behaviour and Cognitive Therapists
Starca Vujadina 1, 18000 Niš, Serbia
Email: srabct1996@gmail.com, 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
isabelle.leboeuf.lanthoe@gmail.com
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,
brigidacaiado.psi@gmail.com

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: johanna.boettcher@phb.de

Co-authors:
Duddeck Laura, Psychologische Hochschule Berlin
E-Mail: l.duddeck@phb.de

Fenski Friederike, Psychologische Hochschule Berlin

E-Mail: f.fenski@tp.phb.de

Behr Solveig, Freie Universitaet Berlin

E-mail: s.behr@fu-berlin.de

Prof. Dr. Knaevelsrud Christine, Freie Universitaet Berlin

E-Mail: christine.knaevelsrud@fu-berlin.de

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Dr. Schaeuffele Carmen, Freie Universitaet Berlin

E-Mail: carmen.schaeuffele@fu-berlin.de

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: noamsarna@mail.tau.ac.il

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: yuvalg300@gmail.com
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: ganholt@bgu.ac.il
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, noemi.seewer@unibe.ch
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
brigidacaiado.psi@gmail.com

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: johanna.boettcher@phb.de
Co-author:
Title: Dr.
Name: Carmen
Surname: Schaeuffele
Affiliation: Freie Universitaet Berlin
E-Mail: carmen.schaeuffele@fu-berlin.de

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 to take into account patients’ perspectives on failed therapies and examine specific adverse
therapeutic behaviors and patients’ learning experiences within these treatments.
Research Question: The current study investigates which specific adverse therapist behaviors are decisive for the fail-
ure of therapy from the patients’ perspective. Furthermore, patients’ learning experiences in relation to treatment
failure and adverse therapeutic behaviors are examined.
Methods: As part of an online survey, patients who underwent a psychotherapeutic treatment they perceived as
“failed” were asked about their experiences in treatment. Their therapists’ behavior (e.g., rigidity, passivity, empa-
thy) and their acquired learning experiences during therapy was assessed. In addition, patients were asked to what
extent ideal-typical strategies (that are recommended according to cognitive-behavioral treatment manuals) were
addressed within their treatment and to what extent they had used these strategies in their everyday life.
Result and conclusion: Descriptive data of specific adverse therapist behaviors are reported. Moreover, it is presented
what kind of learning experiences patients acquired despite the perceived failure of treatment. Finally, the relation-
ship between patients’ learning experiences and the perceived failure of treatment is reported and implications for
therapist training and for future research are discussed.

Keywords:
treatment failure, competence, patient learning, qualitative research, patient perspectives, treatment mechanisms,
mixed-methods

Assessing procedural knowledge: Speech disfluency as a proxy for cognitive fluency on a psychotherapy
performance task
Dan Sacks; Ben-Gurion University, Israel

- no abstract provided -

The therapist effect: A systematic scoping review of reviews

Sven Alfonsson; Karolinska Institutet, Sweden

Several meta-analyses have suggested the existence of a therapist effect but have not been able to assess its magni-
tude or specify the construct. The aim of this scoping review was therefore to map the research on therapist effects
and identify research weak points and strengths as well as to suggest crucial directions for future research. Systematic
searches were conducted in the PubMed, Web of Science, and PSYCHInfo databases and resulted in 29 publications
for analysis. The research methods, results and discussions from these 29 systematic reviews on therapist effects are
analyzed and presented.

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SY24: Acceptance and Commitment Therapy for Transitional-Age Youth (15 to

25 years old): Building the evidence
Chair: Janna Keulen, Department of Clinical Child & Family Studies, Utrecht University, Utrecht, The Netherlands

Janna Keulen
Department of Clinical Child & Family Studies, Utrecht University, Utrecht, The Netherlands, Netherlands
Dario Lipovac
BHACBT, Bosnia and Herzegovina
Denise Bodden
Department of Clinical Child & Family Studies, Utrecht University, Utrecht, The Netherlands., Netherlands

Abstract
Acceptance and Commitment Therapy (ACT) is a third-wave cognitive-behavioral therapy (CBT) developed at the end
of the 20th century. ACT is a transdiagnostic intervention that can be used for individuals with diverse types of phys-
ical and/or psychological issues (e.g., pain, depression, anxiety, stress and substance abuse). The primary goal of ACT
is not to reduce clients’ symptoms, but to increase clients’ psychological flexibility: “the ability to contact the present
moment more fully as a conscious human being, and to change or persist in behavior when doing so serves valued
ends”. There are several meta-analyses showing that ACT is equally effective compared to established evidence-based
treatments (e.g., CBT) and superior to inactive control conditions (e.g., waitlist) and treatment as usual (TAU) in adults
with various problems. Less is known about the implementation and effects of ACT for transitional-age youth (TAY;
youth aged 15 to 25). Investigating the effects of ACT for this specific age group is relevant as TAY are more likely to
experience psychological problems compared to other age groups. Moreover, within TAY, comorbid problems and
changing symptom profiles are often present. The transdiagnostic nature of ACT along with its focus on autonomy
and identity development makes ACT a potentially suitable intervention for this age group. In this symposium we will
present the applicability of ACT in TAY (15-25 years) and also build up the scientific evidence for its effectiveness (from
n=1 to a meta-analysis).
Presentation 1: Dario Lipovac will present a single-case clinical example of a young person who is experiencing severe
depression. This case example highlights more general adaptations of ACT with youth in a clinical approach, such
as importance of structure, behavioral reinforcements, therapeutic relationship, core ACT processes of behavioral
change and the role of self-compassion.
Presentation 2: Dr. Denise Bodden will discuss the ACT your way protocol which was developed specifically developed
for TAY. Experiential exercises will be demonstrated and results of two pilot studies will be presented. In total, 45 TAY
with chronic or recurrent depression (pilot1) and/or other psychiatric disorders (pilot 2), followed the ACT your way
intervention. At posttreatment and follow-up, participants reported significant improvements on several outcomes.
Presentation 3: Janna Keulen will present preliminary results (i.e., posttreatment effects) of a multi-center randomized
controlled trial in which the effectiveness of ACT your way is compared with TAU in a sample of 124 TAY with diverse
psychological problems. Outcomes include amongst others psychological flexibility, psychopathology, personality
problems, global, individual and societal functioning.
Presentation 4: Janna Keulen will also present the results of a meta-analysis integrating the evidence on the effective-
ness of ACT for TAY. Also, the effects of several moderators (i.e., type of (sub) outcome, study characteristics, sample
characteristics and intervention characteristics) were examined. Results suggest that ACT is an effective intervention
for reducing psychopathology and increasing ACT related processes (i.e., psychological flexibility and self-compas-
sion), well-being and coping in TAY with diverse types and levels of psychological problems.

Keywords
Acceptance and Commitment Therapy, Third wave CBT, Transitional-Age Youth, Adolescents, Young adults, Sin-
gle-case clinical example, Pilot study, Randomized controlled trial, Meta-analysis

Acceptance and Commitment Therapy for Youth: A single case clinical example
Dario Lipovac, Private Practice “Savjetovanje ACT”, Banja Luka, Bosnia and Herzegovina

Abstract: Dario Lipovac will present a single-case clinical example of a young person who is experiencing severe
depression. This case example highlights more general adaptations of ACT with youth in a clinical approach, such
as importance of structure, behavioral reinforcements, therapeutic relationship, core ACT processes of behavioral
change and the role of self-compassion.

Keywords: ACT, clinical practice, single-case clinical example, Youth

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Acceptance and Commitment Therapy for Youth: A practical guide and pilot studies
Dr. Denise Bodden, Department of Clinical Child & Family Studies, Utrecht University, Utrecht, The Netherlands.

Abstract: Dr. Denise Bodden will discuss the ACT your way protocol which was developed specifically developed for
TAY. Experiential exercises will be demonstrated and results of two pilot studies will be presented. In total, 45 TAY
with chronic or recurrent depression (pilot1) and/or other psychiatric disorders (pilot 2), followed the ACT your way
intervention. At posttreatment and follow-up, participants reported significant improvements on several outcomes.

Keywords: ACT, Youth, Depression, Transdiagnostic, Practical guide

Acceptance and Commitment Therapy for Youth: A randomized controlled trial

Janna Keulen, Department of Clinical Child & Family Studies, Utrecht University, Utrecht, The Netherlands

Abstract: Janna Keulen will present preliminary results (i.e., posttreatment effects) of a multi-center randomized con-
trolled trial in which the effectiveness of ACT your way is compared with TAU in a sample of 124 TAY with diverse
psychological problems. Outcomes include amongst others psychological flexibility, psychopathology, personality
problems, and individual and societal functioning.

Key words: ACT, RCT, Youth, Effectiveness, Transdiagnostic

Acceptance and Commitment Therapy for Youth: A meta-analysis

Janna Keulen, Department of Clinical Child & Family Studies, Utrecht University, Utrecht, The Netherlands

Abstract
Janna Keulen will also present the results of a meta-analysis integrating the evidence on the effectiveness of
ACT for TAY. Also, the effects of several moderators (i.e., type of (sub) outcome, study characteristics, sample
characteristics and intervention characteristics) were examined. Results suggest that ACT is an effective in-
tervention for reducing psychopathology and increasing ACT related processes (i.e., psychological flexibility
and self-compassion), well-being and coping in TAY with diverse types and levels of psychological problems.

Keywords
ACT, Overview, Meta-analysis, Youth, Transdiagnostic

SY25: Long-term effectiveness of transdiagnostic interventions for children

and ado lescents in municipal services
Simon-Peter Neumer
RBUP, Norway
Pia Jeppesen
Copenhagen University Hospital-Psychiatry, Denmark
Jo Magne Ingul
Norwegian University of Science and Techonology, Norway
Kristin Ytreland
NTNU, Norway
Kaja Liebenberg
University of Oslo, Norway

Abstract
Long-term studies of the effect of interventions are rare, but desirable especially for preventive interventions, since
the ultimate goal of this type of interventions is to prevent the onset of disorders later in life. Revently, several RCT
studies in Scandinavia have been conducted in municipal services, showing positive initial effects immediately after
ending the intervention. Three studies in this field have lately emerged with results concerning the durability of ef-
fects, and this symposium will present results from these three randomized trials.
The Mind my Mind study compared a transdiagnostic individual CBT intervention with “Management as Usual” for
Youth with Common Mental Health Problems in Denmark. The randomized study was carried out between 2017 and
2019 in four Danish municipalities. Youths aged 6-16 years with internalizing and externalizing symptoms were in-

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cluded in 9-13 weekly CBT sessions. Outcomes for 396 youth based on parental reports and register-data 3 years after
the intervention will be presented.
Emotion is another recently developed transdiagnostic group-based CBT intervention designed for schoolchildren
aged 8-12 years, displaying positive initial effects in the cluster randomized TIM study, conducted between 2014 and
2018 in Norway. The TIM study will present first results from the 7-year follow-up for 518 adolescents.
This study was followed by the ECHO trial from 2019 to 2024, aiming to optimize the EMOTION intervention with the
help of selected components in a factorial design. For the ECHO study 12-month post-intervention effects of these
components will be presented based on data from 564 children (aged 8-12 years) and their parents.

Keywords
long term, outcome, transdiagnostic

SY26: The effects of self compassion on mental health

Tatjana Vukosavljević-Gvozden
University of Belgrade, Faculty of Philosophy, Serbia
Matija Gvozden
University of Belgrade, Faculty of Philosophy, Serbia
Doris Rafajlovski
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Peđa Miladinović
Faculty for business and legal studies Dr Lazar Vrkatić, Novi Sad, Union University in Belgrade; Temenos Center, Novi
Sad., Serbia
Tamara Musić
University of Novi Sad, Faculty of Philosophy, Serbia

Abstract
Self-compassion has been shown to be consistently associated with benefits for mental health and well-being across
diverse populations. The aim of the symposium is to present the results of four studies conducted on Serbian popu-
lation samples, concerning the effects of self-compassion on mental health. The first study which will be presented is
a quasi-experimental study on a sample of RE&CBT trainees (N=276), of whom 180 attended the 8-week Mindfulness
Based Stress Reduction Program (MBSR) while others were in the control group. The results show that the MBSR pro-
gram is very effective in increasing mindfulness, self- and other-directed compassion and positive emotional states,
as well as reducing negative emotional states. In addition, increases in mindfulness and compassion have been found
to have strong effects on reducing negative and increasing positive emotional states. The implications of including
the MBSR program in the development of various competencies and skills of trainees in RE&CBT will be discussed. The
second and third studies were conducted on a sample of 1728 participants from the general population. The second
study aimed to examine patterns of connectivity between symptoms of dysphoria and anxiety, and their relationship
to self-compassion. The authors performed state-of-the-art network procedures, both in terms of obtaining networks,
and the moderating effect of self-compassion on the structures of these symptoms. Results suggest that self-compas-
sion may primarily serve as a moderator between symptoms. The third study, conducted on the same sample, aimed
to examine the mediation effects of self-compassion in the relationship between trait anxiety, interpersonal burn-out,
sleep effort, rumination and poor sleep. Results showed that both self-compassion and rumination are significant
mediators in the relationship between all risk factors and poor sleep. In the fourth and final study, the objective was to
validate the Self-Compassion Scale (SCS) long and short forms in a sample of students (N=263) and the clinical popu-
lation (N=69). The results indicate satisfactory reliability of both the long and short forms. The correlation between the
long and the short form was very high. Persons with lower scores on both SCS forms had higher anxiety, depression,
thought suppression and rumination while persons with higher scores had higher life satisfaction, self-competence
and self-liking. A confirmatory factor analysis was performed and higher order models were examined which showed
good fit only for SCS short form in the clinical sample.

Keywords
self-compassion, mental health, research

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SY27: Are therapists’ competences, skills,

and biases the key to success in therapy?
Kim de Jong
Leiden University, Netherlands
Christoph Flückiger
University of Kassel, Germany
Ralf Rummer
University of Kassel, Germany
Caroline Kolle
University of Kassel, Germany
Jana Bommer
University of Trier, Germany
Anne-Katharina Deisenhofer
University of Trier, Germany
Wolfgang Lutz
University of Trier, Germany
Stefan Hofmann
Philipps University Marburg, Germany

Abstract
While psychological therapies are effective in treating psychological problems, in routine practice only about 50%
of patients improve. Research has primarily focused on optimizing therapeutic techniques or patient characteristics
to improve psychotherapy outcomes, while differences between therapists in effectiveness, referred to as therapist
effects, have been understudied. Yet, therapist effects can result in large differences in patient outcomes. Therapist ef-
fects are robust and similar in size to the best predictors of therapy outcomes. Nevertheless, we still know surprisingly
little about what being an effective therapist entails. In this symposium, research projects on therapists’ competen-
cies, skills, and biases are presented.
In the first presentation by Christoph Flückiger (University of Kassel), the results of two experimental studies are pre-
sented in which therapists were asked to give their first clinical impression of a case, based on a case description and
video vignette. Therapists were induced to either take a symptom-oriented or a strength-oriented attentional focus.
Results showed significant differences between the different attentional foci, and suggest that clinicians’ initial opin-
ions are substantially biased.
Jana Bommer (University of Trier) presents the results of workshops in deliberate practice provided to trainee CBT
therapists. Deliberate practice is a promising method to trainee therapists’ competencies in which micro-skills are
practised. The first results show that Deliberate Practice workshops can be an effective tool for training clinical com-
petence and micro-skills. The implications of the findings for future research, clinical training and clinical practice will
be discussed.
In the third presentation, Kim de Jong (Leiden University) will present the results of two studies on assessing trainees’
and therapists’ interpersonal skills. In the first study, trainees’ observed interpersonal skills were assessed using the
Facilitative Interpersonal Skills (FIS) performance task. FIS was found to predict trainees’ course grades for skills class-
es. In a second study, the FIS performance task was administered to experienced CBT therapists working with man-
ualized treatments. Results indicated that contrary to previous research results, therapists’ FIS scores did not predict
treatment outcomes in patients.
In the discussion, Stefan Hofmann (Philipps University Marburg) will synthesize the results of these studies and
discuss further directions for the research field.

Keywords
therapist training; therapist effects; skills; competence

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SY28: Training and Credentialing Standards in CBT

Keith Dobson
University of Calgary, Canada
Helen Macdonald
BABCP, United Kingdom
Mehmet Sungur
Istanbul Kent University, Turkey

Abstract
A critical component of the ethical and effective delivery of any model of psychotherapy is the training of new clini-
cians. Further, practitioners who are already in the field need to stay abreast of developments in training and creden-
tialing, to ensure their use of best practices. In this symposium leaders in the field of training and credentialing will
present various considerations and models for training and credentialing. The symposium will begin with an overview
of the critical nature of training and credentialing (Sungur), including a discussion of the past and present of training
issues, and the journey of training issues until the present. The second presenter (Macdonald) will highlight the devel-
opment of guidelines within the British Association of Cognitive and Behavioural Psychotherapies (BABCP) and the
EABCT more broadly. The third presenter (Dobson) will discuss the evolution of training guidelines through the World
Confederation of Cognitive and Behavioural Therapies (WCCBT) and will review the specific training competencies
that are recommended for global dissemination of the CBT’s. Presenters will also discuss some of the issues and obsta-
cles related to training and dissemination. Considerable time will be retained for audience questions and discussion,
so that the implications of training and credentialing standards can be explored.

Keywords
Training, credentialing, ethics, dissemination

SY30: Exploring Rational Emotive Behavior Therapy (REBT): Practice and

Applications in Diverse Psychotherapeutic Contexts
Natalia Ferrero
International Association for Rational Emotive Behavior Therapy, Peru
Maria Celeste Airaldi
International Association for Rational Emotive Behavior Therapy, Paraguay
Hugo Galo
International Association for Rational Emotive Behavior Therapy, Peru
Giovanni Ruggiero
International Association for Rational Emotive Behavior Therapy / Studi Cognitivi, Italy, Italy

Abstract
This Symposium will explore the use of Rational Emotive Behavior Therapy (REBT) across a spectrum of psychother-
apeutic contexts, emphasizing the critical need for a well-organized and scientifically robust approach to support
therapeutic outcomes and facilitate the professional advancement of psychologists and mental health professionals,
as well as the needed adaptations for diverse cultural settings.
Initially, the symposium investigates the characteristics of mental health professionals in Latin America who are
trained in REBT. Employing both descriptive and exploratory analyses, the research aims to meticulously delineate the
profile of REBT therapists by describing and investigating their training, practices, and underlying beliefs. It highlights
the imperative for supervision and sustained professional development to effectively address the irrational beliefs of
psychotherapists, which significantly influence their clinical efficacy. This focus is particularly relevant given the es-
calating mental health challenges and the gaps in healthcare services observed in the region. Furthermore, the pre-
sentation investigates how irrational beliefs, combined with personality traits and economic factors, shape the pro-
fessional performance of psychologists in Latin America. This analysis aims to foster a deeper understanding of how
these factors interplay to influence the quality and effectiveness of psychological practice. The analysis reveals signifi-
cant implications of these variables on the practice of psychology, highlighting the interrelationship between the per-
sonal life of the psychologist and their professional practice. Finally, the integration of REBT with constructivism and
metacognition within the Italian Cognitive Behavioral Therapy (CBT) tradition is explored. This approach focuses on
how Italian therapists have adapted the ABCDEF framework of REBT to their constructivist and process-CBT training,

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promoting cognitive and emotional awareness among clients, assessing the evolutionary roots of irrational beliefs,
and emphasizing the metacognitive components of REBT. The study advocates for the expansion of the therapeutic
repertoire in REBT, suggesting that integrating multiple approaches can enrich and diversify therapeutic practice.

This symposium will highlight the relevance and impact of irrational beliefs in the practice of psychologists and men-
tal health professionals, the importance of proper training, and the potential of methodological integrations to im-
prove the understanding and treatment of mental disorders around the globe.

Keywords
REBT, training, supervision, irrational beliefs, clinical efficacy

SY31: Integrating Local Realities: Transformative Approaches for Addressing

Mental Health and Substance Use Problems in Africa
Natalie Johnson
University Hospital Basel, Switzerland
Grace Yoon
University Hospital Basel, Switzerland
Monica Swahn
Kennesaw State University, United States
Irene Falgas Bague
Swiss Tropical and Public Health Institute, Switzerland

Abstract
Unmet mental health needs in Africa constitute a significant public health crisis, particularly among disadvantaged
populations. These individuals often navigate a complex interplay of poverty and adversity, which exacerbates men-
tal health challenges. Adding to this demanding mental health landscape are a lack of specialized providers, and
barriers to accessing care, including stigma, low mental health literacy, and long distances to reach a care provider.
Addressing this requires innovative and culturally relevant interventions that can be adapted to local needs. This
symposium highlights transformative strategies for the prevention and treatment of mental health and substance use
problems across different African contexts, showcasing evidence-based approaches tailored to the diverse needs and
preferences of affected populations. In the first paper, Natalie E. Johnson et al. explore coping mechanisms, support
networks and specific interventions for youth who use substances in Zambia, Zimbabwe, and South Africa. Their find-
ings emphasize the importance of music, prayer, sleep and positive relationships with peers and family in manage-
ment of emotions and recovery from substance use. The second paper, presented by Grace H. Yoon et al., examines
treatment preferences for depression and alcohol use among people living with HIV in Lesotho. This study highlights
a preference for phone-based interventions due to their accessibility as well as the importance of involving family
members in treatment. Regarding treatment providers, there is a clear preference for nurses for their clinical exper-
tise and authority, with HIV counsellors also being favoured for their specialized knowledge of HIV-related problems.
Both presentations employ a qualitative approach to richly depict the lived experience of these individuals. The third
presentation by Monica H. Swahn et al. focuses on the socio-economic determinants of mental health among ado-
lescent girls and young women in impoverished areas of Kampala, Uganda. Their research investigates the impacts
of vocational, psychosocial, and empowerment training, aiming to elucidate the pathways through which social de-
terminants influence mental health outcomes. This study follows a cohort over time, enabling a dynamic understand-
ing of how such interventions can effect change in mental health status. In the final paper of this symposium, Irene
Falgas-Bague et al. report on the quantitative and qualitative results from a randomized controlled trial in Zambia,
examining the effectiveness of Problem Management for Moms intervention for distress among women with small
children. This intervention is based in Problem Management+ (from the World Health Organization) and culturally
adapted to be provided in women’s homes or by phone. This study assesses the feasibility, acceptability, and trends
of this program’s impact on wellbeing, empowerment, and early child development. Collectively, these presenta-
tions underscore the necessity of integrated approaches that consider both individual and systemic factors in the
treatment and prevention of mental and substance use problems. They highlight the critical role of socio-economic
empowerment, community-based strategies, and innovative treatment modalities in addressing mental health needs
across diverse African settings. By advancing our understanding of these complex interrelations, this symposium con-
tributes to the development of more effective and sustainable mental health interventions in resource-constrained
environments.

Keywords
substance use, Africa, depression, coping mechanisms, treatment preferences, PM+

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SY32: Cognitive Behavioural Coaching: models, approaches, research

Chair: Natalia Antonova, HSE University, Russia
Convenor/organizer: Natalia Antonova, HSE University, Russia

Natalia Antonova
HSE University, Russian Federation
Alexey Ezhikov
ACBP, Russian Federation
Yulia Platonova
HSE University, Russian Federation
Elena Naumtseva
National Research University Higher School of Economics, Russian Federation
Marianna Frolova
National Research University Higher School of Economics, Russian Federation

Abstract
The purpose of the symposium: to present current models and research in the field of cognitive-behavioral coaching,
and to present the opportunities that it opens for psychotherapists.

Cognitive-behavioral coaching (CBC) is an actively developing area of cognitive-behavioral approach. The cognitive
behavioral coaching focuses on achieving goals and empowering the client, not on solving problems or correcting
dysfunctions. This goal corresponds to modern trends in focusing on the development and well-being of the individ-
ual in a changing world. Mastery of coaching methods expands the repertoire of a cognitive behavioral therapists and
allows them to work with clients who do not experience maladaptation but want to improve their lives and become
more effective.
Currently, cognitive-behavioral coaching is developing very fast, especially its models and technologies. However,
many points need to be clarified, for example, such disputable topics as the relationship between cognitive behav-
ioral coaching and cognitive behavioral psychotherapy, conceptualization in cognitive behavioral coaching, models
of coaching effectiveness.
The following reports will be offered as part of the symposium:

1. Natalya Antonova, Convenor, Chair, Presenter. PhD in Psychology, Associate Professor, HSE University. Coaching
psychologist, member of the ACBT Coaching Unit.
Topic: “An integrative model of cognitive-behavioral coaching as a tool for increasing the psychological well-being of
employees”.
The report will present a systematization of cognitive-behavioral coaching models and the author’s integrative mod-
el, which was the basis for the research of cognitive-behavioral coaching effectiveness. The model for assessing the ef-
fectiveness of cognitive-behavioral coaching in organization will be provided as well. The research demonstrated the
effectiveness of using cognitive-behavioral coaching in organizations to enhance psychological change, resilience,
and reduce workplace stress among employees.

2. Ezhikov Alexey, Presenter. Psychologist, psychotherapist, coach, the head of ACBT Coaching Unit.
Topic: “Systemic cognitive-behavioral coaching: development and testing of the author’s model in business organi-
zations”.
The report will present the author’s model of systemic cognitive-behavioral coaching and analyze the key points from
the practice of business coaching for managers using this model. The results of testing the model in business organi-
zations will be presented. The model relates well to cognitive behavioral psychotherapy models and will be clear for
cognitive behavioral psychotherapists.

3. Yulia Platonova, Presenter. Ph.D. Associate professor, HSE University. Member of the ACBT Coaching Unit.
Topic: “Academic cognitive-behavioral coaching. Results of testing a cognitive-behavioral coaching program for the
development of self-directed learning”.
The report presents the results of the research of cognitive behavioral coaching effectiveness used to develop stu-
dents’ self-regulated learning (SRL). Self-regulated learning refers to a person’s ability to understand and control their
learning environment. Self-regulatory abilities include goal setting, self-monitoring, self-learning, and self-reinforce-
ment (Harris & Graham, 1999; Schraw, Crippen, & Hartley, 2006; Shunk, 1996). Cognitive-behavioral coaching is better
than other approaches in helping high school students to understand their self-learning strategies and increase the
effectiveness of self-learning by overcoming obstacles in the form of limiting beliefs.

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4. Elena Naumtseva, Presenter. PhD. Associate Professor, HSE University. Member of the ACBT Coaching Unit; Marianna
Frolova.
Topic: “Cognitive Behavioral Coaching for Executives: Impact on Psychological Well-Being and Job Satisfaction”.

Keywords
Cognitive-behavioral coaching (CBC), models of CBC, efectiveness of CBC, psychological well - being, organizational
stress, self-regulated learning, coaching in business

An integrative model of cognitive-behavioral coaching as a tool for increasing the psychological well-being
of employees
N.V.Antonova, HSE University, Moscow, Russia

Abstract
Introduction: Subjective well-being (SWB) implies life satisfaction, happiness, presence of positive emotions and ab-
sence of negative emotions (Diener, 1984; Eschleman et al., 2010). We consider SWB as a combination of 3 compo-
nents: life satisfaction, subjective happiness, and optimistic attributional styles. Cognitive-behavioral coaching (CBC)
is a developmental dialogue aimed at achieving the client’s goals, based on the cognitive model, and using CBT
techniques. Models of CBC describe coaching work steps and can be used as a kind of protocol for coaches. The fac-
tors of psychological well-being include cognitive, affective variables, and interpersonal relationships (Khavilo, 2020).
Existing CBC models describe coaching work with cognitive and affective variables but are insufficient for work with
interpersonal relationships. For this reason, we decided to use an integrative model that combines the methods of
cognitive behavioral coaching and transactional analysis.

Purpose: the development and testing of an integrative cognitive-behavioral coaching model which is aimed to in-
crease psychological well – being of employees.

Method: To measure the effectiveness of the coaching program based on the integrative model, we used the fol-
lowing methods: 1) life satisfaction scale (Diener et al., 1985), subjective happiness (Lyubomirsky, Lepper, 1999), The
Attributional Style Questionnaire (Peterson et al., 1982). To control the side variables, we used three open question in
the second measurement after the coaching program was conducted.

Sample: 35 employees aged 23 to 35 years (average age 26.4 years; 71% females, 29% males).

Design: The evidence - based approach was used. The project included the following stages: 1) interview with the
customer and the request enquiry; 2) diagnostic interviews and surveys for employees; 3) developing a coaching pro-
gram; 4) measuring psychological well-being 5) implementing the program; 6) final measurement and assessment of
changes; 7) report and recommendations to the customer.

The integrative cognitive behavioural coaching program was based on PRACTICE and G-ABCDEF models developed
by S. Palmer and included the techniques of CBT such as decatastrophization, ABC technique, Socratic dialogue, guid-
ed discovery. Transactional analysis methods were used to work with the sphere of interpersonal relationships. An
analysis of situations of interpersonal relationships was used from the point of view of ego states (Parent, Adult, Child).
The program included introduction session and 4 main sessions once a week.

Results: The results showed a significant change in the scales of life satisfaction and subjective happiness (p ≤ 0,01);
but no changes in optimistic attributional styles were found.

Discussion: There was no change on the attributional styles, perhaps due to the small sample size or the short dura-
tion of the program, as dispositions take longer to change. We suppose that emotional components of SWB (life satis-
faction and subjective happiness) can change more quickly than cognitive components. The CBC and TA approaches
are well consistent: both use psychoeducation and the principle of operationalization.

Conclusions: 1) The developed model showed good effectiveness in terms of increasing psychological well-being. The
methods of CBC and TA are well consistent and complement each other. 2) The developed integrative approach can
be used in further studies on larger samples.

Keywords:
cognitive behavioral coaching, transactional analysis, integrative cognitive behavioral coaching, subjective well-be-
ing, life satisfaction, subjective happiness, target optimistic attributional styles

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Systemic cognitive-behavioral coaching: development and testing of the author’s model in business organi-
zations
Alexey Ezhikov, ACBP, Moscow, Russia

Abstract
This paper presents the Systemic Cognitive-Behavioral Coaching (CBC-S) model, developed to address two critical
challenges in business coaching: creating a more comprehensive conceptualization framework within the cogni-
tive-behavioral approach and facilitating practitioners with psychological backgrounds in transitioning from a medi-
calist perspective to a developmental orientation. The model aims to enhance the efficiency of business coaches’ CBC
training and contribute to future research in CBC and evidence-based coaching.
The CBC-S model was evaluated with eight business coaches, equally divided between business psychologists and
coaches/mentors without prior CBT knowledge. The study employed a mixed-method approach, comprising a train-
ing workshop and interviews over a three-month period. This methodology allowed for an in-depth exploration of
the model’s applicability and effectiveness in real-world coaching scenarios.
Results indicate that CBC-S enhanced coaches’ ability to conceptualize client states, leading to more confident and
stable coaching presence. Participants reported improved decision-making regarding the application of cogni-
tive-behavioral techniques. The model demonstrated particular efficacy in helping coaches navigate the increasingly
blurred boundary between coaching and counseling, a critical skill in contemporary business and executive coaching.
Key innovations of CBC-S include a diverse conceptualization framework focused on both goals and client conditions,
and tools to navigate the coaching-counseling boundary. The model shows promise in providing short-term educa-
tion for coaches with varying backgrounds, addressing the increasing overlap between coaching and counseling in
business settings.
The CBC-S approach offers a structured yet flexible framework that is more specific than the GROW model while be-
ing more adaptable than the PRACTICE model. This balance makes it particularly suitable for efficient business coach
training, potentially accelerating the development of competent CBC practitioners.
Limitations of the study include the reliance on self-reported data and a small, diverse sample. The lack of objective
measures for coaching effectiveness highlights the need for further research in this area. Additionally, the varied ex-
perience levels and working contexts of the participants limit the generalizability of the findings.
Future research should include quantitative studies with larger samples to validate these preliminary findings. There
is also potential for longitudinal studies to assess the long-term impact of CBC-S training on coaching outcomes and
client satisfaction in business settings.
This study contributes significantly to the field of efficient business coaches’ CBC training. By providing a unified,
flexible framework, CBC-S has the potential to streamline coach education, leading to more consistent and effective
coaching practices. Furthermore, the model’s structured approach may facilitate more rigorous and comparable re-
search in CBC and evidence-based coaching, as it allows for a more standardized yet flexible research protocols in
business coaching contexts.

Keywords
Systemic Cognitive-Behavioral Coaching; Business Coach Training; Coaching Conceptualization; Developmental
Orientation; Coaching-Counseling Boundary; Evidence-Based Coaching

Academic cognitive-behavioral coaching. Results of testing a cognitive-behavioral coaching program for the
development of self-directed learning
Y.A. Platonova, HSE University, Nizhny Novgorod, Russia

Abstract
The paper presents the research outcomes concerning the effectiveness of cognitive behavioral coaching while work-
ing with school and university students to develop their self-directed and self-regulated learning skills. Self-directed
learning refers to learners’ ability to initiate their learning, to understand, evaluate and control the learning strategies
they apply to reach a learning goal (Knowles M.S., 2003). Self-regulatory abilities include goal setting, self-monitoring,
self-learning, and self-reinforcement (Harris & Graham, 1999; Schraw, Crippen, & Hartley, 2006; Shunk, 1996). In the
rapidly changing environment self-directed and self-regulated learning skills help students be more proactive and
adaptive, so be ready to constantly learn and develop.

One of the ways to develop this set of skills is the so called academic coaching. In the monograph (Rademacher
K, Howlett M.A.., 2023) academic coaching is defined as the interaction based on trust and cooperation, in which,
through structured conversations, students are becoming empowered to identify and take actions to achieve their
goals, adhere to commitments and remain committed to their goals, understand their habits and thinking patterns,
understand their strengths and weaknesses, improve self-regulation of their learning, behavior and emotions, and

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comprehend effective learning strategies. The authors of the monograph identify the following most common topics
within which college students formulate their requests: time management, reading strategies, learning strategies,
metacognition. From our coaching practice with school and university students in Russia we consider the following
requests to be the most popular: knowledge application, prioritization of the knowledge areas, time management,
motivation to learn.

Learning strategies students choose and apply are influenced by their beliefs about themselves, their teachers and
the educational environment in general. That’s why we consider cognitive-behavioral coaching as a way to help stu-
dents analyze and improve their learning strategies through understanding and changing their beliefs first.

We’ve designed the coaching program for students and offered them to take part in the 5 coaching sessions either
in a group or individually. 21students took part in the quasi-experiment. We applied the validated questionnaires
to measure the participants’ academic motivation, self-efficacy, self-organization and metacognitive awareness/
regulation before and after their taking part in the coaching program. We’ve indicated the positive shift related
to the self-organization scales. The semi-structured interview with the students proved the positive influence of
their participation in the coaching program on their readiness and abilities to follow the plan, to manage their time
scheduled for learning sessions.

Keywords
Self-directed learning, self-regulated learning, academic coaching

Cognitive Behavioral Coaching for Executives: Impact on Psychological Well-Being and Job Satisfaction
E.A.Naumtseva, HSE University, Moscow, Russia
M.A.Frolova, HSE University, Moscow, Russia

Abstract
The purpose of the study is to analyze the shift in variables such as psychological well-being, decision-making style,
job satisfaction after completing the cognitive-behavioral coaching program for top managers.

Study design. The sample included 15 top managers from the medical and government sectors. Measurements
were taken before and after the coaching program. The coaching program included six 60-minute online coaching
sessions. The program employed 12 coaches using a cognitive behavioral approach. The basic models were CBEC,
Cognitive behavioral executive coaching (D.Good adapted by E.Naumtseva), PRACTICE and SPACE.

Assessment methods

1)Ryffs Scales of Psychological Well-being (adapted by T. Shevelenkova, P. Fesenko).

We used three subscales in our study:

• positive relationships with others (care about the well-being of others, a feeling of satisfaction from warm and
trusting relationships with others)

• environment management (a person’s ability to effectively use external resources);

• personal growth (effective use of personality traits, development of talents).

2)The Decision Style Inventory, DSI(Rowe, Mason)

3)Questionnaire for job satisfaction assessing (Ivanova, Rasskazova, Osin)

Results. The Shapiro-Wilk test did not show evidence of non-normality for most variables(p>.05)

We applied T test to assess the significance of the differences in the means.

Significant differences were found for the following variables.

The results from the pre-test (M = 187.1, SD = 22.2) and post-test (M = 205.9, SD = 21.5) indicate that the 6-sessions
cognitive-behavioral coaching programme resulted in an improvement in subjective well being(three scales). t(14) =
-3.82, p = .002.

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There was a significant increase in the level of «Positive relationships with others» subscale after the end of the 6th
session of the cognitive behavioral coaching program (M = 65.5, SD = 10.8) compared to the week before the start of
the coaching program (M = 61.4, SD = 7.9), t(14) = -2.1, p =.049.

There was a significant increase in the level on the “Environmental Management” subscale after the end of the
cognitive-behavioral coaching program (M = 69.7, SD = 6.5) compared to the week before the start of the coaching
program (M = 63.3, SD = 6.7), t(14) = -3.3, p = .006.

There was a significant increase in the level on the “Personal Growth” subscale after the end of the cognitive-behav-
ioral coaching program (M = 70.7, SD = 7.3) compared to the week before the start of the coaching program (M =
62.4, SD = 10.2), t( 14) =-4.2, p =.001

On the scale “Satisfaction with the process and content of work and one’s achievements,” there was also a significant
increase in the level after the end of the cognitive-behavioral coaching program (M = 21, SD = 2.4) compared to the
week before the start of the coaching program (M = 18, 8, SD =2.2). , t(14) =-3.6, p =.003

No significant differences were found:

-on the remaining subscales of the job satisfaction questionnaire (p>0.05)

-by decision-making styles, DSI (p>0.05)
The value of the results. The findings add to the knowledge about the effects of executive coaching in the cognitive
behavioral approach.

Keywords
cognitive-behavioral coaching, executive coaching, psychological well-being, job satisfaction

SY33: Treating Long COVID haulers: different psychological interventions for

patient-centered care
Chair: PhD Patricia M. Pascoal, Universidade Lusófona- Centro Universitário de Lisboa, Portugal
Convenor/organizer: PhD. Vinicius Jobim Fischer, Centre Hospitalier Neuro-psychiatrique (CHNP), Luxembourg

Vinicius Jobim Fischer, Centre Hospitalier Neuro-psychiatrique (CHNP), Luxembourg

Daniel Bintner, Centre Hospitalier Neuro-psychiatrique (CHNP), Ettelbruck, Luxembourg, Luxembourg
Djenna Hutmacher, Centre Hospitalier Neuro-psychiatrique (CHNP), Luxembourg
Patrícia M. Pascoal, Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Lisbon, Portugal,
Portugal

Abstract
Long-COVID, also known as post-acute sequelae of SARS-CoV-2 infection, has emerged as a significant public health
challenge. Studies show that around 10–20% of infected people with SARS-CoV-2 may develop new or present ongo-
ing symptoms 3 months after the initial SARS-CoV-2 infection, lasting for at least 2 months with no other explanation.
Such circumstance is termed post-COVID condition or long-COVID (LC). Symptoms differ between people, and more
than 200 have been identified with impacts on multiple organ systems and well-being (WHO, 2023).
Among the more prevalent symptoms are: chronic fatigue, neuropsychological impairments, respiratory issues. The
present symposia aim to present the current patient-centered approach carried out in a national specialized center.
The presentation topics are as follow: 1) Acceptance and Commitment therapy with long-COVID haulers, 2) Pacing
interventions for the management of Chronic fatigue and other symptoms, and 3) Sexual therapy for Long-COVID
haulers.
1) Acceptance and Commitment therapy with long-COVID haulers: ACT therapeutic strategies and specificities of the
work among long-COVID haulers. The importance of the acceptance of the context and the reinforcement of personal
values and value-driven actions commitment.
2) Pacing interventions for the management of Chronic fatigue and other symptoms:
Essential part of good therapeutic management, consist activity management (balancing activity and resting peri-
ods), priority setting, symptoms monitoring and anticipation. Such intervention aims to offer energy for the patient
pivotal needs while avoiding the exacerbation of symptoms - post-exertional malaise (PEM)
3) Sexual therapy for Long-COVID haulers: Long-COVID condition impacts sexuality in different manner, might alter-
ing both the sexual response as well as the relationships. Psychosexual therapy interventions focus on addressing
the physical, cognitive, emotional, and relational dimensions of sexuality that are hampered by the symptomatology.

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Keywords
Long-COVID, ACT, Pacing, Sexual therapy

Pacing interventions for the management of chronic fatigue and other symptoms
Ms. Daniel Bintner (Centre Hospitalier Neuro-psychiatrique - CHNP, Luxembourg);
PhD. Djenna Hutmacher (Centre Hospitalier Neuro-psychiatrique - CHNP, Luxembourg);
PhD. Vinicius Jobim Fischer (Centre Hospitalier Neuro-psychiatrique - CHNP, Luxembourg)

ABSTRACT: Long Covid, a condition affecting approximately 10% of those infected with COVID-19, presents a signifi-
cant and complex health challenge as individuals continue to experience lingering symptoms well beyond the initial
phase of a SARS-CoV-2 infection. Characterized by a diverse array of symptoms—reportedly up to 200—Long Covid
includes chronic fatigue, headaches, dizziness, and cognitive impairments, making it difficult to define and distin-
guish from other general conditions. This diversity in symptomatology complicates both diagnosis and treatment.
Current treatment strategies primarily focus on symptom management due to the chronic nature of Long Covid and
the absence of definitive therapeutic interventions. Research activities on Long Covid are multiple, with ongoing
efforts to better understand the disease.
Chronic fatigue and post-exertional malaise (PEM) are hallmark symptoms of Long Covid, characterized by persistent,
debilitating tiredness that is unrelieved by rest and profoundly disrupts daily functioning. PEM exacerbates symptoms
following physical or mental exertion, triggering prolonged fatigue, cognitive impairments, and other manifestations.
This not only challenges patients’ well-being but also sets Long Covid apart from conditions like depression, where
individuals typically experience reduced motivation and difficulty initiating activities. In Long Covid, patients often
retain a desire for activity but must navigate the risk of overexertion, which exacerbates their symptoms and under-
scores the complex interplay between physical capability and psychological resilience in managing its multifaceted
impact on health and daily life.
Hence, there is a critical need for psychotherapy as part of a comprehensive treatment plan. The National Institute for
Health and Care Excellence (NICE) guidelines recommend a personalized approach to managing Long Covid, empha-
sizing the importance of psychological support alongside physical rehabilitation and medical management.
Pacing, an intervention designed to manage activity levels to avoid PEM, emerges as a crucial strategy in treating
Long Covid. Pacing involves balancing periods of activity with rest, enabling patients to engage in daily tasks without
triggering a relapse of symptoms. This approach empowers patients to manage their energy more effectively, reduc-
ing the risk of overexertion and helping to maintain a more stable health condition.
This presentation as part of our symposium will delve into pacing interventions for managing PEM and other symp-
toms in Long Covid patients. The multidisciplinary approach is explained with reference to the Luxembourg approach,
and other important elements for better management and promoting acceptance are discussed. Additionally, the
theoretical underpinnings of pacing, its practical application, and its effectiveness in mitigating symptoms are ex-
plored. By providing a comprehensive overview and sharing clinical insights, we aim to enhance understanding and
implementation of pacing strategies in treating Long Covid, ultimately improving patient outcomes.

Keywords
pacing, Long-COVID, chronic fatigue

Acceptance and Commitment Therapy for Long-COVID: therapeutic strategies and specificities
PhD. Djenna Hutmacher (Centre Hospitalier Neuro-psychiatrique - CHNP, Luxembourg)

ABSTRACT: Patients suffering from Long-COVID experience persistent symptoms long after the acute phase of SARS-
CoV-2 Infection. This condition affects around 10% of people who have been tested positive for SARS-CoV-2. Most
commonly, these symptoms include chronic fatigue, sleep disorder, loss of strength, limited exercise tolerance, vari-
ous muscle pains, headaches, dizziness, cognitive impairments, rapid heartbeat, hypersensitivity, and post-exertional
malaise, representing the worsening of symptoms after mental or physical exertion. In total, up to 200 symptoms are
known in Long-COVID. In such cases of persistent symptoms, also known as Long-COVID, there was a significant cor-
relation with greatly reduced functionality, physical activity, and quality of life, compared to patients who recovered
from their infection (VélezSantamaría et al., 2023), with up to 70% of restraint experienced in activities of daily living.
The underlying mechanisms of this disease are unknown, and until today, there is no targeted medical treatment for
Long-COVID. Patients feel helpless and suffer daily from severe physiological and cognitive impairments, often result-
ing in significant distress accompanied by rigid behaviors. Specifically, these rigid behaviors, such as the fixed belief
“I just need to push myself a little more, and I will regain my fitness,” lead to a worsening of symptoms in this condi-
tion and, consequently, to even greater distress, and a lowering of self-worth. Consequently, the person may remain
entrenched in pre-existing habitual responses, which might not be effective for dealing with the current situation,

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such as Long-COVID. In the context of chronic illnesses, Acceptance and Commitment Therapy (ACT) is particularly
effective because it addresses the automatic or habitual responses that can exacerbate suffering. Chronic conditions
often lead to rigid patterns of thought and behavior, such as avoidance of discomfort or overexertion to regain health.
These responses, while understandable, can perpetuate distress and impair quality of life. ACT helps individuals rec-
ognize and step away from these automatic processes by fostering mindfulness and acceptance. By learning to ob-
serve thoughts and emotions without judgment, individuals can make more intentional choices about their actions.
Moreover, ACT encourages setting meaningful goals based on personal values, which can provide a sense of purpose
and direction, even in the presence of chronic illness. Overall, ACT offers a comprehensive approach to managing
chronic illnesses by promoting psychological flexibility, enhancing coping strategies, and improving overall well-be-
ing. Its focus on acceptance, mindfulness, and value-based actions makes it a valuable tool for individuals navigating
the complexities of long-term health challenges. Despite the limitations imposed by Long-COVID, individuals can find
ways to engage in value-driven actions, which can provide a sense of purpose and motivation, even amidst ongoing
health challenges. The goal of this presentation is to illustrate the strategies of ACT in managing Long-COVID, as ACT
was clinically effective in other complex health conditions (e.g., chronic pain; Hughes et al., 2017), using concrete
examples of psychotherapeutic mechanisms employed in our clinic.

Keywords
Acceptance and Commitment Therapy (ACT), Long-COVID

Sexual Therapy for Long-COVID haulers

Phd. Vinicius Jobim Fischer, Centre Hospitalier Neuro-Psychiatrique - CHNP, Luxembourg

Abstract:
The long-term consequences of SARS-CoV-2 infection, known as Long-COVID, affect about 10% of COVID-19 patients,
posing a substantial and multifaceted health issue. Individuals suffering from persistent symptoms long after the
initial infection phase often experience significant disruptions in their daily lives. Long-COVID can impact many organ
systems with a wide range of clinical symptoms that vary in intensity from minor inconveniences to severe, life-threat-
ening conditions. Among the most common symptoms are chronic fatigue, post-exertional malaise (PEM), cognitive
function impairments characterized by confusion, slow thinking, attentional and concentration difficulties (brain fog),
anxiety, depression, and cardiorespiratory difficulties (Sansone et al., 2022).
In the context of overall health impairments that pose challenges to daily demands, sexuality is often unaddressed
or its importance diminished. Nonetheless, the plethora of Long-COVID symptoms can significantly impact sexual
functioning, thereby affecting sexual and relationship satisfaction.
A holistic approach to Long-COVID haulers should pay close attention to sexual health and relationship satisfaction.
Psychosexual therapy interventions focus on addressing the physical, cognitive, emotional, and relational dimensions
of sexuality that are hampered by the chronic symptoms experienced. These interventions aim to restore or maintain
a fulfilling sexual life despite the ongoing health challenges posed by Long-COVID.
Our approach to psychosexual therapy provided for Long-COVID haulers is based on the PLISSIT (Permission, Limited
Information, Specific Suggestion, Intensive Treatment) model (Annon, 1976). This model is supplemented with cogni-
tive, emotional, and behavioral techniques that can be applied both to individuals and partnerships.
In this regard, psychosexual therapy encompasses several key components. These include: the validation and accep-
tance of the changes experienced, which is crucial for patients to acknowledge and address their new reality. Identifi-
cation and flexibilization of cognitive myths and distortions (such as coitus-centrism and performance beliefs), which
help patients to develop a more realistic and healthy understanding of sexuality. Mindfulness-based strategies are
used to enhance present-moment awareness and reduce anxiety related to sexual performance. Emotion regulation
techniques assist patients in managing their emotional responses, while behavioral strategies focus on gradually
reintroducing sexual activities in a comfortable and enjoyable manner. Communication skills training is essential for
improving intimacy and understanding between partners.
Such elements are pivotal to keeping or restoring a pleasant sexual life. Despite the limitations imposed by Long-
COVID, individuals can find ways to keep their sexuality fulfilled by engaging in pleasurable activities adapted to their
context and health challenges. For example, couples can explore new forms of intimacy that do not require physical
exertion, or they can focus on non-sexual forms of affection and connection. Open communication between partners
about needs, limitations, and desires is essential for maintaining a healthy sexual relationship.
Ultimately, addressing the sexual health of Long-COVID haulers is an integral part of a holistic treatment plan. By
incorporating psychosexual therapy into the care of Long-COVID haulers, healthcare providers can help individuals
navigate the complexities of their condition and improve their quality of life.

Keywords
Sexual therapy, Long-COVID

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SY34: The development of the cognitive conceptualization diagram and its

modern forms
Convenor, Chair: Dmitrii V. Kovpak, Association for Cognitive Behavioral Psychotherapy (Russia), Russian Federa-
tion

Dmitrii V. Kovpak
Association for Cognitive Behavioral Psychotherapy (Russia), Russian Federation
Albert Murtazin
Association for Cognitive Behavioral Psychotherapy (Russia), Russian Federation
Maksim Zriutin
Association for Cognitive Behavioral Psychotherapy (Russia), Russian Federation
Mikhail Burdin
Russian CBT Association, Russian Federation

Abstract
The cognitive model proposed by A. T. Beck as a methodological basis for cognitive behavioral therapy becomes
a structural basis for diagnosis, including its systematization in the form of cognitive conceptualization. From the
linear connections of the cognitive model in cognitive conceptualization, we move on to the nonlinear and sys-
temic connections presented in the diagram of cognitive conceptualization by J. Beck. To date, the traditional
problem-oriented conceptualization of J. Beck (1993) supplemented by the strength-based cognitive concep-
tualization diagram by J. Beck (2018, 2021). The diagram of cognitive conceptualization reflects a system of com-
plex interrelations of human mental constructs and the external manifestation of their functioning in the form
of his phenomenologically recorded emotions and behavior. The basis of the cognitive conceptualization dia-
gram and the belief system reflected in core beliefs (represented as a “Self-concept” and reflected in characteris-
tics starting with the personal pronoun “I”) and relevant data of life and childhood associated with their formation.
During the symposium, we consider various options for expanding the model of cognitive conceptualization, including
by taking into account reflexive thoughts and beliefs, meta-beliefs, an expanded history of childhood and the client’s
social history, and of course, the concept of needs. In the cognitive behavioral approaches needs were mentioned by W.
Glasser in the 80s of the 20. century.Then needs were included as theoretical basis of schema therapy by J. E.Young, A. Arntz,
J. M. Farrell, I. A. Shaw, but they emphasized emotional needs, specifically singling it out among other groups of needs.
Conceptualization of the approach named needs-based therapy propose to register needs for building connections of not
only mental constructs serving core beliefs, such as compensatory strategies, intermediate beliefs, schemes and modes,
but also to the genesis of the core beliefs themselves, schemes and proto-schemes, in connection with the satisfaction or
dissatisfaction (frustration) of actual human needs. As an important part of cognitive conceptualization, it is considered
to register data on satisfied and unmet needs both in the past and on actually realized or unrealized needs in the present.

Fig. 1: Conceptualization based on needs (Kovpak D. V., 2020, 2023)

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Сontact details of the symposium сonvenor: Dmitrii V. Kovpak, President of the Association for Cognitive Behavior-
al Psychotherapy (Russia), representatives at large of the International Association of Cognitive Behavioral Therapy,
member of the International Advisory Committee Beck Institute for Cognitive Behavior Therapy, e-mail kovpak@list.
ru, +79219023053

Keywords
cognitive model, cognitive conceptualization, biopsychosocial model, сonceptualization based on needs, needs-
based therapy

SY35: Understanding and tackling mental health problems in adolescents

and emerging adults: a focus on emotion regulation
Yakov Kochetkov, The Moscow Center for Cognitive Therapy, Russian Federation
Ksenia Syrokvashina, Nonaffiliated researcher, Russian Federation
Anna Timoshkina, Clinical Psychologist, Russian Federation

Abstract
Modern cognitive behavioral therapy for OCD has achieved considerable success. At the same time, many unresolved
problems remain, including patient resistance to therapy. Some of these problems are related to the comorbidity
of OCD with other disorders. Comorbidity with personality disorders and eating disorders greatly complicates the
therapy process and often requires the inclusion of DBT protocols in working with such patients. In addition, cultural
factors can play a large role in resistance to therapy, such as the peculiarities of magical thinking in some cultures,
attitudes toward the expression of emotions, attitudes toward personal boundaries, and other aspects.
At our symposium, we will discuss additional methods for working with comorbid conditions of OCD, such as eating
disorders and sexual dysfunction. In addition, methods for adapting standard OCD treatment to a cultural context
will be discussed.

Keywords
OCD, eating disorders. sexual dysfunction

SY36: Between stress and psychopathology: Examination of the role of

factors of vulnerability in mental health dynamics
Radomir Belopavlović
Faculty of Philosophy, University of Novi Sad, Serbia
Tamara Musić
Faculty of Philosophy, University of Novi Sad, Serbia
Peđa Miladinović
Faculty for business and legal studies Dr Lazar Vrkatić, Novi Sad, Union University in Belgrade; Temenos Center, Novi
Sad, Serbia
Snežana Tovilović
Faculty of Philosophy, University of Novi Sad, Serbia
Bojan Janičić
Faculty of Philosophy, University of Novi Sad, Serbia
Marija Volarov
Faculty of Philosophy, University of Novi Sad, Serbia
Mina Velimirović
Faculty of Philosophy, University of Novi Sad, Serbia
Aleksandar Vujić
Doctoral School of Psychology, Faculty of Education and Psychology, ELTE Eötvös Loránd University, Budapest, Hun-
gary, Hungary

Abstract
Factors of vulnerability have been long established as important phenomena in the onset and maintenance of men-
tal health outcomes. For decades, they have been understood as dispositional factors or fertile ground on which

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stressful life events or daily hassles exude their effects (Monroe & Simmons, 1991). Although some factors have been
traditionally associated with specific mental disorders, recent studies suggest their nature may be transdiagnostic,
that is, affecting more than one disorder (Dobson & Dozois, 2008). Furthermore, it would seem that these factors may
not exclusively influence psychopathological phenomena, but rather, influence stress emergence, distress and dys-
functionality that symptoms bring, and interpersonal dynamics. Thus, these factors deserve attention from the period
prior to onset, during an episode, and throughout therapeutic interventions, until remission.
Within this symposium, we will focus on and present the effects of various vulnerability factors such as ruminations,
psychological inflexibility, negative cognitions about self and others, self-esteem, retroactive inhibition, and emotion-
al dysregulation, to name a few.
We have focused on several aspects and potential effects of said factors. In doing so, in the first three studies, we
have relied on three psychopathological constructs - depression, social anxiety, and paranoid tendencies. We exam-
ined potential influences of vulnerability factors on the relation between stressors assessed across two time points,
focusing on the potential stress generation effect. Additionally, we have examined whether factors of vulnerability
contribute to the levels of distress and dysfunctionality, over and above symptom intensity. Finally, we have explored
the role of these factors in the patterns of associations between symptoms from the so-called network approach and
statistical modelling. While these three studies were focused on symptoms that vulnerable individuals may experi-
ence at certain times, the fourth study accentuates how vulnerable potential can interfere with the parental role, and
potentially lead to problematic child behaviours. Namely, we looked into the direct effect of mothers’ emotional dys-
regulation on children’s problematic smartphone/tablet use, and whether this relationship was mediated by mothers’
tolerance of children’s distress.

Keywords
Factors of vulnerability

SY37: Understanding and tackling mental health problems in adolescents

and emerging adults: a focus on emotion Regulation
Chairs: Prof. Caroline Braet - Ghent University, Vlaamse Vereniging voor Gedrags Therapie (VVGT), Belgium
Dr Marija Mitković-Vončina - University of Belgrade, Faculty of Medicine; Institute of Mental Health, Belgrade;
Serbian Association of Behavioural and Cognitive Therapists (SRABCT), Serbia
Convenor/organizer: Dr Marija Mitković-Vončina - University of Belgrade, Faculty of Medicine; Institute of Mental
Health, Belgrade; Serbian Association of Behavioural and Cognitive Therapists (SRABCT), Serbia

Speakers:
Marija Mitkovic Voncina, University of Belgrade, Faculty of Medicine; Institute of Mental Health, Belgrade; Serbian
Association of Behavioural and Cognitive Therapists (SRABCT), Serbia
Laura Wante, Ghent University - Department of Development, Personality, and Social Psychology, Belgium
Sarah Bal, Ghent University -Department of Child and Adolescent Psychiatry at Ghent University Hospital, Belgium
Marija Lero, Institute of Mental Health, Belgrade; Serbian Association of Behavioural and Cognitive Therapists
(SRABCT), Serbia
Sanja Lestarevic, Institute of Mental Health, Belgrade; Serbian Association of Behavioural and Cognitive Therapists
(SRABCT), Serbia

Abstract
Understanding and addressing adolescent mental health problems have been recognized as a contemporary pri-
ority worldwide, due to the discrepancy between the increasing needs of youth on one hand, and still insufficient
resources for support on the other hand. Emotion dysregulation has been associated with a variety of different mental
health problems of youth, providing one of the frameworks to approach them, comprehend them better and design
interventions.
The aim of this symposium is to present different approaches to understanding and addressing adolescent and
emerging adult mental health problems (prevention, early intervention, clinical intervention, as well as taking deeper
look into specific clinical challenges), with a special focus on emotion regulation.
The first part of the symposium will be dedicated to the Boost Camp – a new, school-based prevention program
targeting young adolescents’ emotion regulation skills. Data from two studies evaluating the effectiveness of this
program will be presented. The first study had a clustered randomized controlled design, while the second study
explored the feasibility and effectiveness of an optimized Boost Camp program.
The second part of the symposium will present the development of a large care centre for mental wellbeing for stu-
dents, within a unique shared partnership between ‘education’ and ‘care’, aimed to create a common support base to
sustain, broaden and strengthen care continuity for young people within the transition age (18-25 years of age). The

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needs underlying the establishment of such service and the process of development of this center are thoroughly
discussed.
The third part will present the EMODYA project aimed to investigate the predictors and outcomes of emotion dys-
regulation of youth (15-24 years of age) as a clinical cohort followed-up throughout transitioning to adulthood. This
presentation will also describe the emotion-regulation based intervention in a transdiagnostic clinical setting, and
provide the preliminary evaluation data.
Finally, the fourth part, consisting of two presentations, will focus more narrowly on non-suicidal self-injury (NSSI) as
a specific clinical challenge among transdiagnostic youth with emotion dysregulation (using data from the EMODYA
project). The first presentation will focus on associations and distinctions between the NSSI and the suicidal behavior,
in regards to emotion regulation, emotional schemas and cognitive distortions. The second presentation aims to
explore the relationship between the NSSI, response suppression/inhibition (RDoC), and cognitive distortions. Both
presentations will discuss the potential preventative implications of the findings, and future research directions.
In conclusion, this symposium provides an opportunity to integrate various views and make one step further towards
the understanding and tackling the multifaceted adolescent and emerging adult mental health problems.

Keywords
adolescents, emerging adults, mental health, emotion regulation, intervention, NSSI

1.
BOOST CAMP: A universal school-based prevention program targeting adolescent emotion regulation skills
Laura Wante1,2, Brenda Volkaert1,2, Caroline Braet1,2, Tom Loeys1
1. Gent University, Belgium
2. Vlaamse Vereniging voor Gedrags Therapie (VVGT), Belgium

Abstract:
Early adolescence is a period of elevated risk for the development of psychopathology. One factor that contributes
to this risk is the ability to regulate emotions. In the present talk, two studies evaluating the effectiveness of Boost
Camp, a new prevention program targeting young adolescents’ emotion regulation skills, will be discussed. In the
first study, junior high school adolescents (n = 347) were randomly allocated to the intervention condition or to the
control condition using a clustered randomized controlled design. The results demonstrated that Boost Camp had
beneficial short-term effects on mental health outcomes, which disappeared at follow-up. In the second study, the
effectiveness of an optimized Boost Camp program was tested using network analyses. The results point to changes
in the process of emotion regulation.

Key words: emotion regulation, adolescents, school-based, universal prevention

2.
Development of a Mental Health Care Centre for all students in the transition age in the city of Ghent, Belgium
Prof. dr Sarah Bal
Ghent University

Abstract
The development of a care centre for mental wellbeing for students within a unique shared partnership between ‘ed-
ucation’ and ‘care’ in Ghent can be a means to create a common support base to sustain, broaden and strengthen care
continuity for young people within the transition age (18-25 years of age). The establishment of a care centre aims to
meet the following existing needs: 1. Societal need for more effective mental help for students. In Flanders 20% of stu-
dents with mental health complaints seek help, 5%(of 20%) have severe complaints, 56%(of 20%) report an explicit
need for treatment, but still 75% do not find their way to mental help. 2. Need within the higher education institutions
of Ghent. Student psychologists report the following problems: after COVID more serious problems are reported,
the external referral network is clogged up, long waiting lists, the quality of external help cannot be guaranteed, the
basic service provision within the higher education institutions is compromised, more need for expertise. This leads
to the fact that not enough students receive customized help. 3. Need for mental help specifically within the transition
age group. 75% of mental problems in adulthood appear before the age of 25, 90% comorbidity with psychosocial
problems resulting in more complex problems, discontinuity of mental health care in Belgium, (children, adolescents
versus adults), students report an under-consumption of mental health care because of: ‘having’ to solve problems
yourself, idea that the problem is not bad enough, increased tolerance of context’.
This new centre for students is an addition to the mental health care of the higher education institutions (student psy-
chologists) so that care continuity of the mental well-being of the students in Ghent can be strengthened, broadened
and sustained. For this, joined forces are made with all Ghent higher education institutions, University of Ghent, the

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city of Ghent, Ghent University Hospital, community and private mental health care in Ghent, and the government
convention “psychological functions in the first line”. The specific objectives of the Mental health care centre for all stu-
dents in the city of Ghent are: (1) location is accessible, neutral and central location (2) it is an initiative for all students
in Ghent, (3) early detection and early intervention for students with mild to moderate psychological complaints, (4) a
multidisciplinary team, (5) affordable care to all students, (6) peer-to-peer support, experiential expertise and student
participation in the design and decision-making of their pathway is highly valued, (7) specific expertise of mental
health, psychiatric issues and evidence-based psychotherapy within the transition period, (8) an active involvement
in scientific research by pre-post evaluation of therapies and by implementing online evidence-based CBT treatment,
(9) the care centre is a collaboration of the different partners, this with a view to care continuity, (10) the care centre
is a necessary complement to the functioning of welfare policy/student psychologists at the higher education insti-
tutions. The presentation will provide further explanations of the needs and development of this mental health care
centre for students.
Key words: mental health care centre, students, transition age, continuity of care

3.
Clinically manifested emotion dysregulation among transdiagnostic adolescents and emerging adults: pre-
dictors, outcomes and directions for intervention
Marija Mitković-Vončina1,2,3, Marija Lero1,3, Sanja Lestarevic1,3, Milica Pejovic-Milovancevic1,2,4
1. Institute of Mental Health, Belgrade, Serbia
2. University of Belgrade, Faculty of Medicine
3. Serbian Association of Behavioural and Cognitive Therapists (SRABCT)
4. Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)

Emotion dysregulation (EDR) has been associated with a variety of different mental health problems of youth, as a
common underlying construct, providing one of the frameworks to understand these problems better and tailor
interventions. The objective of this presentation is to present the project “Emotion dysregulation of adolescents: the
study of predictors and outcomes” (EMODYA), aimed to investigate different variables associated with the clinical-
ly manifested EDR among youth, as well as different outcomes of EDR throughout transitioning to adulthood. The
method refers to establishing a cohort of youth (15-24) with emotional and behavioural disorders at the Institute of
Mental Health, Belgrade, Serbia. The instruments include retrieving general and medical data from psychiatric record;
general questionnaire (socio-demographics, personal and family psychiatric and medical history, data on daily habits,
treatment data); emotion and cognition-based instruments (emotion dysregulation, emotion regulation strategies,
emotional schemas, cognitive distortions); symptom based instruments (for anxiety, depression, anger); self-harm
and suicide assessment instruments; personality structure-based instruments; motivation for change assessment,
family functioning and child maltreatment experiences, RDoC protocols for rejection sensitivity, response selection
and inhibition/suppression; and device to measure physiological arousal. The study also includes a qualitative assess-
ment of patients’ views on the key aspects of dealing with difficult emotions and motivation to change. After baseline
assessment, the cohort is followed throughout transitioning to adulthood. This presentation will also describe the
directions for the proposed emotion-regulation based intervention in a transdiagnostic clinical setting, based on the
preliminary data.
Acknowledgement: This study is a part of the EMODYA project (Emotion dysregulation of adolescents – the study of
predictors and outcomes), supported by The Association for Child and Adolescent Psychiatry and Allied Professions
of Serbia (DEAPS), No. REF: DEAPS-NIR-2022/01.

Key words: emotion dysregulation, adolescents, emerging adults, predictors, outcomes, transdiagnostic intervention

4.
Linking suicidality with emotion (dys)regulation and emotional schemas in transdiagnostic youth with and
without non-suicidal self-injury
Marija Lero1,4, Sanja Lestarevic1,4, Milica Pejovic-Milovancevic1,2,5, Marko Kalanj1,3, Ivana Perunicic-Mladenovic1,3,5, Ar-
senije Matic2, Vladimir Jovanović2, Marija Mitković-Vončina1,2,4

1. Institute of Mental Health, Belgrade, Serbia

2. University of Belgrade, Faculty of Medicine
3. University of Belgrade, Faculty of Philosophy
4. Serbian Association of Behavioural and Cognitive Therapists (SRABCT)
5. Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)

Introduction: Adolescents who experience emotion dysregulation are more prone to intense and overwhelming emo-
tional states, which they may try to manage through self-harm or suicidal actions. Maladaptive emotional schemas

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may contribute to the adoption of harmful coping strategies, and may also lead to non-suicidal self-injury (NSSI) and
suicidality. Given the specific and still insufficiently understood relationship between NSSI and suicidality, this study
aims to investigate the emotion (dys)regulation and emotional schema correlates of suicidal phenomena among
transdiagnostic youth with emotional and behavioral disorders.
Methods: Youth (15-24 years old) treated in outpatient and inpatient departments at the Institute of Mental Health
Belgrade, for depressive disorders, anxiety disorders, reactions to severe stress and adjustment disorder, or mixed
disorder of conduct and emotion, were assessed by the following instruments: The Difficulties in Emotion Regulation
Scale Short Form (DERS-SF), Emotion Regulation Questionnaire (ERQ), Leahy Emotional Schemas Scale (LESS II), Sui-
cidal Ideation Attributes Scale (SIDAS) and a questionnaire about NSSI and suicidal behaviour.
Results: Preliminary results indicate that among participants with NSSI, suicidality variables (higher SIDAS score, pos-
itive history of suicidal plan or attempt) were associated with higher expression suppression (ERQ), lack of emotion-
al awareness (DERS-SF), and stronger emotional numbness (LESS II). When it comes to participants with no NSSI,
suicidality variables had no significant correlates among emotion regulation, emotion dysregulation and emotional
schema variables.
Discussion: These findings speak in favor of possibly different profile of emotion (dys)regulation and emotional sche-
ma factors associated with suicidality between youth with and without NSSI. Further research and practical implica-
tions are discussed in the presentation.
Acknowledgement: This study is a part of the EMODYA project (Emotion dysregulation of adolescents – the study of
predictors and outcomes), supported by The Association for Child and Adolescent Psychiatry and Allied Professions
of Serbia (DEAPS), No. REF: DEAPS-NIR-2022/01.

Key words: emotion dysregulation, youth, self-harm, suicide, emotional schema

5.
Detangling the relationship between response suppression/inhibition, cognitive distortions and self-harm in
a transdiagnostic sample of adolescents

Sanja Lestarevic1,4, Marija Lero1,4, Milica Pejovic-Milovancevic1,2,5, Marko Kalanj1,3, Ivana Perunicic-Mladenovic1,3,5, Ar-
senije Matic2, Vladimir Jovanović2, Marija Mitković-Vončina1,2,4

1. Institute of Mental Health, Belgrade, Serbia

2. University of Belgrade, Faculty of Medicine
3. University of Belgrade, Faculty of Philosophy
4. Serbian Association of Behavioural and Cognitive Therapists (SRABCT)
5. Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)

Introduction: Research Domain Criteria (RDoC), response selection, inhibition and suppression (sub constructs of cogni-
tive control), are tightly related to effortful control. Effortful control deficiency is associated with emotion dysregulation,
and it can also be related to the biased thinking styles. The actual relationship between both self-reported and behav-
iorally assessed response inhibition/suppression disposition, the frequency and intensity of cognitive distortions and
different psychopathology symptoms in youth is not fully understood. Therefore, we aimed to explore the relationship
between the response inhibition/suppression attitude, the cognitive distortions and the history of non-suicidal self-inju-
ry (NSSI) in a transdiagnostic sample of adolescents, treated for emotional and behavioral difficulties.
Methods: The preliminary sample comprised outpatient and hospitalized adolescents (15 – 24 years old, both sexes),
treated for emotional disorders (anxiety disorders, depressive disorders, adjustment disorders, mixed disorders of
conduct and emotions). The study design is cross-sectional, with the following instruments used: The Cognitive Dis-
tortions Questionnaire (CD-Quest), Effortful Control subscale of the Adult Temperament Questionnaire (ATQ) and the
Go/NoGo task. The history of NSSI was assessed as a dichotomous variable (having inflicted a self-injury on purpose
since the age of 7).
Results: The adolescents with the history of NSSI had slightly lower percentage of correct responses in the Go/NoGo
task and slightly shorter reaction time to Go stimuli, without reaching significance. The differences in total Effortful
Control scores, Activation, Attentional, Inhibitory Control and total Cognitive Distortions scores were insignificant be-
tween the adolescents with or without the history of NSSI. The differences between the scores of cognitive distortions
did not reach significance between groups, except dichotomous thinking. We have found significant correlations
between the correct response frequency in Go/NoGo and Attentional control in negative direction, Activation Control
and fortune-telling, Attentional Control and personalization, and jumping to conclusions in the negative direction;
total Effortful Control also inversely correlated to jumping to conclusion.
Discussion: Our data indicates significant correlations between various cognitive distortions and measures linked to
effortful control. Those concepts might be significant for the occurrence of NSSI or other manifestations of emotional

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dysregulation in adolescence. These preliminary results initially point out to the significance of further exploring the
association between response inhibition/suppression, cognitive distortions and NSSI, in order for these aspects to be
mapped as treatment elements. Further scientific and practical implications are discussed in the presentation.
Acknowledgement: This study is a part of the EMODYA project (Emotion dysregulation of adolescents – the study of
predictors and outcomes), supported by The Association for Child and Adolescent Psychiatry and Allied Professions
of Serbia (DEAPS), No. REF: DEAPS-NIR-2022/01.

Keywords
emotional dysregulation, response inhibition/suppression, cognitive distortions, non-suicidal self-harm

SY38: Therapist’s schemas, modes, and self-care: challenges and perspectives

Tijana Mirović
Schema Therapy Center Belgrade, Serbia
Diana Ridic
Psihološko Savjetovalište - Domin, Bosnia and Herzegovina
Karolina Vörös
Schema Therapy Center Belgrade, Serbia
Ines Jakovčić
Teaching Institute for Public Health of Primorsko-goranska County Department for Mental health, drug prevention
and outpatient treatment, Croatia

Abstract
As therapists we aim to care for others. As Schema therapists we aim to attune to clients’ unmet needs and to offer a
reparenting stance. We offer corrective emotional experience by reparenting, being “at a scene” and doing rescripting
in the most difficult moments of our clients’ lives. As therapist in Former Yugoslav countries, we share the same collec-
tive trauma such as war, poverty, exile, exposure to violence, corruption etc.
Furthermore, therapists too may have developmental traumas and related maladaptive schemas and modes. Re-
search findings indicate that a significant proportion of mental health professionals report adverse childhood cir-
cumstances and schemas such as: self-sacrifice, emotional deprivation, and unrelenting standards. We strive to reach
higher standards whilst denying personal needs and emotions. Due to fears of letting others down we show reluc-
tance to set boundaries and ask for support. We may feel guilty when we give “too little” and feel spent when we give
“too much”. Schemas, especially when joined with shared trauma and trauma related schema therapy work, can lead
to empathy-based stress or burnout, vicarious traumatization, and poor self-care. Clearly, we need to improve self-
care but also recognize and address schemas and modes as they may imperil the therapist, bias clinical reasoning and
negatively affect the therapeutic relationship.
Having all this in mind, we designed symposium that would investigate above mentioned issues and address thera-
pist’s schemas, modes, and self-care. Being that presenters come from different countries within the same, war-struck
region we wanted to compare our experiences, similarities, and differences. Additionally, we aimed to address sche-
mas, modes, and self-care within the different aspects of therapist’s work (training, supervision, practice) and settings
(individual and group; private practice and refugee camps). Finally, drawing on our experiences as psychotherapists,
researchers, trainers, and supervisors we wanted to offer recommendations that strengthen the Healthy Adult / Ther-
apist self and promote creative, compassionate self-care.
The symposium will consist of the following papers:
1) Ines Jakovčić will present the results of a study (Jakovčić. et al., 2024) about burnout and self-care activities in coun-
sellors and psychotherapists from Former Yugoslavian area.
2) Tijana Mirović will discuss schemas and modes triggering and healing within supervision.
3) Karolina Vörös and Ines Jakovčić will demonstrate “Deliberate practice” and how it can serve as an important train-
ing, supervision and Health Adult strengthening tool.
4) Karolina Vörös will show how Schema Therapy experiential self-reflective groups can be useful in addressing thera-
pists’ schema / mode triggering (in sessions and personal life) and in enhancing Happy Child Mode and Healthy Adult
or Therapist self.
5) Drawing on experiences from collective trauma work, Diana Riđić will discuss how strengthening Healthy Adult
mode in therapists can serve as a mechanism for preventing empathy-based stress.
The papers and symposium will demonstrate that by utilizing schema therapy principles therapists can enhance
their self-awareness, emotional resilience, and boundary-setting skills. Through self-awareness, maintaining healthy
boundaries, self-care practices, and fostering a supportive network, therapists can effectively prevent empathy-based
stress and burnout while maintaining their ability to provide quality support to clients.

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Keywords
Schema Therapy, Schemas, Modes, Self-Care, Empathy-based stress

While we take care of others, (how) are we taking care of ourselves?

Ines Jakovčić
Teaching Institute for Public Health of Primorsko-goranska County Department for Mental health, drug prevention
and outpatient treatment, ijakov@yahoo.com
Damjan Dušević
Thalassotherapia Opatija, Special hospital for medical rehabilitation of heart, lung and rheumatic diseases, Opatija,
Croatia
Marina Letica Crepulja
Faculty of Medicine, University of Rijeka, Rijeka, Croatia; Clinical Hospital Center Rijeka, Department of Psychiatry,
Referral Center for PTSD of the Ministry of Health of the Republic of Croatia, Rijeka, Croatia
Duška Car Drljača
Association UZOR, Rijeka, Croatia
Danijela Perić Kosović
Salesian Classical Gymnasium Rijeka, Croatia

Abstract
Counselors and psychotherapists work in a stressful and emotionally demanding environment on a daily basis, which
puts them at risk of burnout. Data shows that between 21% and 67% of mental health professionals suffer from burn-
out. As burnout in the workplace can have a negative impact on clinical work, it is important to consider self-care as
an ethical imperative. Self-care activities refer to physical, emotional, psychological, spiritual or professional activities
and processes that we practice with the aim of better managing stress. In this way, we promote and support our own
health and well-being. In dealing with the most common schemas among therapists (self-sacrifice, emotional depri-
vation and unrelenting standards), the mechanisms of the compliant surrender, demanding parent or various forms
of overcompensation are often activated, which can hinder appropriate self-care.
With the aim of raising awareness of the importance of self-care and investigating burnout among mental health
professionals, a survey was conducted among 286 counselors and psychotherapists. Of these participants, 94.4%
were women and 73.4% were psychologists who provided psychological counseling to at least one client per week
(an average of 12 sessions per week). Participants completed the Counselor Burnout Inventory (Lee et al., 2007), the
Self-Care Practice Scale (Bloomquist et al., 2015) and demographic data.
The results show that, on average, respondents do not have pronounced problems related to burnout at work. They
scored highest on the Negative Work Environment scale, while the lowest scores were on the Client Devaluation
scale. For self-care, therapists used physical activities the most and spiritual activities the least. Hierarchical regression
analysis showed that 22.6% of the variance in burnout at work was explained by physical and professional self-care
activities, while the number of sessions per week and emotional self-care activities were also significant predictors of
certain subscales of the Counselor Burnout Inventory.
Various ways of encouraging the therapist to activate their Healthy Adult Mode and self-care, i.e. to reduce the thera-
pist's actions from the Parentified Child Mode, will be discussed. The healthier and better functioning therapists are,
the better and more successful they will be with their clients.

Keywords
burnout, counselors, psychotherapists, self-care

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SY39: Kognitivno bihevioralna terapija Harm OKP-a

Chair: Andrea Vlašić, MUP K10 Livno, Bosnia and Herzegovina
Convenor/organizer: Andrea Vlašić, MUP K10 Livno, Bosnia and Herzegovina

Andrea Vlašić
Ministry of Internal Affairs, Bosnia and Herzegovina
Irma Čorbo
JU OŠ Grbavica II, Bosnia and Herzegovina
Amela Bektaš
Bosnia and Herzegovina

Abstract
Opsesivno-kompulzivni poremećaj (OKP) je iscrpljujuće stanje mentalnog zdravlja koje karakterizira nametljive misli,
slike ili porivi (opsesije) i ponavljajuće ponašanje ili mentalne radnje (kompulzije) usmjerene na smanjenje anksiozno-
sti ili oblikovanje ishoda kojih se klijent boji. Podvrsta OKP-a koja predstavlja značajne izazove je Harm OKP, u kojem
se pojedinci suočavaju s nametljivim, uznemirujućim mislima o ozljeđivanju drugih ili sebe. Kognitivno-bihevioralna
terapija (KBT) pojavila se kao zlatni standard za liječenje OKP-a, uključujući Harm OKP, ali snalaženje u složenosti ovog
stanja unutar KBT okvira predstavlja značajne prepreke. Ovaj simpozij istražuje složenost Harm OKP-a i KBT-a, ukl-
jučujući prikaz slučaja, raspravu o kognitivnim distorzijama i ispitivanje učinkovitosti i prepreka svojstvenih pružanju
učinkovite KBT-a za Harm OKP.
Prikaz slučaja: simpozij započinje detaljnim prikazom slučaja osobe kojoj je dijagnosticiran Harm OKP. Slučaj naglaša-
va iscrpljujuću prirodu poremećaja, ilustrirajući mučne opsesije i odgovarajuće kompulzije koje dominiraju životom
pojedinca. Kroz ovu prezentaciju, polaznici dobivaju uvid u suptilne manifestacije Harm OKP-a i utjecaja koji ima na
svakodnevno funkcioniranje pojedinca, odnose se s drugima i općenito dobrobit kao i rezultate prevencije izloženosti
i odgovora (ERP) i kognitivnog restrukturiranja.
Kognitivna iskrivljenja u Harm OKP-u: Za razumijevanje i liječenje Harm OKP-a izuzetno su važne kognitivne distorzije
koje su u podlozi opsesija i kompulzija. Predavač istražuje specifične kognitivne distorzije tipično povezane s Harm
OKP-om, kao što su katastrofično razmišljanje, precjenjivanje prijetnji i moralna skrupuloznost. Kroz primjere i teori-
jske okvire, slušatelji stječu dublji uvid u to kako ove kognitivne distorzije potiču ciklus opsesije i kompulzije u Harm
OKP-u, održavajući individualne distrese i oštećenje.
Učinkovitost i poteškoće u izvođenju KBT-a s Harm OKP-om: KBT je pokazao učinkovitost u liječenju OKP-a, uključu-
jući Harm OKP, ali postoje jedinstvene poteškoće s kojima se suočavamo kod ove podvrste. Te prepreke dolaze i od
terapeuta i od klijenta i mogu uključiti otpor prema izlaganju i prevenciji odgovora (ERP), poteškoće u prepoznavanju
i rješavanju kognitivnih distorzija i prekide u terapijskoj suradnji, koji proizlaze iz osjetljive prirode opsesija. Međutim,
usput ovim poteškoćama, terapeuti ostaju predani postizanju mentalnog zdravlja i dobrobiti svojih klijenata te po-
državati njihov osobni rast i oporavka. Predavajući istražuju strategije za prevladavanje ovih prepreka, oslanjajući se
na kliničko iskustvo, empirijske dokaze i suradničke pristupe rješavanju problema.
Kroz sveobuhvatno istraživanje o Harm OKP-u i KBT-u, ovaj simpozij ima za cilj podići svijest i raspraviti navedene teme
kako bi se adekvatnije pristupilo klijentima s Harm OKP-om. Integrirajući prezentaciju slučaja, raspravu o kognitivnim
poremećajima i uvid u terapijske izazove, slušateljima se pružaju praktični alati i strategije za pružanje skrbi temeljene
na dokazima klijentima s Harm OKP-om. U konačnici, ovaj simpozij služi kao platforma za proširenje razumijevanja i
promicanje najboljih praksi u liječenju ovog oblika OKP-a u kontekstu KBT-a.Vrh obrasca

Keywords
Harm OCD, Case presentation, Cognitive distortions, Treatment obstacles, ERP

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Kognitivno bihevioralna terapija nasilnog OKP-a - prikaz slučaja

Andrea Vlašić
MUP K10 Livno, Bosna i Hercegovina;
Irma Čorbo, JU O.Š. Grbavica II, Bosna i Hercegovina;
Amela Bektaš
Psihološko savjetovalište Domino, Bosna i Hercegovina

CILJ RADA

Opsesivno-kompulzivni poremećaj (OKP) je iscrpljujuće stanje mentalnog zdravlja koje karakteriziraju nametljive
misli, slike ili porivi (opsesije) i ponavljajuće ponašanje ili mentalne radnje (kompulzije) usmjerene na smanjenje ank-
sioznosti ili izbjegavanje ishoda kojih se klijent boji. Podvrsta OKP-a koja nameće terapeutima značajne izazove je
nasilni OKP (Harm OCD), u kojem se pojedinci suočavaju s nametljivim, uznemirujućim mislima o ozljeđivanju dru-
gih ili sebe. Kognitivno-bihevioralna terapija (KBT), s naglaskom na izlaganje i prevenciju odgovora (IPR), pojavila se
kao zlatni standard za liječenje OKP-a, uključujući nasilni OKP, ali snalaženje u kompleksnosti ovog stanja unutar KBT
okvira predstavlja značajan izazov. Cilj ovog prikaza je opisati iscrpljujuću prirodu ovog poremećaja, ali i dati uvid u
terapijski pristup olakšavanju simptoma i poboljšanju kvalitete života kroz povećanu funkcionalnost.

OPIS SLUČAJA

Učiteljica u dobi od 29 godina samoinicijativno se javlja za psihoterapiju. Prije 4 godine imala zdravstvenu anksioznost,
s kojom se samostalno izborila. Sada ima svakodnevne opsesivne misli nasilnog sadržaja, o ugrožavanju sebe i drugih,
a koje je uznemiruju, te smanjuju funkcionalnost i zadovoljstvo životom. Uključuje se u brojna izbjegavanja, rituale,
te se čvrsto drži sigurnosnih osoba i ponašanja, provjeravanja i razuvjeravanja. Identificira se sa svojim opsesivnim
mislima (Ako imam ove misli, ja sam opasna / depresivna / suicidalna / luda / loša).

Visoko je anksiozna, osjeća strah, očaj i veliki stid zbog takvih misli. Izniman strah od gubitka kontrole, te netoleranci-
ja na neizvjesnost, zbog kojih održava perfekcionističke standarde za sebe i uključuje se u rituale koji joj olakšavaju
tjeskobu (čišćenje, pranje ruku, distrakcije, provjeravanje i razuvjeravanje). Učestalo ima lupanje srca i drhtanje. Bez
poznatog psihijatrijskog herediteta, niti je ikad bila u psihijatrijskom tretmanu.

Ciljevi uključuju smanjivanje simptoma anksioznosti, prepoznavanje i mijenjanje iracionalnih misli i shema o opasnos-
ti, odgovornosti, nemogućnosti tolerancije opsesija, razlikovanju misli od ponašanja i identiteta, izlaganje opsesivnim
mislima, i strahovima bez uključivanja u ritualna ponašanja, uključivanje u ranije izbjegavana ponašanja, uklanjanje
sigurnosnih ponašanja, povećavanje funkcionalnosti, povećavanje vremena provedenog u opuštanju.

Korištene su kognitivne tehnike (psihoedukacija, identifikacija stresnih okidača i NAM, kognitivna restrukturacija, bi-
hevioralni eksperiment, odgađanje briga, pita grafikon – odgovornost, samoupute i samokontrola), i bihevioralne
tehnike (hijerarhija strahova, izlaganje u mislima i uživo uz prevenciju odgovora, modeliranje, abdominalno disanje,
usredotočena svjesnost, relaksacija).

Napredak u tretmanu je praćen primjenom MOCI, BAI, BDI i BHS, te projektivnog Wartegg testa crteža.

ZAKLJUČAK

Rezultati primjene kognitivno-bihevioralnog tretmana i IPR pokazuju smanjenje težine OKP-a, simptoma anksiozno-
sti, depresivnosti, beznađa, uključivanje u sva ranije izbjegavana ponašanja, uklanjanje / reorganizaciju rituala i sig-
urnosnih ponašanja (čišćenje po dogovorenom planu, pranje ruku u situacijama koje su dogovorene s terapeutom,
npr. prije jela), povećanje funkcionalnosti u svim područjima, povećanje vremena u opuštajućim aktivnostima. Za-
dovoljna vlastitim napretkom.

Ključne reči
Nasilni OKP, Prikaz slučaja, kognitivno bihevioralna terapija OKP-a, IPR, nasilne opsesije

Kognitivne distorzije kod nasilnog OKP-a

Irma Čorbo, JU O.Š. Grbavica II, Bosna i Hercegovina;
Andrea Vlašić, MUP K10 Livno, Bosna i Hercegovina;
Amela Bektaš, Psihološko savjetovalište Domino, Bosna i Hercegovina

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Kognitivne distorzije predstavljaju pogrešan način razmišljanja, dajući iskrivljenju sliku mišljenja o nama, događa-
jima, drugim ljudima i svijetu koji nas okružuje. Beck predstavlja kognitivne distorzije kroz tri novoa razmišljanja
povezana u hijerarhiji. Iskrivljene automatske misli su najdostupnije i najneposrednije, njih slijede disfunkcionalne
pretpostavke, a na kraju hijerarhije nalaze se disfunkcionalne sheme kao najnedostupnije. Ljudsko razmišljanje pred-
stavlja složen proces, koji je sklon greškama, odnosno zamkama mišljenja koje pomažu razvoju različitih mentalnih
poremećaja. MKT – OKP se bavi kognitivnim distorzijama koje su relevantne za razvoj OKP-a. Kognitivne distorzije kod
OKP-a su: kontrola misli, prefekcionizam, pristrane kognitivne mreže, netolerancija na neizvjesnost, precjenjivanje
odgovornosti, akciona fuzija, precjenjivanje prijetnji, pristrana pažnja. Specifičniji oblik OKP-a, koji je centralna tema
ovog simpozija jeste nasilni OKP koji uključuje neželjene nasilne misli i slike koje nisu u skladu sa vrijednostima osobe
i njezinim karakterom. U nastavku će biti više govora o kognitivnim distorzijama koje su detektovane u studiji slučaja
klijentice s nasilnim OKP-om.

Perfekcionističke misli (moranja/trebanja)

Uključuju kruta i apsolutna pravila, gdje osoba prizaje da je samo prihvatljivo kada je zadatak odrađen bez greške. Per-
fekcionizam često dovodi do frustracije jer osoba nije u mogućnosti da ispuni sve zadatke bez pogreške, što dovodi
do pogoršanja OKP-a.

Netolerancija na neizvjesnost

Potreba za kontrolom nad „situacijom“ koju osobe sa OKP-om pokušavaju ostavriti pomoću rituala kao što je čišćenje
ili dodirivanje predmeta određeni broj puta.

Akciona fuzija / magično razmišljanje

Jedna od najučestalijih kognitivnih distorzija kod osoba sa OKP-om, manifestuje se na način da osoba smatra da će
dogoditi nešto loše, ako misli na određene stvari ili ne uspije izvršiti određenu radnju na određeni način.

Dihotomno mišljenje

Razmišljanje u sve ili ništa terminima – ako sam pomislio da bih mogao nešto nažao učiniti nekome, ja sam opasni
ubojica.

Precjenjivanje odgovornosti

Odnosi se na nerealistično preuzimanje odgovornosti za negativne događaje izvan vlastitog objektivnog uticaja, te
postojanje duplih standarda, na način da sebi nikada ne opraštaju pogreške, dok drugima pronalaze opravdanje.

Katastrofiziranje

Svoje opsesivne misli prepoznaju kao znakove nadolazeće katastrofe – to što sam pomislio „Šta da si nešto napravim“
znači da sam lud i ubit ću se.

Kontrola opsesivnih misli

Opsesivne misli se javljaju jer osoba s OKP-om nije u stanju napravit distancu u odnosu na njih, kontinuirano se bavi
njima. Često se dešava začarani krug ljutnja (agresija) - krivnja (ljutnja prema sebi) – pokušaj kompenzacije – frus-
tracija.

Precjenjivanje prijetnji

Sklonost precjenjivanju određene situacije davanjem moći mislima. Često se priklanjaju pretjeranom optimizmu
odnosno pesimizmu, tako što npr. koriste jedan negativan događaj za predviđanje budućnih događaja.

Pristrana pažnja/pozornost

Pojava fenomena „OKP naočala“ predstavlja tendenciju da se više pažnje usmjeri na stvari i situacije relavantne za OKP.
Zamjećuju se vizuelni, auditivni i taktilni podržaji relevantni za OKP.

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Pristrane kognitivne mreže

Spoznaje koje se često pojavljuju zajedno snažno su povezane, kada se aktivira jedna misao odmah je slijedi druga
misao. Osobe s OKP-om često imaju jednoznačne asocijacije, npr. broj 13 se povezuje samo s nesretnim okolnostima.

Identifikacija i restrukturacija kognitivnih distorzija kod nasilnog OKP-a je ključna jer motivira i olakšava uključivanje
u ERP i zadržavanje u tretmanu.

Ključne reči
nasilni OKP, kognitivne distorzije, kognitivna restrukturacija, ERP, KBT

Učinkovitost i poteškoće u provođenju KBT-a s nasilnim OKP-om

Amela Bektaš, Psihološko savjetovalište Domino, Bosna i Hercegovina;
Andrea Vlašić, MUP K10 Livno, Bosna i Hercegovina;
Irma Čorbo, JU O.Š. Grbavica II, Bosna i Hercegovina

Kognitivno-bihevioralna terapija (KBT), koja uključuje izlaganje s prevencijom odgovora (ETP) i kognitivnu terapi-
ju, pokazala se učinkovitom u tretmanu opsesivno-kompulzivnog poremećaja (OKP), uključujući i nasilni OKP (harm
OCD). Istraživanja potvrđuju ERP kao prvu liniju psihoterapijskog tretmana OKP-a, a rezultati tretmana su trajni. Među-
tim, postoje određene teškoće tijekom psihoterapijskog procesa nasilnog OKP-a koje dolaze od strane klijenta, ali i
terapeuta.

Najčešće poteškoće koje se javljaju u toku tretmana su vezane za otpor prema izlaganju i strah od potvrđivanja vlas-
titih opsesija / strahova – da su opasni za sebe ili druge ljude. Upravo zbog toga postoji problem i sa uključivanjem
u tretman, otvaranjem terapeutu o sadržaju opsesija, ali i zadržavanjem u tretmanu. Zbog nasilnih misli koje su di-
stone s klijentom, izuzetno je visok nivo anksioznosti koja otežava klijentu fokusiranje na terapijske zadatke poput
izlaganja strahovima ili na primjenu tehnika. Izražena je i rezistencija na promjene – teško je odreći se sigurnosnih
radnji i izbjegavanja jer se boje da će „pokleknuti pred opsesijama“ i dokazati da su opasne osobe. Simptomi nasilnog
OKP-a mogu biti skriveni od spoljnjeg posmatrača, što može otežati terapeutu da dođe do prave dijagnoze i tretmana.
Najčešće se ovaj poremećaj pepozna u okviru tretmana nekog drugog problema. Klijenti s nasilnim OKP-om često
izjednačavaju opsesije s identitetom, te traže razuvjeravanja i od terapeuta. Nekad gaje sumnje o tome da terapeut
zna da su opasni / ludi i da samo prikupljaju dodatne podatke kroz psihoterapiju. Jako je važna temeljita psihološka
procjena kako bi se utvrdila moguća komorbidna stanja. Nakon perioda poboljšanja, klijenti mogu doživjeti povratak
simptoma, tj. pogoršanje stanja, što zahtijeva dodatnu podršku i prilagođavanje terapijskog plana.

Niz je teškoća s kojima se suočavaju terapeuti u radu s klijentima koji imaju nasilni OKP. To je, između ostalih, emocio-
nalna reaktivnost. Terapeuti mogu osjećati frustraciju ili bespomoćnost zbog teškoća klijenta, naročito ako terapijski
napredak nije očigledan ili je spor. Neiskusni terapeuti mogu imati teškoća prepoznati da se radi o OKP-u. Empatijsko
preopterećenje može uticati na emocionalnu stabilnost terapeuta i zahtijevati od njih da aktivno upravljaju sopstven-
im emotivnim granicama. Još jedan od bitnijih problema je suočavanje s rastućim otporom klijenta. Naime, klijenti
s nasilnim OKP-om mogu pokazati otpor prema terapijskim tehnikama, posebno terapiji izlaganjem s prevencijom
odgovora (ERP) i promjeni kompulzivnih ponašanja. Terapeuti moraju biti spremni da se suoče s ovim otporom i razvi-
ju strategije za postepeno motivisanje klijenta. Nerijetko i terapeuti imaju otpor ka korištenju ERP-a vjerujući da klijen-
ti ne mogu tolerirati stresnost izlaganja, da bi mogli izgubiti kontroli u izravnom izlaganju strahovima, te da bi ERP vo-
dio prekidu terapije. Česta teškoća je i potreba za prilagođavanjem terapije - terapeuti moraju biti fleksibilni i kreativni
u prilagođavanju pristupa kako bi odgovarali individualnim potrebama klijenta i zadržali ga u procesu. Razumijevanje
kompleksnosti nasilnog OKP-a i potreba pravovremenog korištenja odgovarajućih terapijskih tehnika kao što su kog-
nitivna restrukturacija, izlaganje sa prevencijom odgovora i tehnike relaksacije, zahtijeva visoku stručnost, iskustvo i
vještinu terapeuta. Održavanje granica između profesionalnog angažmana i spostvenih potreba - samozbrinjavanje i
očuvanje mentalne i emocionalne dobrobiti ključni su za dugoročnu sposobnost pružanja podrške klijentima.

Ključne reči
Nasilni OKP, učinkovitost KBT, poteškoće u provođenju KBT, ERP, KBT

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Open Paper Symposium 1 - Approaches to interventions 1
Chair: Vinicius Jobim Fischer, Centre Hospitalier Neuro-psychiatrique (CHNP), Luxembourg

• Combining Motivational Interviewing with TEAM-CBT: Leading with the patient’s ambivalence
Yehuda Bar Shalom, Ramat Gan Academic College, Israel

Abstract
There is ample evidence demonstrating the advantages of combining Motivational Interviewing (MI) with Cogni-
tive-Behavioral Therapy (CBT) (e.g., Allot & Earnshaw, 2007; Naar-King et al., 2013; Earnshaw, 2020; Westra & Norou-
zian, 2018), with promising results: improving treatment outcomes (e.g., Westra et al., 2009; Westra & Dozois, 2006),
greater homework adherence ( Westra et al., 2009; Westra & Dozois, 2006), and decreased resistance during the ther-
apy (Aviram & Westra, 2011).
Spuriously, little attention has been paid to comparing their position to an ambivalence issue in therapy. The patient’s
ambivalence toward change is a critical issue in therapy when he or she is adhering to the status quo and does not
make the necessary change. The ambivalence explanation for this circumstance is the existence of confronting wishes
to do and not to do the change simultaneously.
Where there is in-depth discussion on the patient’s ambivalence on the MI approach alongside specific strategies and
theory, there is room for more discussion on this issue in CBT, specifically when considering the combination with MI.
Both therapies have the assumption that people are more persuaded by their own arguments in favor of change than
by the therapist’s statements. However, each one of the therapies suggests different ways to achieve this goal and
resolve the ambivalence. In the current presentation we will focus on comparing MI with TEAM-CBT.
Understanding the unique attitude toward ambivalence and the similarities between MI and TEAM-CBT contributes
to expanding the theoretical background of the successful integration of MI with CBT. Moreover, the comparison
might help therapists to solve the patient’s ambivalence effectively by adopting the most relevant strategies from
both theories. The 1st part of the presentation will describe the concept and strategies for resolving ambivalence in
the MI approach and the 3 main ways of integrating MI with CBT. The second part will introduce the TEAM-CBT atti-
tude and strategies toward ambivalence. The third and last part of the presentation will analyze the similarities and
differences between these two approaches. Also, a practical and theoretical implication of the combination will be
discussed.

Keywords
Motivation, TEAM CBT, Motivational Interviewing

• Autism and Difficulties in Social Situations - Implications for CBT

Asdis Bergthorsdottir, Iceland

Abstract
Many autistic individuals are diagnosed with social anxiety. A meta-analysis (Hollocks et al., 2019) reported a cur-
rent prevalence of social anxiety of 29% for autistic people. The front-line therapy for social anxiety is cognitive be-
havioural therapy (CBT). CBT models for social anxiety are well established, e.g. Clark & Wells (1995). These models fail
to account for the fact that autistic people experience the world and process information differently from non-autistic
people. Autistic people commonly experience sensory challenges and have difficulties engaging in small talk. They
also often have slow processing speed, making it difficult to follow conversations and significantly impacting their
ability to engage in group communication.
Moreover, many autistic individuals are often unaware of these challenges and hold the belief that their social capa-
bilities should be of the same kind as those of non-autistic individuals. This belief is also frequently held by therapists,
meaning that the exposure part of social anxiety therapy for autistic people often involves sending autistic individu-
als into situations which are not autistic-friendly and have not been carefully selected for the individual. This means
that the chances that the autistic individual will fail are high. This presumption that autistic people can function in
the same way as non-autistic people in social situations also affects the cognitive part of CBT because autistic clients
are not taught to think about social situations in a more autistic way. CBT for social anxiety generally involves trying
to convince autistic clients that social situations are not dangerous instead of determining if it is autism-friendly and
how that can be modified.
By changing CBT therapy to make autistic clients more aware of what sort of situations suit them and to change their
underlying beliefs that there is only one way to socialize. This talk will focus on the cognitive difficulties of autistic
people in everyday social situations, what social situations are more suited to their needs, how autistic people can try
to make social situations more autism-friendly and why it can be challenging to transition from a non-autistic way to
an autistic way of socializing.

Keywords
autism

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• Chronic Night Terrors Comorbid with Somnambulism in Adult - A Case Report of CBT Treatment
Ivan Zečević, Nastavni zavod za javno zdravstvo dr. Andrija Štampar, Croatia
Krešimir Radić, Clinic for Psychiatry Vrapče, Croatia

Abstract
There are currently no psychological of pharmacological treatment guidelines for treatment of night terrors and som-
nambulism in adults. Night terrors and somnambulism are rare disorders in adult population, and most frequently are
accompanied by other psychopathological phenomena. Additionally, some pharmacological treatment option can
produce more frequent and more intensive problems with sleeping. There are come cognitive-behavioral interven-
tions that showed promise but they were researched only in young children. This case representation aims to explore
how effective would be to use different cognitive-behavioral approach interventions to this problems. The patient
was 31-year old white male with chronic problems who visited somnologist and psychiatrist for treatment options.
Treatment plan included psychoeducation about night terrors and somnambulism to patient and his wife, behavioral
management of wife’s behavior toward husbands problems, sleep hygiene and stimulus control, and mindfulness
training combined with progressive muscle relaxation. The results showed complete reduction of night terrors and
reduction of sleepwalking by 87%. The treatment was considered successful.

Keywords
night terrors; somnambulism; sleeping problems; mindfulness; cognitive-behavioral therapy

• Transdiagnostic approach to sex therapy: an internet-based emotion regulation training and sexual health
Vinicius Jobim Fischer, Centre Hospitalier Neuro-psychiatrique (CHNP), Luxembourg
Maila Rossato Holz, Conectare Neuropsi, Porto Alegre, Brazil, Brazil
Joël Billieux, Institute of Psychology, University of Lausanne, Lausanne, Switzerland, Switzerland
Gerhard Andersson, Department of Behavioural Science and Learning, Linköping University; Department of Clinical
Neuroscience Karolinska Institute, Sweden
Claus Vögele, Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of
Luxembourg, Esch-sur-Alzette, Luxembourg, Luxembourg

Abstract
Emotional regulation (ER) skills are essential for sexual function as they influence emotional awareness and expres-
sion during sexual activities, impacting satisfaction and distress. Interventions aimed at improving emotion regula-
tion could be promising for enhancing sexual health. Internet-based ER interventions might be a viable therapeutic
strategy for individuals with sexual health concerns. However, there is a notable lack of intervention trials exploring
their effects in this context, particularly those utilizing the internet.
Objective:
This study aims to evaluate the impact of a Internet-based emotion regulation training program on sexual function
in both men and women.
Methods:
Participants with self-reported sexual problems were recruited, defined for men by a score of less than 25 on the Inter-
national Index of Erectile Function (IIEF) and for women by a score below 26.55 on the Female Sexual Function Index
(FSFI). The study included 60 participants who were randomly assigned to either the web-based emotion regulation
training for sexual function or a waitlist control group. The intervention consisted of an 8-week web-based emotion
regulation training program. Assessments were conducted at baseline, post-intervention, and at a 3-month follow-up.
The modules encompassed: psychoeducation on sexual function, psychoeducation on emotion and emotion regu-
lation, breathing and muscle relaxation techniques, cognitive flexibility, self-acceptance and compassion, emotional
analysis and sexual emotional exposures.
Results:
The low adherence rate limits the generalizability of the findings. Among completers, large-to-moderate within-group
effect sizes were observed between assessment points for measures of emotion regulation, depression, lubrication,
orgasm, thoughts of sexual failure, and abuse during sexual activity.

Keywords
emotion regulation; internet; sexual health; psychosexual intervention; internet-based

• Cognitive Behavioural Therapy and Dreaming: Aaron Back’s path to understanding and applying dream con-
tent in CBT therapy. Beliefs and Attitude towards Dreaming in Bulgarian population
Krista Peneva, Master of Clinical Psychology, Bulgaria
Irina Lazarova, Bulgarian Association for Cognitive-Behavioral Psychotherapy, Bulgaria
Abstract

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Cognitive behavioral therapy (CBT) is a widely recognized and effective treatment for a variety of mental disorders,
including anxiety, depression, and post-traumatic stress disorder. Various studies have explored how dream content
can be used in cognitive behavioral therapy work and influence therapy outcomes.
Aaron Beck, the founder of Cognitive Behavioral Therapy, made significant contributions to the understanding and
application of dreaming within this therapeutic framework. Initially trained in psychoanalysis, Beck shifted his focus
towards cognitive processes after empirical research failed to support psychoanalytic theories about depression.
Regarding dreaming, Beck takes a different approach from traditional psychoanalytic interpretations. Instead of fo-
cusing on hidden meanings and unconscious desires, he sees dreams as reflecting maladaptive thought patterns.
Beck suggests that dreams may mirror the same cognitive processes that people experience while awake. There-
fore, analyzing dreams can provide insight into these patterns and assist in identifying and restructuring problematic
thinking that leads to emotional distress.
In CBT, dreams are sometimes explored to uncover negative beliefs and cognitive distortions that influence a patient’s
mental health. This approach is consistent with Beck’s broader therapeutic goals: helping patients recognize, ques-
tion, and modify their negative thoughts to improve their emotional and psychological well-being
The article presents data collected from the Bulgarian population regarding beliefs and attitudes towards dreaming.
311 people were asked to complete a questionnaire assessing beliefs about sleep, dreams, and their content. Initial
analysis and summary of the results are also presented.
The Beliefs about Dreams Questionnaire (BADQ) focusses on five major factors: Dream Omen and Health, Dream
Superstition, Dream Meaninglessness, Dream Reality and Dream Attitude. Initial analysis and summary of the data
are presented. In addition, ideas for the application of dream content will be discussed in the context of CBT case
conceptualization and the therapeutical work in general.

Keywords
dream content, dreaming, cognitive behavioural therapy, dream attitude, case conceptualization

• Balancing Hope and Hurdles: Cognitive Reappraisal as Part of Process- Based Treatment for Misophonia – RCT
Findings
Marta Siepsiak, Faculty of Psychology, Univeristy of Warsaw, Poland
Anna Turek, Faculty of Psychology, University of Warsaw, Poland
Andrzej Śliwerski, Institute of Psychology, University of Łodz, Poland
Kamila Grochowska, Faculty of Psychology, Univeristy of Warsaw, Poland
Weronika Araszkiewicz, Faculty of Psychology, Univeristy of Warsaw, Poland

Abstract
Introduction
Misophonia is a type of decreased tolerance to specific, often quiet and repetitive sounds such as chewing, breathing,
or tapping (Swedo et al., 2022). Although this disorder is not officially included in diagnostic classifications, studies
worldwide suggest that misophonia cannot be explained by symptoms of other disorders. The prevalence of miso-
phonia in the general population ranges from 4-5% to 20%, depending on the inclusion of non-clinical levels of
symptom severity. Cognitive-behavioral therapy is the most researched and promising therapy for misophonia, with
cognitive reappraisal (CR) being a commonly used technique.
The intervention in the discussed study is based on a process-oriented approach, testing one technique at a time,
previously validated in basic research, within the context of multiple factors such as health, emotional and cognitive
functioning, social support, and therapeutic relationships. Preliminary data from the main study, which is ongoing
and includes a control group, will be presented at the conference. The following sections describe selected data from
the pilot study.
Methodology
Twenty-three participants completed the pilot study (the main study will include a separate group of 108 partici-
pants). In the pilot study, data from the PHQ-9, GAD-7, and S-Five were collected at three time points: twice before
treatment and 7-10 days after the last treatment session. In the main study, a control group receiving relaxation
training allows for more rigorous pre- and post-treatment assessments. Misophonia symptoms, psychiatric, and per-
sonality disorders were assessed through semi-structured interviews, as well as cognitive and audiological tests, and
multiple psychological questionnaires.
The treatment consisted of four weekly sessions. The first session was a 90-minute online group session focused on
psychoeducation related to CR and increasing motivation (controls received Schultz’s Autogenic Training). This was
followed by three weekly individual 30-minute sessions tailored to each participant’s needs, such as finding the op-
timal time for CR implementation, the most accessible situations, and the most acceptable types of reappraisals, as
well as reinforcing motivation to use CR (controls had the same structure but with relaxation training). All sessions
were audio-recorded and analyzed to ensure protocol adherence. After completing the study, volunteering partici-
pants took part in additional audio-recorded sessions to discuss the most and least valuable aspects of the study and
potential adverse effects.

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Results
There was a significant decrease in misophonia symptoms post-treatment. The impact of misophonia, as measured by
the S-Five scale, significantly decreased (p < .001; partial eta-squared = .41). Eighteen participants (78%) experienced
at least a 10% reduction in symptoms, while three had no change, and two experienced a worsening of symptoms.
Qualitative analysis suggested that meeting others with the same disorder was also beneficial.
Conclusions
The primary results indicate that CR is a promising intervention for misophonia. However, factors influencing these
results need to be further identified. Results from the ongoing randomized controlled trial (RCT) will be presented at
the conference, in addition to the pilot study results.

Keywords
misophonia, process-based therapy, cognitive reappraisal, RCT

Open Paper Symposium 2 – Assessment

Chair: Nele Jacobs, FARESA Evidence-Based Psychological Centre, Hasselt, Belgium; VUB - Brussels School of Gover-
nance - Pleinlaan 2, 1050 Brussels, Belgium

• Development and Preliminary Validation of a Self-Report Scale, Metacognitive Questionnaire for Social Anx-
iety Disorder
Emre Unal, Sağlık Bilimleri Üniversitesi, Ankara Etlik City Hospital, Department of Psychiatry, Turkey
Kadir Özdel, Sağlık Bilimleri Üniversitesi, Ankara Etlik City Hospital, Department of Psychiatry, Turkey

Abstract
Social Anxiety Disorder (SAD) is a psychiatric disorder characterised by excessive fear of social situations, such as en-
gaging in social interactions, being observed, and performing in front of others.SAD is a relatively common disorder in
Western cultures, with lifetime prevalence ranging from 4.4% in Europe to 12.1% in the USA. The understanding of SAD
has been enhanced by cognitive models that enable its effective conceptualisation and treatment (Clark&Wells,1995;
Rapee&Heimberg,1997). One similarity between these models is the focus on cognitive aspects of self-knowledge,
such as beliefs about the social self(social beliefs) and cognitive processes(e.g., worry and rumination-like processes
and self-focused attention). However, another dimension of self-knowledge, metacognitive beliefs (i.e., beliefs about
one’s thinking), seems to have been neglected (Wells&Matthews,1994).
The ability to measure metacognitive beliefs/processes specific to SAD is still lacking.
With the development of such a questionnaire, research can begin to better understand the underlying relationships
between SAD-specific metacognitive beliefs and related factors (e.g. anticipatory anxiety-processing, post-event ru-
mination) and SAD, and also help therapists and clients to better understand the underlying relationships between
effective metacognitive beliefs.
Our research consists of 6 study. The first 3 studies of the research have been completed and the results will be pre-
sented at the congress.
a) In the first study, the items of the questionnaire to be applied to the sample were created. The questionnaire con-
sists of 27 combinations including 3-temporal(anticipatory, in situation, postevent) dimensions, 3-Cognitive Attention
Syndrome dimensions(threat monitoring, maladaptive coping behaviour, rumination/worry) and 3-Metacognitive di-
mensions(positive beliefs, uncontrollability, danger).While creating this questionnaire; four sources of information
were utilised;
-Current Metacognitive Questionnaire MCQ-30 (Wells&Cartwright-Hatton, 2004)
-Expert opinions in the field of metacognitive therapy;
-Knowledge of the existing literature in the field of SAD and Metacognition;
-Semi-structured interviews with patients diagnosed with SAD(N:40) and information about metacognitions in the
therapy notes of patients diagnosed with SAD who underwent CBT in the past.
The opinions of MCT experts about the item pool were taken and corrections, additions and extractions were made
in the items in line with the suggestions.Based on the information collected, 82 items concerned with metacognitive
beliefs specific to SAD were generated.
b) In the second study; the first questionnaire was applied to a sample of N: 865 undergraduate and graduate stu-
dents via the internet and social media, and the results obtained were evaluated in an exploratory factor analysis.
Principal components factor extraction method was applied on these data. The item pool was revised as a few items
loaded on more than one factor. These redundant items, and those which loaded less than a conservative 0.40 on
their factor were discarded. The obtained questionnaire proposed an 8-factor structure in the scree test. New version
of the questionnaire was obtained. The variance of the questionnaire was calculated as 64,99%.
b) In the third study; in order to determine the reliability of the obtained factor structure, the final version of the
questionnaire was applied to a new sample consisting of N: 1810 undergraduate and graduate students via internet

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and social media and confirmatory factor analysis was performed. According to the results of the confirmatory factor
analysis, the validity of the 8-factor structure was confirmed.

Keywords
Social Anxiety Disorder, Metacognition, Development and Preliminary Validation of Questionnaire

• Exploring the Feasibility of the Experience Sampling Method (ESM) for Blended Care – a Co-Creation Ap-
proach Including Individuals with Varying Levels of Mental Health Complaints
Veerle Ross, UHasselt - School of Transportation Sciences - Transportation Research Institute (IMOB) - Martelarenlaan
42, 3500 Hasselt, Belgium; FARESA Evidence-Based Psychological Centre, Hasselt, Belgium
Nele Jacobs, FARESA Evidence-Based Psychological Centre, Hasselt, Belgium; VUB - Brussels School of Governance -
Pleinlaan 2, 1050 Brussels, Belgium
Sukhveer Singh, UHasselt – Faculty of Rehabilitation Sciences, REVAL - Rehabilitation Research Center, Agoralaan,
3590 Diepenbeek, Belgium
Naomi Daniëls, Orato, Bilzen, Belgium; PXL University of Applied Sciences and Arts – Department PXL People & Soci-
ety, Vilderstraat 5, 3500, Hasselt, Belgium
Anne Neyskens, FARESA Evidence-Based Psychological Centre, Hasselt, Belgium; De Facto, Group Practice for Behav-
ioral Therapy and Psychological Counseling, Stationsstraat 32, 3800 Sint-Truiden, Belgium
Geert Wets, UHasselt - School of Transportation Sciences - Transportation Research Institute (IMOB) - Martelarenlaan
42, 3500 Hasselt, Belgium
Hélène Dirix, UHasselt - School of Transportation Sciences - Transportation Research Institute (IMOB) - Martelaren-
laan 42, 3500 Hasselt, Belgium
Kris Brijs, UHasselt - School of Transportation Sciences - Transportation Research Institute (IMOB) - Martelarenlaan 42,
3500 Hasselt, Belgium

Abstract
Introduction: Behavioral therapy is advancing with real-time monitoring techniques like the Experience Sampling
Method (ESM). ESM captures momentary experiences by collecting real-time data on behaviors, thoughts, and feel-
ings through repeated assessments. However, the frequent questionnaires may burden clients, especially those with
mental health issues. This study explores ESM’s practical applicability across diverse mental health profiles. By under-
standing users’ experiences and opinions, we aim to find strategies to reduce burdens and optimize ESM’s integration
into therapy and blended care.
Methods: This study, approved by the UHasselt Committee for Medical Ethics (CME2023/066), involves ongoing re-
cruitment that should ensure a mix of mental health complaints. Initially, five UHasselt students completed ESM ques-
tions for one month, likely representing milder or no mental health issues. Currently, clients undergoing therapy for
depression and their therapists are being recruited at Faresa, aiming for 10 more participants. Therapists will review
the ESM responses with clients post-data collection. The Patient Health Questionnaire (PHQ-9) assesses participants’
mental health status.
The m-Path tool, developed by KULeuven, administers ESM questionnaires. Participants receive ten questionnaires
daily, categorized into morning, daytime, and evening, distributed randomly within two-hour intervals from 8 AM to
8 PM. Example items include: “What am I doing?”, “I feel anxious”, and “How long did I lie awake this morning before
getting up?”. Responses use a 7-point Likert scale or multiple choice. Each questionnaire contains 3 to 21 items and
takes about one minute to complete once participants are familiar with them.
At the end of the ESM period, all participants (students, clients, and their therapists) complete a 60-minute semi-struc-
tured interview to share their viewpoints on ESM’s applicability. Example questions are: “Did completing the question-
naire provide you with useful insights?”, “To what extent has the app made your communication with clients more
convenient?”.
Results and discussion: The participating students (mean age: 31.2, 1 female, PHQ ranging from minimal to moderate
depressive symptoms) were generally positive about ESM. They felt it fostered self-reflection and provided insight
into their feelings, though completing the questionnaires for a month was challenging. They suggested allowing for
modifications, such as adding open- or closed-end questions and reviewing the questionnaires beforehand to ensure
clarity. While they had no issues with the frequency, they preferred the option to complete questionnaires later, which
contradicts the goal of momentary assessment. Results for clients and their therapists will follow. To avoid burdening
clients, the study duration was reduced to a minimum of two weeks, depending on the interval between therapy
sessions. We anticipate ESM will help both clients and therapists gain better insights into clients’ affect and behavior,
though this needs confirmation from the data.
Conclusion: This abstract concerns an ongoing qualitative study. Initial results are positive, but increasing user input
will be necessary to boost motivation. Ultimately, this study will offer crucial insights into the practical usability of
ESM, providing perspectives from individuals with diverse mental health statuses.

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Keywords
Behavioral Therapy, Real-time monitoring, Experience Sampling Method (ESM), Mental Health, Depression, Feasibility
Study

• Development and Validation of the Schedule for the Assessment of Insight in Anxiety Disorders (SAI-A)
Asala Halaj, University College London1, Israel
Anthony David, University College London, United Kingdom
Jonathan Huppert, The Hebrew University of Jerusalem, Israel

Abstract
Introduction:Insight, the awareness and understanding of one’s mental disorder plays a significant role in character-
izing various psychological disorders. While much research on insight has focused on psychosis,there is a growing
interest in understanding insight or illness awareness in anxiety, often assessed by instruments designed for psycho-
sis. However, the unique features of anxiety highlight the need for tailored measures to accurately evaluate insight.
Recognizing the limitations of existing measures, we developed the Schedule for the Assessment of Insight in Anxiety
(SAI-A), a clinician-rated scale for assessing insight in anxiety disorders.The SAI-Aaims to capture insight’s unique
characteristics and address the complexities of assessing it in anxiety disorders.
Methods:We interviewed 46 participants diagnosed with anxiety disorders, conducted SAI-A interviews, and admin-
istered self-report measures of insight and symptoms. Using correlation and principal component analysis, we identi-
fied and assessed scale components, assessing their reliability and consistency.
Results:The SAI-A demonstrated good psychometric properties, including convergent validity with an established
self-report measure (r= -0.39, p= 0.008) and internal consistency (Cronbach’s alpha = 0.70). It showed moderate inter-
rater reliability (weighted kappa = 0.53, ICC = 0.67), and strong test-retest reliability (ICC = 0.65). Two distinct insight
components emerged: awareness of disorder and need for treatment. Higher overall SAI-A scores correlated with
symptom severity and impairment (r= 0.56, r= 0.51, p< 0.001) and medication usage.
Discussion:We developed and validated a new interviewer rating scale for insight in anxiety, the SAI-A, while examin-
ing the relationships between insight levels, anxiety symptoms, and demographic characteristics in anxiety disorders.
Higher overall SAI-A scores correlated with symptom severity and impairment. This correlation is unlike psychosis,
where insight is typically inversely correlated with symptom severity. This presents a challenge in using insight im-
provement as a treatment goal, as changes might not reflect improvement in anxiety symptoms. SAI-A total score
correlated with medication usage but not with other demographic characteristics, suggestingthat individuals with
higher levels of insight are more likely to use medications.
Conclusion:The SAI-A is a valid and reliable assessment tool, offering a comprehensive framework for understanding
and addressing insight in the context of anxiety disorders. This new assessment tool bridges existing research gaps
and offers a tailored approach to assessing insight, with the goal to improve clinical understanding for those facing
these challenges.

Keywords
Insight into illness; illness awareness; denial of mental disorder; need for treatment; anxiety disorders

• A Unidimensional Consensus? Evaluating the Serbian NN-11 Scale’s Approach to Intolerance of Uncertainty
through Network Analysis
Nikola Goljović, Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Goran Bogdanović, Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia

Abstract
Intolerance of Uncertainty (IU) is a pivotal construct in understanding anxiety, integral to both clinical and therapeutic
contexts, particularly in CBT. In Serbia, the IU-11 scale is extensively utilized for evaluating IU. Recent scholarly con-
tributions have questioned the traditional bipartite division of IU into inhibitory and prospective types, proposing
instead either a unidimensional or a more complex three-dimensional approach. This shift suggests a need for a
comprehensive reassessment of the IU construct through advanced methodologies. This study aims to undertake a
comparative analysis employing CFA and network analysis to evaluate these suggested dimensional structures of IU
using the Serbian NN-11 scale (which is slightly different from the short scale in English) on a non-clinical sample, thus
aiming to refine the understanding of its internal structure.
The study utilized a cross-sectional design with a non-clinical sample of 478 adults. Participants completed the Ser-
bian version of the NN-11 scale. The CFA was used to test the fit of the unidimensional, bidimensional, and three-di-
mensional models of IU as proposed in recent studies. Network analysis using Gaussian Graphical Models (GGM) with
LASSO regularization was performed to examine the inter-item relationships and to identify central nodes within the
IU construct, providing a visualization of the direct interactions between scale items. Additionally, when assessing
the strength of connections within the differently colored models based on previous findings, the two-factor solu-

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tion exhibited a better fit than the three-factor solution. However, it still failed to achieve ideal segregation among
the communities. This observation suggests that while there are some indicators of multidimensional attributes, the
distinctions are not robust enough to categorically separate the IU construct into independent factors. In essence,
the extensive inter-item connectivity revealed by the network analysis largely supports a unidimensional model of
Intolerance of Uncertainty, indicating a cohesive construct rather than distinct separable elements.
The results from this study illuminate the complexities inherent in the measurement of IU. While the CFA strongly
supports a unidimensional approach, the network analysis introduces nuanced insights that challenge a straightfor-
ward interpretation. The identification of three thematic communities within the IU construct highlights the multi-
dimensional potential of the construct, yet the significant interconnectedness across these communities supports
the dominance of a unified dimension. This suggests that the IU construct, as measured by the Serbian NN-11 scale,
encompasses a spectrum of related anxieties that are not entirely discrete, thereby supporting the practicality and
applicability of a unidimensional model for assessing IU in non-clinical settings.

Keywords
Intolerance of Uncertainty, Network Analysis, CFA, Serbian Short IU Scale, NN-11 scale

• The Test Related Negative Cognitions Scale: A key piece of the puzzle in understanding the relationship be-
tween test anxiety and psychological resources
Ercan Akın, Hacettepe University, Department of Guidance and Psychological Counseling, Turkey
Türkan Doğan, Hacettepe University, Department of Guidance and Psychological Counseling, Turkey
Eyüp Sabır Biçer, Hacettepe University, Department of Guidance and Psychological Counseling, Turkey
Nilüfer Koçtürk, Hacettepe University, Department of Guidance and Psychological Counseling, Turkey
Duygu Betül Özkanca, Bahçeşehir University, Department of Guidance and Psychological Counseling, Turkey
Elif Özüm Kuş, Halic University, Department of Clinical Psychology, Turkey
Cemile Dur Öztürk, Hacettepe University, Department of Guidance and Psychological Counseling, Turkey
M. Furkan Kurnaz, Hacettepe University, Department of Guidance and Psychological Counseling, Turkey

Abstract
Introduction: While students with sufficient resources are expected to have positive beliefs about their capacity to
effectively manage a challenging exam scenario, according to the cognitive-behavioral model, negative cognitions
are a key component in test anxiety. However, few studies have measured negative thinking directly. In this regard, we
aimed to develop a valid and reliable scale to evaluate adolescents’ negative cognitions about the exam (Study I) and
to examine whether these negative cognitions mediate the relationship between psychological resources (self-es-
teem and resilience) and test anxiety (Study II).
Method: Ten steps in scale development and reporting, as described by Carpenter (2018), were followed in the report.
In Study I, we examined the reliability and Exploratory Factor Analysis (EFA) results of the TRNCS with R version 4.2.2.
We included 446 students from various high schools. In Study II, the internal structure of the TRNCS was assessed by
CFA using maximum likelihood estimation in Mplus 8.8. Study II consisted of 466 high school students. Reliability was
also calculated with different coefficients in R version 4.2.2. The mediating role of test-related negative cognitions in
the relationships between resilience with Brief Resilience Scale, self-esteem with Two-Dimensional Self-Esteem, and
test anxiety with Test Anxiety Inventory was examined in Mplus 8.8.
Results: In Study I, 15 items explained 68% of the total variance. In Study II, the CFA revealed that the items fit with
four factors, and the model indicated a perfect model fit with the 15-item TRNCS. TRNCS total score was positively
correlated with TAI and negatively correlated with the BRS and TDSE. The reliabilities of the 15-item TRNCS with four
factors were highly acceptable. The negative cognitions mediated the relationships between resilience, self-esteem,
and both worry and emotionality dimensions of test anxiety.
Discussion: TRNCS is a valid and reliable scale to assess negative cognitions related to testing, and it consists of four
subscales: Performance deficit, social consequences, distraction, and catastrophizing failure. Overall, this study iden-
tified that individuals suffering from test anxiety may form negative beliefs about themselves, others, the future,
and the examination itself. The content of negative cognitions may vary in students with test anxiety, similar to the
cognitive triad included in the CBT’s theoretical explanation of depression, and test-related negative cognitions are
also encompassed.
Conclusion: TRNCS enables the identification of the domains in which students form negative cognitions and the
specific content of these cognitions. Consequently, TRNCS may inform the design of targeted interventions and be
a valuable tool for clinicians to identify these negative thoughts. Ultimately, the results proposed that the negative
influence of negative test-related cognitions on test anxiety can be decreased with interventions aimed at enhancing
resilience and self-esteem.

Keywords
Test anxiety, negative cognitions, adolescent, dysfunctional thinking

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• Measure of psychological inflexibility in romantic relationships: The romantic relationships acceptance and
action questionnaire
Ruveyda Yegen, Department of Psychological Counseling and Guidance, Gaziantep University, Gaziantep, Turkey
Bayram Cetin, Gaziantep University, Turkey

Abstract
This study aims to develop the romantic relationships acceptance and action questionnaire and conduct validity
and reliability studies to measure psychological inflexibility in romantic relationships. Acceptance and Commitment
Therapy (ACT), assumes that painful events that people encounter in their lives are a part of life. Acceptance is allow-
ing these feelings and thoughts to come to one’s mind without struggling with unwanted and disturbing feelings
and thoughts that are going through one’s mind at the present moment, instead of trying to change them or acting
according to feelings and thoughts. Making a choice is defined as making choices towards the life one wants to live.
Taking action, on the other hand, is defined as taking decisive actions to change one’s behaviour in order to achieve
the goals determined in relation to one’s values. The combination of these concepts is expressed as psychological
flexibility. There are many scales measuring psychological inflexibility in the literature. Some of them are Acceptance
and Action Questionnaire (AAQ), Acceptance and Action Diabetes Questionnaire, Body Image AAQ, Social Anxiety
AAQ. However, no scale measuring this construct for couples was found. It has been observed that psychological in-
flexibility in romantic relationships has been examined using scales that give the individual’s individual psychological
inflexibility level, and it was thought that there was a need for such a scale in the context of romantic relationships
in the literature. In this study, a four-point Likert-type acceptance and action in romantic relationships questionnaire
developed in Turkish will be presented. In this context, firstly, the relevant literature was reviewed in detail and an
item pool of 41 items was created. An expert opinion form was prepared and the opinions of 6 experts who have
at least a PhD degree in Guidance and Psychological Counseling and have studies on ACT or romantic relationships
were obtained. The expert opinions were analyzed to determine the content validity ratio for each item and the items
below 0.80 were removed from the scale. In addition, a panel was organized with an expert with at least a PhD degree
to discuss the scale items and items that were not suitable for the structure were removed from the scale. After these
steps, 27 items remained in the scale. According to the results of the Exploratory Factor Analysis, the KMO value was
determined as .82 and Bartlett’s test was found to be statistically significant (χ2=1364.4, sd=171, p<.01). Items with
factor loadings below .45 were removed from the scale. As a result, 7 items were removed from the initial 27-item
scale and a 19-item scale was obtained.2-factor structure (acceptance and action) was obtained as a result of direct
oblimin-oblique rotation performed during the EFA process. The factors explained 37% of the total variance of the
scale. The internal consistency coefficient for the final version of the 19-item scale was determined as .82. These results
are preliminary findings and the research process will continue.

Keywords
romantic relationships, psychological inflexibility, acceptance, couples, questionnaire

Open Paper Symposium 3 – Training & supervision

Chair: Ivana Peruničić-Mladenović, University of Belgrade, Faculty of Philosophy, Department of Psychology, Serbia

• Personal growth and development of psychotherapist in psychotherapy

Milja Krivokuća, Center for protection and growth of psychological health, Serbia

Abstract
Personal growth and development in psychotherapy is something to which we would all agree with common sense
that it is a self-evident process. In most areas of psychotherapy, the focus of research is on change in the client and the
effectiveness of techniques and approaches. So the process of changing psychotherapist itself remains insufficiently
empirically and systematically examined. It should be borne in mind that the complete response to the change, and
personal growth and development of therapists, it is possible to examine precisely within the framework of longitudi-
nal studies. In our work, we relied on the subjective assessment and experience of the therapist himself, which is ac-
tually relevant. As with clients, in addition to monitoring the tendency to reduce some symptoms or change behavior,
the subjective experience and feeling of personal gain is also important. As the existentialists, experimentalists and
phenomenologists such as Jourard (1964), Mullan & Sanguiliano (1960), Perls (1965) pointed out, the therapist must
be reflective and self-aware in order to achieve an authentic relationship with the client, be who he is and achieve
his full of not only professional but also personal potential. Of course, the stated point of view is partly questionable,
because the therapist-client relationship is professional and takes place in a specific context. In order to realize this
research, we constructed a special questionnaire. The sample of respondents included 202 psychotherapists, includ-
ing psychotherapists under supervision. The most important results indicate that 56.4% of respondents experienced
personal growth and development through psychotherapy work with others. In 38.3%, this happened through spon-
taneous self-insights. It is significant that 72.3% of respondents solved really important problems through hours of

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personal work, but also that 83.9% learned how to work with clients through personal work. As many as 80.6% believe
that their personal difficulties contributed significantly to their professional performance. Therefore, the main con-
clusions of the work are that the personal change of the therapist happens most often spontaneously, as well as that
personal work is very important for the improvement of personal and professional skills. We would like to point out
that the majority of those surveyed also emphasize their personal psychotherapy during education as important for
personal growth and development, which speaks in favor of the fact that it is not only necessary, but also evaluated
as useful in many ways.

Keywords
Personal growth and development of psychoterapist

• Deliberate Practice in CBT Therapist Development

Kamila Grochowska, Faculty of Psychology, Univeristy of Warsaw, Poland

Abstract
Cognitive Behavioral Therapy (CBT) is a highly effective therapeutic approach, but its efficacy hinges on the therapist’s
skill. Deliberate practice, a structured and purposeful method of skill enhancement, is essential for CBT practitioners
aiming to improve their therapeutic abilities. This presentation explores the concept of deliberate practice in the
context of CBT, highlighting its role in honing specific skills such as cognitive restructuring, behavioral activation, and
empathy. Deliberate practice involves setting targeted goals, obtaining immediate feedback, and engaging in repet-
itive, focused exercises to refine techniques. We will discuss practical strategies for implementing deliberate practice,
including role-playing, supervision, and self-reflection. Additionally, we will examine the empirical evidence support-
ing its effectiveness in enhancing therapeutic competence and client outcomes. Attendees will gain insights into how
to integrate deliberate practice into their professional development routines, fostering continuous improvement and
ensuring high-quality care for their clients. By committing to deliberate practice, CBT therapists can enhance their
skills, adapt to new challenges, and ultimately provide more effective interventions, leading to better therapeutic
outcomes. This presentation aims to empower therapists with the tools and motivation to engage in ongoing skill
development through deliberate practice.

Keywords
Deliberate practice; competence; professional development

• Trainee Self-Appraisal of Therapeutic Skills in Managing Session Components

Zorica Marić, Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Ivana Peruničić-Mladenović, University of Belgrade, Faculty of Philosophy, Serbia

Abstract
Supervision is a cornerstone in psychotherapy education, vital in instilling professional therapeutic skills, ethics and
effectiveness among future therapists. Nevertheless, there is insufficient data and literature on trainee evaluation
of their progress in their therapeutic competencies in relation to the number of supervisory sessions they receive.
In response, this research examines the self-assessment of progress in developing therapeutic skills as a function of
time and the number of supervisory sessions attended. The sample consists of therapist trainees undergoing REBT
education. In the course of their education, they are required to complete four case studies of which one’s audio is
recorded. Following every case study, prior to receiving supervisory feedback, the trainees performed a self-eval-
uation on a questionnaire consisting of 28 items divided into three categories (general behavior of the therapist,
self-conception of the consolidation of the problem and therapeutic intervention and homework assigned). The gen-
eral results showed there to be statistically significant differences between the first and last self-evaluations in relation
to the majority of variables, thereby indicating that supervision is beneficial in building their therapeutic skills and
competencies. The strongest effect size was for those items where they assessed their therapeutic interventions and
homework, demonstrating that the number of supervisions received, the trainees noted that they attained significant
improvements in these areas. It may be concluded that stronger support lent to the supervision of burgeoning thera-
pists yield higher dividends in a return on increased competencies and effectiveness as therapists.

Key words
supervisions, trainee of psychotherapy, feedback, session, REBT

• Zooming into the unknown: a comparison of CBT teaching outcomes for online and in-person classes during
the pandemic
Emily Cooney, Otago University, New Zealand
Fiona Mathieson, Otago University, New Zealand
Tracey Barnfield, Otago University, New Zealand

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Abstract
The advent of the global COVID-19 pandemic heralded a rapid and unexpected shift from in-person to online delivery
of cognitive and behavioural therapies. Treatment outcomes associated with this transition have garnered global re-
search attention (Zandieh et al., 2024). However fewer studies have examined the CBT learning outcomes across these
two modes of delivery. Research has found no difference in learners’ satisfaction and ratings of didactic quality be-
tween asynchronous (e.g. on-demand) online versus in-person training (Soll et al., 2021), however information about
the relative merits of these two training modalities delivered in real-time for treatment adherence is relatively scant
(Valenstein-Mah et al., 2020). With notable exceptions (Baumann et al., 2023), evaluations of online psychotherapy
dissemination that have examined treatment fidelity have either been asynchronous or used comparison conditions
such as waitlist control/delayed training (Kobak et al., 2017), rather than comparing real-time in-person training with
real-time online training (Mallonee et al., 2018).
The current study is a pragmatic opportunistic non-randomised comparison of learning outcomes associated with
online vs in-person CBT training. The Department of Psychological Medicine at Otago University, Wellington, has been
offering two papers teaching CBT to allied mental health professionals for the past 25 years. The course deploys multi-
ple methods of evaluation, including supervisor and supervisee ratings scales of competence, evaluation of students’
written case summaries of CBT formulations and treatment plans, ratings of students’ cognitive behavioural therapy
session recordings for adherence using the revised cognitive therapy scale (CTS-R: (Blackburn et al., 2001), and auto-
mated academic course evaluations assessing satisfaction ratings of the course faculty, content, and delivery. Follow-
ing two years of reactive and erratic remote delivery induced by COVID-related lockdowns, in 2023, an online stream
of the course was offered in response to rising travel costs and the needs of students living in areas far from the two
main teaching locations.
The study examines outcomes for online versus in-person teaching for course evaluations and CTS-R scores. Study
strengths include the use of CBT adherence via ratings of session recordings as a dependent variable, and the natu-
ralistic real-life context. Limitations include the lack of random assignment and the number of covarying factors (e.g.
stress, infection, technology issues), which means that it is impossible to attribute outcome differences to delivery
modality alone. Regardless of these shortcomings, the results highlight an important area of enquiry for the future
dissemination of CBT in an unpredictable world.

Keywords
Dissemination, training methods

• Indicators of Ineffectiveness in Clinical Supervision

Alba Luque González, Universidad Autónoma de Madrid, Spain
Diego Fernández-Regueras, Universidad Autónoma de Madrid, Spain
Ana Calero-Elvira, Universidad Autónoma de Madrid, Spain

Abstract
Clinical supervision is a crucial component in the training and development of professionals in the field of psychology.
In recent years, there has been much discussion about the importance of clinical supervision, but there is very little
empirical research supporting its effectiveness. This study, framed within the Evidence-Based Clinical Supervision
model proposed by Milne (2007), focuses on identifying signals and behaviors that can alert us to the ineffectiveness
of clinical supervision, with the aim of improving the quality and effectiveness of this process.The main objective of
this study is to identify specific behaviors and behavior sequences that indicate that clinical supervision is not being
useful and will not have a significant impact on the subsequent work of supervisees with their clients. Observational
methodology was used to analyze 100 supervision sessions and 200 therapy sessions at the Certer for Applied Psy-
chology of the Autonomous University of Madrid (CPA-UAM). The sessions were recorded, and the behaviors were
analyzed moment by moment using ‘The Observer XT’ software. This software allowed for the recording of the guide-
lines offered by supervisors and the evaluation of the extent to which these guidelines were followed by supervisees
in their therapy sessions. The results show that when behaviors are analyzed individually, there are no significant
differences in the compliance with guidelines in the therapy sessions by the supervisees. However, when studying the
sequences of behaviors, significant differences emerge. Specifically, certain sequences of behaviors by supervisors
and supervisees are associated with low compliance with guidelines in subsequent therapy sessions. These findings
suggest that it is not enough to observe behaviors in isolation; it is crucial to analyze the dynamics of interactions
to understand the effectiveness of clinical supervision. The sequences of behaviors that show significance in terms
of low compliance with guidelines provide important clues for improving clinical supervision. Identifying these se-
quences allows supervisors to adjust their strategies in real-time, thus increasing the likelihood that the guidelines
will be effectively implemented by supervisees in their therapeutic practice. This study highlights the importance of
a dynamic and sequential approach in the evaluation of clinical supervision, proposing new ways to optimize the
training of future professionals in psychology.

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Keywords
Clinical supervision; Behavioral sequences; Compliance with supervision guidelines; Observational methodology, Ev-
idence-Based Clinical Supervision

Open Paper Symposium 4 – Obsessive Compulsive Disorder

Chair: Borjanka Batinić, Department of Psychology, Faculty of Philosophy, Belgrade, Serbia

• The brain “locked in obsessive doubt” and cognitive-behavioral techniques for overcoming imagined danger
Borjanka Batinic, Department of Psychology, Faculty of Philosophy, Belgrade, Serbia

Abstract
Obsessive doubt is one of the fundamental symptoms of obsessive-compulsive disorder, more or less prominent
in different subtypes of the disorder making it a “doubt disorder.” That doubt is selective and aimed at ambiguous
aspects of self-identity, characterized by the persistent questioning of certainties or the assumption that anything
fundamental to a person’s value system, including oneself and hidden motives, is doubtful. It leads to checking com-
pulsions (one’s thoughts, emotions, behavior, the entire self, and the environment), seeking reassurance or avoiding
anxiogenic stimuli.
Obsessive doubt is hypothetical, beginning with intuition, and followed by imaginative mental actions and recon-
struction of a possible events. Checking compulsions lead to momentary relief, but also to the emergence of new
imaginative versions that require verification, leaving a person “stuck in doubt”.
The presentation discusses abnormal information processing resulting in “confusion of reasoning” and an inability to
break the vicious cycle of frightening uncertainty. Various therapeutic techniques from REBT, CBT, and IBA contexts
are presented to achieve the therapeutic goal of distancing oneself from doubt as irrelevant to the present moment.
Being able to tolerate uncertainty, as opposed to the unsuccessful resolution of doubt, is essential when addressing
the foundations of obsessive doubt.
Keywords
Obsessive-compulsive disorder, obsessive doubt, untolerance of uncertainty, treatment

• Obsessive-compulsive symptoms and sleep disturbance in youth

Omer Linkovski, Bar Ilan University, Ramat Gan, Israel, Israel
Denis Lissitsa, Bar-Ilan Univesity, Israel

Abstract
Background: Obsessive-compulsive symptoms (OCS) are common stressors across psychopathologies in youth. OCS
are associated with sleep disturbance and depression in adults, but there are conflicting results regarding OCS, sleep,
and depression in youth. The talk will present a study which tested whether sleep disturbance affects OCS and wheth-
er depressive symptoms moderate this association in a large community sample.
Methods: Using data from the Healthy Brain Network (HBN) project (n=3,508), we investigated the relationship be-
tween OCS and sleep disturbance, in a youth cohort aged 5-17. We examined differences in OCS between youth with
and without sleep disturbance. In addition, we examined how OCS is associated with sleep disturbance while ac-
counting for possible cofounders. Lastly, we used a mediation model to test whether depressive symptoms mediate
the association between OCS and sleep disturbance.
Results: Youth with sleep disturbance reported more severe OCS compared to youth without sleep disturbance. Fur-
thermore, the severity of sleep disturbance was associated with the severity of OCS and this relationship was only
partially mediated by depressive symptoms.
Conclusions: OCS are associated with sleep disturbance among youth and depressive symptoms only partially explain
this relationship, settling inconsistencies in the literature. Our findings stress the utility of assessing sleep disturbance
in youth and warrant studying the causal links between sleep disturbance and OCS

Keywords
Obsessive-compulsive symptoms, sleep, sleep disturbance, depressive symptoms; youth

• Predictors and mechanisms of exposure-based CBT in obsessive-compulsive disorder: the putative contribu-
tion of fear reversal learning
Benedikt Reuter, MSB Medical School Berlin, Germany
Jan Beucke, MSB Medical School Berlin, Germany
Norbert Kathmann, Humboldt-Universität zu Berlin, Germany
Björn Elsner, Humboldt-Universität zu Berlin, Germany

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Abstract
Background. Although exposure-based cognitive-behavioral therapy (CBT) is an effective first-line treatment of ob-
sessive-compulsive disorder, the conditions and mechanisms of successful treatment are not fully understood. In
particular, given the learning theory roots of exposure, there are surprisingly few studies on the relationship between
outcome of exposure-based CBT and psychophysiological parameters assessed in learning experiments. Of special
interest are Pavlovian fear conditioning experiments with a reversal of contingencies between threatening uncondi-
tioned and conditioned stimuli (fear reversal paradigm). In such experiments, better differentiation between condi-
tioned signals of threat and safety after reversal may indicate the ability to flexibly adapt to changing contingencies,
which is presumed to facilitate learning in exposure therapy.
Objectives. We present a study that investigated for the first time whether outcome of exposure-based CBT is pre-
dicted by parameters of acquisition and extinction of fear responses in a fear reversal experiment. It was expected
that better differentiation between signals of threat and safety after contingency reversal was associated with better
outcome of exposure-based CBT.
Methods. Thirty-two individuals with a primary diagnosis of OCD participated in a fear reversal experiment prior to
receiving individual cognitive-behavioral therapy with a focus on exposure and response prevention in an outpatient
setting. CBT outcome was measured using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). The first part of the
experiment consisted of presenting a picture of a face (CS+) together with an electrical stimulation (US) in one third of
the trials, while a second face (CS-) was never presented with the US (acquisition stage). During a subsequent reversal
stage, the formerly safe face was now paired with the US (new CS+) and the former CS+ was no longer coupled with
the US (new CS-). Skin conductance response (SCR) was measured as an indicator of the fear response, and regression
analysis was used to test whether SCR differences between threat and safety stimuli (CS+ vs. CS-) predicted outcome
of exposure-based CBT.
Results. Sixty-three percent of participants achieved remission (Y-BOCS score ≤ 12) during therapy, and average
Y-BOCS score reduced from M = 23.5 (SD = 6.1) pre-treatment to M = 10.2 (SD = 7.0) post-treatment. The SCR differ-
ence (CS+ vs. CS-) during late reversal predicted both symptom reduction and remission at post-treatment.
Discussion. Adaptive learning skills as indicated by experimental conditioning measures may contribute to success
in exposure-based CBT for OCD. The results are discussed in a broader framework of predictors and mechanisms of
exposure-based treatment of OCD.

Keywords
obsessive-compulsive disorder, exposure with response prevention, skin-conductance response, conditioning

• Treating OCD in 4 days: Bergen 4-Day Treatment versus gold standard CBT
Max Sannemalm, Karolinska Institutet, Sweden
Ekaterina Ivanova, Karolinska Institutet, Sweden
Robin Fondberg, Karolinska Institutet, Sweden
Oskar Flygare, Karolinska Institutet, Sweden
Erik Andersson, Karolinska Institutet, Sweden
David Mataix-Cols, Karolinska Institutet, Sweden
Volen Ivanov, Karolinska Institutet, Sweden
Christian Rück, Karolinska Institutet, Sweden

Abstract
Introduction: Bergen 4-Day Treatment (B4DT) is a new, intensive approach to treating OCD. It aims to combat the
challenges associated with gold standard CBT, including time inefficiency, high costs and moderate dropout rates.
While initial studies have shown promising results, the non-inferiority of B4DT compared to gold standard CBT has
not been evaluated.
Methods and analysis: We conducted a single-blind, randomized controlled trial with a total of 120 patients to com-
pare B4DT to gold standard CBT. We hypothesized that B4DT would demonstrate non-inferiority compared to gold
standard CBT at the primary endpoint, 15 weeks after treatment start. The primary outcome measure was the blind as-
sessor-rated Yale-Brown Obsessive Compulsive Scale (Y-BOCS), analyzed with a between-group analysis of covariance
at post-treatment, with the pre-treatment Y-BOCS score as a covariate. The non-inferiority margin was four points on
the Y-BOCS. Secondary outcomes included time to treatment response, cost-effectiveness, response and remission
rates, quality of life, and symptoms of depression. Data on dropout rates and adverse events were also collected in
both groups.
Preliminary results: As of today, all 120 patients have been included in the study. By August 2024, all primary endpoint
data will be collected and analyzed, except for possible participants who might be late with their assessments and
whose measurements will not be available by the time the analyses for the current presentation are conducted. We
will present preliminary results on the primary and secondary outcomes.
Relevance of the study: This study is the first trial to compare B4DT to gold standard CBT for OCD. Should clinical

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efficacy between the two treatments prove comparable, B4DT could emerge as a viable option for integration into
routine care, given its intensive format, potentially appealing to certain patient preferences. Moreover, additional
evidence-based treatment alternatives might create opportunities for patients to receive help faster, facilitate a re-
duction in waiting lists and expediting symptom relief for individuals with OCD.
Ethics and dissemination: This study has received approval from the Swedish Ethical Review Authority. Before gather-
ing any data, we pre-registered hypotheses and made the analysis code publicly available. The findings from all anal-
yses will adhere to the reporting guidelines outlined in the Consolidated Standards of Reporting Trials for non-phar-
macological trials and the Consolidated Health Economic Evaluation Reporting Standards. Trial registration number
NCT05608278.
Additional information: As only eight authors who contributed to this submission could be listed, I will list the rest
here: Sofia Asplund (Karolinska Institutet), Sofia Dahlén (Stockholm Health Care Services, Region Stockholm) and Fili-
pa Sampaio (Uppsala University). They are placed in order between Oskar Flygare and Erik Andersson.

Keywords
adult psychiatry, obsessive-compulsive disorder, OCD, Bergen 4-Day Treatment, B4DT, cognitive behavioral therapy,
CBT, exposure and response prevention, ERP, intensive treatment

Open Paper Symposium 5 – Eating disorders and body image

Chair: Noam Weinbach, University of Haifa, Israel

• How Hunger Influences Children’s Consumption of a Novel Fruit: Possible Implications for Treatment in Eat-
ing Disorders
Britt Fleischeuer, Maastricht University, Netherlands
Chantal Nederkoorn, Maastricht University, Netherlands
Rosalie Mourmans, Maastricht University, Netherlands
Anouk van den Brand, Maastricht University, Netherlands
Anouk Hendriks-Hartensveld, Maastricht University, Netherlands
Pauline Dibbets, Maastricht University, Netherlands
Katrijn Houben, Maastricht University, Netherlands

Abstract
Avoidant/Restrictive Food Intake Disorder (ARFID) is characterized by severe avoidance or restriction of food intake,
leading to significant nutritional deficits, weight loss, and psychosocial impairment. Commonly avoided foods include
fruits and vegetables, despite their essential role in development. Established treatments for ARFID, such as cognitive
behavioral therapy (CBT) and exposure therapy, have shown varying degrees of success. The present study explored
an additional strategy: leveraging hunger to enhance fruit and vegetable consumption, based on the premise that
hunger may diminish taste perception and increase food intake. Previous research indicates that hunger can increase
the intake of familiar fruits and vegetables in children, but its impact on unfamiliar foods remains unclear. To inves-
tigate this, a study was conducted with typically developing children using a 2 x 2 factorial design. Children were
randomly assigned to one of four conditions: hunger (yes/no) and exposure to the type of fruit/vegetable (familiar/
unfamiliar). The present study was examined in typically developing children to see if the relationship can be applied
here, with the potential of examining it as a follow-up in children with ARFID. Results revealed two main effects: chil-
dren consumed more fruit when hungry (F(1, 174) = 9.73, p = 0.002) and ate more familiar fruits compared to unfa-
miliar ones (F(1,174) = 40.09, p = < 0.001). Notably, food rejection tendencies measured with a parental questionnaire
did not significantly interact with the experimental conditions (p values all > 0.05). These findings suggest that lever-
aging hunger as a strategy to enhance food intake, irrespective of food familiarity, is effective in typically developing
children. Given these promising results, further research is needed to examine the applicability of this strategy for
children with ARFID, positioning hunger manipulation as a potential and promising adjunct treatment option.

Keywords
Hunger; appetite; food intake; eating disorders

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• Developmental Pathways of Disordered Eating from Early to Mid-Adolescence and Their Association with
Potential Risk Factors
Kärol Soidla, University of Tartu, Estonia
Kadi Reintam, University of Tartu, Estonia
Kirsti Akkermann, University of Tartu, Estonia

Abstract
Disordered eating (DE) often begins in early adolescence, is characterized by heterogeneous development, and is
associated with long-term physical and mental health consequences, including the development of eating disorders.
Research indicates that the development of DE is heterogeneous, with multiple trajectories depending on individual
factors and specific types of DE behavior. This study had two main objectives: to identify homogeneous developmen-
tal trajectories of DE and to investigate cognitive and behavioral factors predicting membership in these trajectories.
Data from a four-wave longitudinal study were used. Participants (n=298; girls n=167, boys n=131) who took part in
at least two assessment points (from ages 11 to 16 years) were included in the data analysis. The Children’s Eating
Attitudes Test (ChEAT) and its subscales (Body Concerns, Dieting, Food Preoccupation, Pressure to Eat) were used in
Growth Mixture Modeling to identify developmental trajectories. Multinomial logistic regression analysis was con-
ducted to assess the probability of belonging to different developmental trajectories considering potential cogni-
tive-behavioral risk factors (perfectionism, self-esteem, perceived social pressure to thinness, depression, and anxiety
symptoms). Based on the ChEAT total score, three distinct developmental trajectories were identified and labeled
accordingly: Low-Stable (16% of participants, exhibiting few symptoms of DE that did not significantly increase over
time), High-Stable (36% of participants, consistently displaying high levels of DE), and Medium-Increasing (48% of
participants, experiencing moderate DE that increased with age). A higher proportion of boys were categorized in
the Low-Stable developmental trajectory (60% vs. 40%), while a larger percentage of girls fell into the High-Stable tra-
jectory (34% vs. 66%). Higher body mass index, perceived social pressure, and perfectionism were found to increase
the likelihood of belonging to the High-Stable trajectory. Results were similar for predicting membership in the Medi-
um-Increasing trajectory. Depending on the ChEAT subscales, two to four trajectories were identified. Body Concerns
was the only subscale that exhibited solely stable trajectories, all with no significant changes over time (High-Stable,
Medium-Stable, and Low-Stable), confirming this cognitive aspect to be central in the development of DE. In conclu-
sion, strongly manifested DE tends to exhibit a stable course during adolescence, whereas individuals with moderate
DE tend to experience an increase in symptoms over this developmental period. The identification of these develop-
mental trajectories and their associations with cognitive-behavioral risk factors facilitates more effective planning
of preventive measures and the identification of adolescents in need of urgent attention or specific interventions.
In addition, it emphasizes the importance of early prevention and intervention efforts targeting preoccupation and
worries about one’s body weight or shape and perfectionism.

Keywords
disordered eating, adolescence, perfectionism, body concerns

• The effects of self-compassion and cognitive reappraisal on appearance-related rumination among adoles-
cent girls
Noam Weinbach, University of Haifa, Israel
Hadas Hevron, The University of Haifa, Haifa, Israel

Abstract
Appearance-related rumination is a major cause of emotional distress among adolescents. Adaptive emotion reg-
ulation strategies were suggested to counteract the harmful consequences of rumination. This study examined if
cognitive reappraisal and self-compassion can improve female adolescents’ body satisfaction and appreciation after
engaging in appearance-related rumination. In an online experiment, 142 healthy female adolescents underwent an
appearance-related rumination induction that included ruminating on an imaginary scenario where an unflattering
photo of them was uploaded to a social network app . ‎Then, participants were randomly allocated to one of three ex-
perimental conditions. Using a writing task, one group engaged in self-compassion (e.g., engaging in self-kindness), a
second group implemented cognitive reappraisal (e.g., thinking of reasons why the situation not so bad), and a third
group continued to ruminate regarding their appearance. State body dissatisfaction ‎and appreciation were assessed
at baseline, post-appearance rumination, and post-‎writing tasks using the body image state scale (BISS) and the
state body appreciation scale (BAS-2), respectively. The results showed that appearance-related rumination increased
state body dissatisfaction and reduced body appreciation in all groups. Importantly, state body dissatisfaction and
appreciation were fully restored to their baseline levels in the self-compassion and cognitive reappraisal groups, but
not in the rumination group. The findings provide empirical evidence regarding the negative consequences of ap-
pearance-related rumination among adolescent girls. Furthermore, the study highlights the utility of self-compassion
and cognitive reappraisal as coping mechanisms that can efficiently alleviate emotional distress that is associated
with appearance-related rumination. Overall, the study suggests that incorporating self-compassion and cognitive

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reappraisal into cognitive behavioral treatments for adolescents with body image concerns could assist in buffering
against appearance-related rumination.

Keywords
emotion regulation, self-compassion, cognitive reappraisal, body dissatisfaction, body appreciation, adolescents

• Association of Irrational Beliefs, Perfectionism, and Self-Esteem with Orthorexia Nervosa Symptoms in Ser-
bia
Jovana Stanimirović, University of Belgrade, Faculty of Philosophy, Department of Psychology, Serbia

Abstract
Orthorexia Nervosa (ON) represents a recent phenomenon and is characterized as a restrictive eating pattern marked
by an obsession and pathological preoccupation with consuming food believed to be healthy, all in pursuit of overall
health. Guided by the transdiagnostic model, which posits a fundamental psychopathology underlying all eating dis-
orders, as well as common mechanisms that underlie and perpetuate eating disorders, the research aimed to explore
the relationship between ON (which has not yet gained disorder status in the ICD and DSM-5 classification systems)
and irrational beliefs, perfectionism, and self-esteem, identified as responsible mechanisms for the development and
maintenance of eating disorders. A correlational-regression study was conducted with data collected from 689 par-
ticipants from the general population. The instruments used were the Irrational Beliefs about Orthorexia Nervosa
Questionnaire (IROX), the Clinical Perfectionism Questionnaire (CPQ), the translated Rosenberg Self-Esteem Scale
(RSRS), and the Orthorexia Nervosa Inventory (ONI). The results indicate a significant positive and strong correlation
between ON and irrational beliefs, as well as between irrational beliefs and all three sub-scales of the ONI inventory.
Irrational beliefs are a statistically significant positive predictor of ON. Furthermore, a significant positive and moder-
ate correlation was observed between ON and clinical perfectionism, as well as between clinical perfectionism and all
three sub-scales of the ONI inventory. Clinical perfectionism serves as a reliable positive predictor of ON. A significant
negative and weak correlation was obtained between ON and self-esteem, as well as between self-esteem and all
three ONI sub-scales. However, through multiple linear regression analysis, where the criterion was the total score on
the ONI inventory and the predictors were irrational beliefs, clinical perfectionism, and self-esteem, self-esteem did
not emerge as a significant predictor of ON. Examining these phenomena and their relationships provides data that
can be utilized to enhance the prediction and prevention of individuals at risk of developing ON, contributing to the
scientific understanding of the phenomena under investigation.

Keywords
Orthorexia Nervosa, irrational beliefs, clinical perfectionism, self-esteem

Open Paper Symposium 6 – Child mental health & parenting

Chair: Chantal Nederkoorn, Maastricht University, Netherlands

• Hands-On Texture - Evaluating the effect of exposure on food acceptance

Rosalie Mourmans, Maastricht University, Netherlands
Chantal Nederkoorn, Maastricht University, Netherlands
Britt Fleischeuer, Maastricht University, Netherlands
Anouk Hendriks-Hartensveld, Maastricht University, Netherlands
Anouk van den Brand, Maastricht University, Netherlands

Abstract
Picky eating is common in early childhood and is associated with frequent refusal of various foods. The texture of food
plays a crucial role in these rejections. Once preferences or rejections are learned, they are difficult to change later in
life. In some children, picky eating can develop into a clinical condition known as Avoidant/Restrictive Food Intake
Disorder (ARFID). Research indicates that almost one-third of ARFID patients have shown selective eating patterns
since early childhood. Individuals with ARFID may experience high levels of anxiety and distress when exposed to cer-
tain foods, smells, or textures. Therefore, it is important to encourage healthy eating habits, including the acceptance
of diverse textures, from an early age.
Previous research has demonstrated that tactile exposure can increase food acceptance in young children. This study
aims to investigate whether the increase in food acceptance results from tactile sensations related to specific textures
or from a growing familiarity with the food.
The study involved 131 children aged 4 to 6 years from four elementary schools in the Netherlands. Participants were
randomly assigned to one of four exposure conditions: exposure to the target fruit (yes/no) and exposure to the
target texture (yes/no). The tasks included interacting with passionfruit seeds, basil seeds, polystyrene foam balls,

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and whole passion fruits using their hands. The primary outcome measure was acceptance of the passionfruit seeds,
evaluated on a 7-point scale ranging from 1 (physical refusal) to 7 (eating more than one spoon). Baseline variables,
including child food rejection (CFRS) and child tactile sensitivity, were reported by parents.
The results revealed no significant differences in fruit acceptance levels across the different exposure conditions. This
suggests that the exposure, as implemented in this study, did not significantly influence fruit acceptance among
young children. However, children identified as picky eaters by their parents showed lower acceptance of passionfruit
compared to non-picky eaters.
While tactile exposure tasks have shown effective in previous studies, their impact on fruit acceptance may vary de-
pending on contextual factors and individual differences among children. Furthermore, mere exposure is a proven
method to enhance food acceptance—familiarity with a food through repeated exposure increases liking— and the
present study involved only a single exposure. Further research is necessary to determine whether repeated exposure
would result in different outcomes.

Keywords
food acceptance; selective eating; sensory play task; food texture; young children

• Tactile tastes: the relation between pickiness in eating, liking of textures and tactile thresholds
Chantal Nederkoorn, Maastricht University, Netherlands
Emmy van den Heuvel, Maastricht University, Netherlands
Anouk van den Brand, Maastricht University, Netherlands
Anouk Hendriks- Hartensveld, Maastricht University, Netherlands

Abstract
Severe picky eating and the rejection of a wide variety of foods is the main characteristic of Avoidant/Restrictive Food
Intake Disorder (ARFID). This rejection can be based on sensory aspects, meaning that specific tastes, smells or tex-
tures are avoided. Several studies found that avoidance of food textures is related to a general dislike of tactile stimuli,
for example the dislike of certain fabrics, toothbrushing or walking barefoot on sand. This dislike of tactile stimuli
might stem from lower thresholds to detect touch, causing over-stimulation and therefore aversion for specific tactile
stimuli. Alternatively, picky eaters might have the same objective tactile thresholds as non-picky eaters, but different
subjective evaluations. The aim of the present study is to test the relations between pickiness in eating, subjective lik-
ing of textures, and tactile thresholds. In a sample of 86 adult participants, picky eating was measured with the Adult
Picky Eating Questionnaire (APEQ) and an adjusted food frequency questionnaire (adjFFQ). Tactile thresholds were
tested with Semmes-Weinstein monofilaments (both on the tongue and fingertip) and liking of different textures was
measured by feeling several textures with the hands. Results showed that subjective liking of textures was related to
both measures of picky eating. However, tactile thresholds were not related to the liking of textures. Thresholds of
the fingertip, but not the tongue, were weakly related to the adjFFQ measure of picky eating, but not the APEQ. The
results indicate that picky eaters indeed have a general subjective dislike of textures, but this cannot be explained by
lower tactile thresholds. Future research might focus on how differential liking of textures develops.

Keywords
ARFID, tactile sensitivity, tactile thresholds, food textures, pickiness in eating

• Knowing is liking? Exploring food knowledge and food rejection in 3-year-olds

Anouk Hendriks-Hartensveld, Maastricht University, Netherlands
Anouk van den Brand, Maastricht University, Netherlands
Britt Fleischeuer, Maastricht University, Netherlands
Rosalie Mourmans, Maastricht University, Netherlands
Chantal Nederkoorn, Maastricht University, Netherlands

Abstract
Avoidant restrictive food intake disorder (ARFID) is defined as a severe disturbance in eating behavior that is mainly
manifested by extreme food rejection. In prior studies, food rejection tendencies in children have been found to be
related to their cognitive food-domain related abilities (e.g., recognition and categorization). Therefore, in this study
we aimed to shed more light on the relationship between food recognition, categorization and food rejection in
3-year-olds. A total of 259 children and 289 parents participated in the study. The children performed two food cate-
gorization tasks in which they were asked to sort pictures of fruits and vegetables, and pictures of savory and sweet
foods. Furthermore, children’s ability to recognize deviating food forms (e.g., a food in a different color) was tested.
Food rejection behavior was measured with a taste test (children were offered two familiar and two unfamiliar vegeta-
bles and invited to taste them). Parents also reported their children’s food rejection behavior by completing the Child
Food Rejection Scale and reporting their child’s liking of a list of vegetables and fruits. Preliminary results show that

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neither categorization performance, nor performance on the recognition task was related to any of the food rejection
measures. In conclusion, this study shows contrasting evidence regarding the relationship between children’s cogni-
tive food-domain related abilities and their food rejection tendencies, pointing to a limited influence of the ability to
categorize and recognize foods on picky eating.

Keywords
ARFID, food rejection, picky eating, food knowledge, food-domain cognitive abilities

• Biased bites? Exploring confirmation bias in preschoolers’ food rejection

Anouk van den Brand, Maastricht University, Netherlands
Anouk Hendriks-Hartensveld, Maastricht University, Netherlands
Remco Havermans, Maastricht University, Netherlands
Rosalie Mourmans, Maastricht University, Netherlands
Britt Fleischeuer, Maastricht University, Netherlands
Chantal Nederkoorn, Maastricht University, Netherlands

Abstract
Food rejections are common in young children and impair the variety and quality of their diet. Severe food rejection
behavior is characteristic of Avoidant/Restrictive Food Intake Disorder (ARFID), a condition that further complicates
meeting nutritional needs. Previous research has revealed parallels between food rejection behavior and fear and
anxiety. Building on these findings, the present study examined whether confirmation bias (the tendency to search
for information confirming one’s initial beliefs) – which has been implicated in fear and anxiety – also plays a role in
child food rejections. A total of 302 children and 313 parents participated in the study as part of an ongoing longitudi-
nal project. Child food rejection was measured at age 3 and 4 years old using two parental questionnaires (Child Food
Rejection Scale [CFRS] and a Liking of Foods scale) and an ad lib taste test, in which children were asked to try two
familiar and two unfamiliar vegetables. Confirmation bias was assessed using an iPad task at age 3 years old, in which
children were presented with five unfamiliar fruits and were first asked whether the fruit looked yummy or yucky,
and next chose if they wanted to hear the experience from a child who liked or disliked the fruit (either confirming or
disconfirming their belief ). Preliminary data revealed no relationship between confirmation bias and our three food
rejection measures, suggesting confirmation bias does not play a role in food rejection behavior. Future studies may
examine the role of other information processing biases in explaining food rejection behavior.

Keywords
food rejection, confirmation bias, picky eating, food neophobia, ARFID

• Exploring the Dynamics of Strength-Based Parenting and Positivity Ratio: Insights from Parent-Child Dyads
in Urban Muslim Arab Communities
Ayat Abu Kheit, Ono Academic Center, Israel

Abstract
This study delves into the intricate relationship between Strength-Based Parenting (SBP) and the Positivity Ratio (PR)
within parent-child dyads in two urban Muslim Arab communities in the Triangle area. Anchored in the principles of
positive psychology, which underscores the paramount role of positive emotions and environments in fostering op-
timal functioning and well-being, this research explores how SBP and PR contribute to children’s positive worldview,
resilience, and journey toward self-fulfillment. Utilizing a cross-sectional design, the study gathered data from 220
pairs of children and their parents through self-report questionnaires, emphasizing the crucial aspects of SBP and PR.
Employing an Actor-Partner Interdependence Model (APIM) to scrutinize both actor and partner effects within these
dyads, the findings highlight significant actor effects. This indicates a strong association between the identification
component of SBP—recognizing strengths—and higher PR in both parents and children. This suggests that recogniz-
ing strengths plays a more substantial role in contributing to positive emotional outcomes than merely using them.
However, partner effects did not show significant impact, suggesting the SBP behaviors in parents or children did
not significantly influence the other party’s PR. This revelation points to the individualistic rather than dyadic impact
of SBP behaviors on positive emotional outcomes, emphasizing the importance of nurturing individual and familial
strengths to foster a positive emotional climate within families.
By integrating the core tenets of educating children within the framework of positive psychology, this study under-
scores the pivotal role of family environment and parent-child relationships in cultivating happy, resilient, confident,
and optimally functioning children. The findings not only contribute to the existing body of literature by elucidating
the differential impacts of SBP’s identification and usage sub-factors on PR but also highlight the complex dynamics
of family relationships and their influence on well-being, reaffirming the critical role of positive psychology in under-
standing and enhancing parent-child dynamics

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Keywords
Strength-Based Parenting, Positivity Ratio, Parent-Child Dyads, Actor-Partner Interdependence Model, Positive Psy-
chology

• Assessing the Efficacy of a Group Program for Anxious Parents in Preventing Offspring Anxiety: A Parallel
Randomized Controlled Trial
Sigrid Elfström, Karolinska Institutet, Sweden
Ata Gadheri, Uppsala Universitet, Sweden
Johan Åhlén, Karolinska Institutet, Sweden

Abstract
Background: Anxiety disorders are the most prevalent psychiatric conditions among children, and offspring of anx-
ious parents are known to be at particularly high risk. Targeting families with anxious parents has emerged as a prom-
ising approach to prevention. The primary objective of the current trial was to evaluate the efficacy of a novel parent-
ing program, the Confident Parents Brave Children program (CPBC), compared with an active control, in preventing
pediatric anxiety symptoms and disorders over a period of 12 months.
Method: 215 parents were randomly allocated to either take part in the CPBC or to a self-help control condition. The
inclusion criteria encompassed heightened parental anxiety and having a child aged 5-9 years who did not meet the
criteria for an anxiety disorder. The CPBC program, a novel group-based parenting intervention for anxious parents,
involves six group meetings and one individual booster, all administered through video conferencing. It targets pa-
rental overprotection and anxious modeling, and provides parents with skills to help their children deal with anxiety.
Participants in the self-help control condition received a book promoting positive and effective parenting strategies
and were instructed to read it over a period of ten weeks.
The primary outcome was severity of childhood anxiety disorder, assessed by the Anxiety Disorders Interview Sched-
ule (ADIS). Assessors at the 12-month follow-up were masked to participant allocation. Secondary outcomes included
parent-rated child anxiety symptoms and parental self-efficacy.
Results: At the 12-month follow-up, no significant effect on child anxiety disorders was found. However, children
whose parents participated in the CPBC program exhibited lower levels of parent-rated anxiety symptoms compared
to children in the control group after one year. When stratifying by age, a significant reduction in the risk for anxiety
disorders and clinical severity rating was observed in younger children (5-6 years) whose parents had participated in
the CPBC program. For parents in both conditions, effects were observed on parental self-efficacy.
Conclusion: Interventions targeting families with anxious parents represent a promising avenue for childhood anxiety
prevention; however, further research is warranted to deepen our understanding and assess the effectiveness of such
interventions. One important question for future research regards the optimal timing for family preventive interven-
tions.

Main funder: Swedish Research Council

With contributions from: The Söderström - Königska Foundation and the Fredrik and Ingrid Thuring Foundation

Keywords
Anxiety disorders, parent intervention, prevention

Improve Mental Health (Improve-MH) for Refugee Families using a culturally adapted, General Practitioner-de-
livered cognitive behavioral therapy intervention - a multi-center randomized controlled trial
Lisa Heller, Department of Clinical Child and Adolescent Psychology, Ruhr-University Bochum, Bochum, Germany,
Germany
Karim Zagha, Department of Clinical Child and Adolescent Psychology, Ruhr-University Bochum, Bochum, Germa-
ny, Germany
Kerstin Konietzny, Department of Clinical Child and Adolescent Psychology, Ruhr-University Bochum, Bochum,
Germany, Germany
Silvia Schneider, Department of Clinical Child and Adolescent Psychology, Ruhr-University Bochum, Bochum, Ger-
many, Germany

Abstract
Introduction
Germany and the European Union have experienced waves of refugees, totaling over 2.6 million arrivals since 2014,
many being families with young children. This vulnerable population faces xenophobia, discrimination, and limited
healthcare access, contributing to a high prevalence of mental health problems (MHP).
Our primary goal is to proactively address MHP in refugee parents and prevent its impact on their children through
effective early interventions. Using a low-threshold, general practice-delivered treatment, and an online parenting
program, we aim to enhance parenting skills and address parental psychopathology to prevent the development of
MHP in children.

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Methods
In this randomized controlled trial, we planned to include 188 refugee parents of children < 7 years, assigned to either
the experimental intervention (Improve) or treatment as usual (TAU). Improve includes face-to-face sessions, an inter-
active online parenting program (Triple P online), and regular telephone calls by psychologists.
Challenges to implementation
Implementing this project faced challenges rooted in the stigmatized nature of the topic and a prevalent lack of
knowledge about the German healthcare system among the target population. Additionally, concerns regarding data
privacy and apprehensions about potential impacts on residency, citizenship applications, or naturalization added to
the complexities. An online survey, we conducted, within the target population provided insights into these barriers.
Results and Conclusion
This study aims to compare the effectiveness of Improve and TAU, delivered by GPs, on parental and child MHP and
parenting skills at post, 3-, and 6-month follow-ups. Preliminary results will be presented, and implications for men-
tal health care delivery to refugees, incorporating insights from the online survey, will be discussed. This nuanced
approach contributes to understanding challenges and opportunities in addressing mental health in this vulnerable
demographic, emphasizing the importance of tailored interventions.

Keywords
refugees, mental health, parenting, prevention

Open Paper Symposium 7 - Third Wave CBT

Chair: Josef Mattes, AVM, Austria

• Personal Construct Theory, ACT, and Narrative Psychology: ACTing Towards Integration
Vladimir Mušicki, Dijalogika, Serbia

Abstract
Personal construct theory (PCT), Acceptance and Commitment Therapy, and narrative psychology all operate within
the metatheoretical framework of contextualism. All these approaches are dependent on the context in which human
behavior manifests, making it impossible to separate them. A person’s behavioral change relates to their ability to
change their view of themselves and their environment, potentially leading to positive therapeutic outcomes. While
PCT and narrative psychology primarily focus on the lenses through which an individual perceives themselves and
the world, highlighting the agency of the “construer/man as a scientist” or the “narrator/man as a storytelling being,”
ACT incorporates specific mindfulness practices and places a strong emphasis on behavior, thereby revealing the po-
tential for change from the “observer self.” Still, all three approaches share a similar orientation towards values, which
PCT incorporates into its core construct structure, and these approaches aim to produce lasting changes in clients’
behavior based on these values. Concepts from PCT, like permeability and propositional construing, closely align with
the ACT concept of psychological flexibility. Narrative psychology and its effort to raise the level of awareness of mar-
ginalized stories and challenge dominant oppressive narratives could be seen as an orientation towards meaningful
life when a person starts to behave more in line with values-saturated (instead of problem-saturated) stories that were
neglected in favor of certain cultural practices.

Keywords
Personal Construct Theory, Acceptance and Commitment Therapy, Narrative Psychology, contextualism

• ACTing innocently? How to combine good therapy with highly questionable philosophy
Josef Mattes, AVM, Austria

Abstract
In a recent special section of Behavior Therapy (2023), ACT (Acceptance and Commitment Therapy) received strong
criticisms from a number of authors. These critical evaluations targeted both its empirical status and the general phi-
losophy (“functional contextualism”) that is usually added in expositions of ACT. In the same issue there appeared also
a strong defence by Hayes, Hofmann and Ciarrochi, against these critiques.
The present talk argues that while part of this defence succeeds well, this does not hold for at least one often-affirmed
aspect of the general philosophy (specifically, the alleged “pragmatic truth criterion”). Furthermore it is explained why
this is important. In addition, other possible defences of this alleged truth criterion, beyond those presented by Hayes
et al., are considered and shown to be inadequate.

Keywords
ACT, philosophy, pragmatism, functional contextualism, truth, ethics

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• Comparison of the Effectiveness of Acceptance and Commitment Therapy and Cognitive Behavioral Therapy
on Anxiety and Depression Levels of Preadolescents
Aykut Kul, Gaziantep University, Turkey
Fulya Türk, Department of Psychological Counselling and Guidance, Yildiz Technical University, Istanbul, Turkey

Abstract
Internalizing problems, such as anxiety and depression, are frequently encountered in pre-adolescents. These mental
health issues disrupt functionality in academic, social, and familial areas. This study aims to compare the effectiveness
of group psychoeducation programs for anxiety, developed based on Cognitive Behavioral Therapy (CBT) and Accep-
tance and Commitment Therapy (ACT), on the anxiety and depression levels of pre-adolescents.
The experimental application was structured with a 3x4 mixed design, including pre-test, post-test, one-month, and
three-month follow-up measurements, with two experimental groups (CBT and ACT) and one control group. The
study group consisted of 38 pre-adolescents (ACT=10, CBT=13, Control=15; M=11.38 years, SD= .561) studying in
three different public schools and attending the sixth grade. The “Revised Child Anxiety and Depression Scale - Child
Version” (RCADS-Y) was used as a data collection tool. Pre-adolescents in the experimental groups underwent 8-week
psychoeducation programs based on CBT and ACT, while the control group received no intervention. Repeated Mea-
sures ANOVA was used to analyze the data.
The findings are as follows:
The difference in RCADS-Y total anxiety scores across the pre-test, post-test, one-month follow-up, and three-month
follow-up measurements for the ACT, CBT, and control groups was significant with a large effect size (F(2-26)= 5.728;
p<.05, ηp2= .306). The difference in RCADS-Y total anxiety scores across the same measurements, regardless of group
distinction, was significant with a large effect size (F(3-78)=16.609; p<.001, ηp2= .390). The results of the Group*Time
interaction effect indicated that the mean scores for the ACT, CBT, and control groups differed significantly across the
measurement points with a large effect size (F(6-78)=3.636; p<.05, ηp2= .219). This finding suggests that group member-
ship (experimental or control) had differing effects on reducing anxiety. The Bonferroni post-hoc test revealed that
the post-test RCADS-Y total anxiety scores of pre-adolescents in the ACT and CBT groups were significantly lower than
those of the control group ( ACT-Control= -34.46, p< .05; X̄CBT-Control= -19.23, p< .05), while the difference between the ACT
and CBT groups was not significant ( ̄ACT-CBT= -15.22, p> .05). These results indicate that both CBT and ACT group psy-
choeducation programs are effective in reducing anxiety levels among pre-adolescents, with no significant difference
in effectiveness between the two methods.
The difference in the mean RCADS-Y depression scores (pre-test, post-test, one-month follow-up, and three-month
follow-up) among the ACT, CBT, and control groups was not significant (F(2-26)= 1.461; p> .05). However, the overall
difference in these scores, without group distinction, was significant with a large effect size (F(3-78)=8.016; p<.001, ηp2=
.236). The Group*Time interaction effect showed significant differences among the ACT, CBT, and control groups with
a large effect size (F(6-78)=4.009; p<.05, ηp2= .236), indicating varying impacts on depression reduction. The Bonferroni
post-hoc test revealed that ACT group showed a significant decrease in depression scores from pre-test to post-test,
sustained through follow-ups (X̄Pretest-Posttest= 9.345, p< .05; Posttest-Follow up-1= -1.059, p> .05; X̄Posttest-Follow up-2= .941, p> .05)..
In the CBT group, no significant differences were found (X̄ Pretest-Posttest = 1.134, p> .05; X̄ Posttest-Follow up-1= -.214, p> .05;
̄ Posttest-Follow up-2= -.934, p> .05).

Keywords
Pre-adolescents, Anxiety, Depression, Acceptance and Commitment Therapy, Cognitive Behavioral Therapy, Psycho-
education

• ACT-enhanced behavior therapy in group format for skin-picking disorder: An effectiveness study
Torun Grøtte, NTNU, Norway
Erna Marie Moen, Oslo university hospital, Norway
Benjamin Hummelen, Oslo university hospital, Norway

Abstract
Background: Skin-picking disorder (SPD) has a prevalence of 1-2% of the general population and is characterized by
recurrent skin picking, resulting in skin damage. Behavioral treatment is considered as the best treatment option for
SPD to date, but further studies are needed to investigate different types of psychotherapies and modalities.
Methods: The aim of this study was to investigate the effectiveness of ACT-enhanced behavior therapy for SPD, de-
livered in a group format within a public health setting. The treatment followed the manual by Woods and Twohig
(2008) and was a combination of habit reversal training (HRT) and acceptance and commitment treatment (ACT). The
participants received 10 group sessions lasting three hours each, and three booster sessions. Out of the 93 patients
initially enrolled in treatment, 12 (13%) were classified as dropouts, i.e., discontinued treatment before the seventh
session.

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The primary outcome measures were the self-report inventory Skin Picking Scale-Revised (SPS-R), the clinician-rated
Massachusetts General Hospital Hair Pulling Scale, adapted for SPD (MGH-SPD), and the clinical global impression
scale for SPD (CGI-SPD), measured at baseline, end of treatment, and one-year follow-up. Secondary outcome mea-
sures were symptoms of depression (PHQ-9), anxiety (GAD-7), and work- and social adjustment (WSAS).
Results: Preliminary analyses using linear mixed models, with SPS-R as outcome measure, revealed a significant im-
provement of SPD symptoms from baseline to the end of treatment, extending to one-year follow-up (t =.10.8, p <
.001). Cohen’s d from baseline to follow-up was substantial at 1.5. Moreover, there was considerable variability in
treatment outcomes among patients, as indicated by the large random slope variance (0.80, p = .073).
Conclusions: The results provide initial support for the efficiency of group-based ACT-enhanced behavior therapy for
SPD.

Keywords
Skin picking disorder; trichotillomania; habit reversal training; ACT; group therapy

• Does Acceptance Lead to Change? Training in Radical Acceptance Improves Implementation of Cognitive
Reappraisal
Or Segal, University of Haifa, Israel
Helene Sher, Soroka Medical Center, Israel
Idan M Aderka, University of Haifa, Israel
Noam Weinbach, University of Haifa, Israel

Abstract
Third-wave cognitive behavioral treatments such as dialectical behavioral therapy (DBT) theorize that practicing emo-
tional acceptance can facilitate cognitive change. The goal of the current study was to provide an empirical evidence
for this notion by assessing if a two-week online training to cultivate acceptance of negative personal events can
subsequently improve the ability to implement cognitive reappraisal while being exposed to aversive stimuli. During
six training sessions, 120 healthy individuals recorded personal events from their lives that evoke negative emotions
in them. Participants were randomly allocated into three groups: In a Radical Acceptance group, participants imple-
mented a DBT skill aimed to promote acceptance of the negative events they described. In a Check the Facts group,
participants reappraised their automatic interpretations of the described events. A Control group described the
events, but did not use any DBT skill to cope with them. A picture-based emotion regulation task was used before and
after the training to assess implementation of emotional acceptance and cognitive reappraisal. The results showed
that following the training, participants who practiced radical acceptance of reality improved in their ability to imple-
ment both emotional acceptance and cognitive reappraisal. In contrast, Check the Facts group improved only in the
implementation of cognitive reappraisal, but not emotional acceptance. The control group did not improve in either
strategy. The findings provide empirical evidence to support the notion that cultivating acceptance can subsequently
improve the ability to reinterpret reality for coping adaptively with negative events

Keywords
Emotion regulation, Dialectical behaviour therapy, Acceptance, Cognitive reappraisal

• Translating and Evaluating Metacognitive Training for Borderline Personality Disorder: A Promising Thera-
peutic Approach
Maja Marija Muškić, Clinical Psychologist, Croatia
Macha Natacha Bogdanović, Psychiatric Resident, Croatia

Abstract
Borderline Personality Disorder (BPD) is a complex mental disorder characterized by intense emotional reactions,
unstable interpersonal relationships, impulsive behavior, and identity disturbances. Metacognitive Training (MCT) has
proven effective in treating various psychiatric disorders, but its application to BPD has yet to be thoroughly explored.
Metacognitive Training is a form of psychotherapy focused on enhancing an individual’s ability to recognize and regu-
late their thought processes. The goal is to reduce cognitive distortions and increase awareness of one’s mental states.
For BPD, MCT can aid in recognizing and regulating intense emotional reactions and dysfunctional thinking patterns.
The translation of MCT for borderline disorders involved adapting materials and techniques to be culturally and lin-
guistically relevant to the target population. The translation process included several steps:
Selection of materials
Translation and adaptation: Translation of materials by experts and adaptation to cultural specifics.
Back-translation: Back-translation to ensure accuracy and consistency.
Pilot testing: Conducting pilot studies with a small group of patients to assess the comprehensibility and effectiveness
of the translated materials.

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The evaluation of MCT’s effectiveness for BPD was conducted through clinical studies employing both quantitative
and qualitative methods. The main components of the evaluation included:
Symptom measurement: Use of standardized questionnaires to assess the intensity of BPD symptoms before and
after the intervention.
Qualitative feedback: Interviews with patients about their experience with MCT.
Control groups: Comparison of results with a control group that did not receive MCT.
The study was conducted on a sample of 16 patients diagnosed with borderline personality disorder (BPD). The
diagnosis was made by a licensed psychiatrist, and the patients received treatment at a major psychiatric hospital
throughout the year 2024. In addition to the experimental group, a control group was established, consisting of an
equal number of participants matched for age and gender. The program, which was predominantly conducted on
female participants, involved group sessions lasting for two months. All participants provided informed consent. The
evaluation results indicated that MCT has a slight positive impact on reducing BPD symptoms. Patients reported a
decrease in the intensity of emotional reactions, improved interpersonal relationships, and better impulse control.
Qualitative data revealed that patients gained a better understanding of their thought processes and learned tech-
niques for regulating them.
The translation and evaluation of metacognitive training for borderline personality disorder indicate its potential
effectiveness in treating this complex disorder. MCT offers a structured approach that can help patients better under-
stand and control their emotional and cognitive processes. Further research is needed to confirm these findings and
develop specific interventions tailored to the individual needs of BPD patients.
Recommendations for Future Research:
Future research should include larger samples of patients and longer follow-up periods to assess the long-term ef-
fects of MCT. Additionally, studies could incorporate comparative research with other therapeutic approaches to de-
termine the relative effectiveness of MCT. The integration of neurobiological measures could provide deeper insights
into the mechanisms of action of this therapy.

Keywords
Metacognitive training, borderline personality disorder, BPD Therapy, innovative therapies, therapeutic efficacy

Open Paper Symposium 8 - Digital CBT 1

Chair: Saeedeh Zenoozian, Zanjan University of Medical Sciences, Islamic Republic of Iran

• Comparison of the efficacy of face-to-face and online unified protocol of transdiagnostic treatment in people
with sub-clinical symptoms of anxiety disorders: A Randomized Clinical Trial
Saeedeh Zenoozian, Zanjan University of Medical Sciences, Islamic Republic of Iran
Zeinab Hasanpour Pirbasti, M.sc student of clinical psychology, Islamic Republic of Iran
Farzane Ahmadi, assistant professor of biostatistics and epidemiology, Islamic Republic of Iran
Vahideh Javadi, PhD student of clinical psychology, Islamic Republic of Iran

Abstract
Introduction: Anxiety disorders are the most common psychiatric disorders and are associated with a high burden of
disease. Anxiety disorders are often underrecognized and undertreated in primary care. The World Health Organiza-
tion (WHO) reported that in 2015, anxiety disorders ranked sixth among all mental and physical illnesses worldwide
as the cause of so-called years of life with disability. Unified protocol of transdiagnostic treatment has been designed
and evaluated from the beginning as a general prevention program for anxiety and depression. Some of the reasons
for people not attending treatment are related to the nature of their disorder, as well as the high costs of face-to-face
treatment and transportation problems, especially in big cities, and staying on long waiting lists. This is while these
problems can be solved by using technology. This study aimed to compare the efficacy of face-to-face and online
unified protocols of transdiagnostic treatment in people with sub-clinical symptoms of anxiety disorders.
Methods: The statistical population of this research included people with sub-clinical symptoms of anxiety disorders.
As the present study’s sample, 44 people were selected through purposive (accessible) sampling. After evaluating the
included criteria, the clients were randomly assigned to two groups: face-to-face unified transdiagnostic treatment
protocol (n1=22) and online unified protocol (n2=22). All clients completed the demographic information and the
Beck Anxiety Inventory (BAI) before and after the intervention and three months after. Three persons in each group
still need to complete the sessions (n1= n2=19). The generalized linear mixed effect model with random intercept was
used to compare the two groups. Data was analyzed by R 4.3.0 with the lme4 package.
Findings: In the comparative study of online and face-to-face groups, the median ± IQR ages were 23±7 years and
28±12 years, respectively. The composition of both groups predominantly consisted of female participants, account-
ing for 78.9% in the online group and 84.2% in the face-to-face group. Similarly, most of the participants in both set-
tings were single, with percentages being 73.7% for the online group and 57.9% for the face-to-face group. Further-
more, individuals holding a bachelor’s degree represented 47.4% of the online group and 57.9% of the face-to-face

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group. Statistical analysis revealed that age, gender, marital status, and educational attainments were insignificant
between the two groups (P>0.05). The online group exhibited an average improvement rate of 0.1% higher than the
face-to-face group. However, this difference did not reach statistical significance (P=0.714). Contrarily, a significant
finding was observed in the follow-up phase, where the average improvement rate was 0.6% higher than immediate-
ly post-intervention (P<0.001).
Conclusion: The present study shows that a unified protocol of transdiagnostic treatment in remote settings (video
call) appears to be as effective as conventional face-to-face therapy and effectively treats anxiety and related condi-
tions. There is a need for more trials and the feasibility and cost-effectiveness of online interventions.

Keywords
anxiety, face-to-face, online, unified protocol of transdiagnostic treatment

Comparison of therapeutic alliance in face-to-face and online Transdiagnostic cognitive behavioral therapy in
people with Sub-clinical symptoms of anxiety disorders: A Randomized Clinical Trial
Saeedeh Zenoozian, Zanjan university of medical sciences, Islamic Republic of Iran
Zeinab Hasanpour Pirbasti, M.sc student of clinical psychology, Islamic Republic of Iran
Farzane Ahmadi, assistant professor of biostatistics and epidemiology, Islamic Republic of Iran
Vahideh Javadi, ph.D student of clinical psychology, Islamic Republic of Iran
Abstract
Introduction: Although there is evidence supporting the effectiveness of psychotherapy in remote settings, research
comparing therapeutic alliance in face-to-face and online psychotherapy is still limited, and the therapeutic alliance
in transdiagnostic cognitive behavioral therapy has been studied in a few types of research. Given that transdiagnos-
tic cognitive behavioral therapy was designed originally and evaluated as a general prevention program for anxiety
and depression, and also considering the benefits of online therapy, including better access to evidence-based treat-
ments and removing personal barriers such as stigma and physical presence at a service compared to face-to-face
therapy can reduce the workload of mental health care providers with significant cost savings. This study aimed to
compare therapeutic alliance in face-to-face and online transdiagnostic cognitive behavioral therapy. The statistical
population of this research included people with sub-clinical symptoms of anxiety disorders. As the present study’s
sample, 44 people were selected through purposive (accessible) sampling. After evaluating the included criteria, the
clients were randomly assigned to two groups: face-to-face transdiagnostic cognitive behavioral therapy (n1=22) and
online transdiagnostic cognitive behavioral therapy (n2=22). The therapists completed the therapist’s version, and the
clients completed the client version of the Work Alliance Questionnaire (WAI-SR) in the sixth session and at the end
of the treatment (twelfth session). Three persons in each group did not complete the sessions (n1= n2=19). The gen-
eralized linear mixed effect model with random intercept was used to compare the two groups. Also, the therapist’s
agreement with the client was checked through Intra-class correlation (ICC). Data was analyzed by R 4.3.0 with the
lme4 package.
Findings: Median ±IQR age were 23±7 and 28±12 years old in online and face-to-face groups, respectively. The ma-
jority of participants were female (78.9% and 84.2%), single (73.7% and 57.9%), and with Bachelor degree (47.4% and
57.9%) in online and face-to-face groups. Two groups were homogeneous across age, gender, marital status, and
education level (P> 0.05). On average, the therapist’s and client’s therapeutic alliance in the face-to-face group were
1.25 and 1.21 units higher than online, respectively, but these differences were insignificant (P=0.255 and P=0.279).
ICC (confidence interval, IC 95%) were 0.912 (0.786, 0.982) and 0.884 (0.725, 0.954) in the online group and 0.862
(0.677, 0.944) and 0.875 (0.704, 0.950) in the face-to-face group in the sixth session and at the end of the treatment,
respectively.
Conclusion: The present study shows that face-to-face and online transdiagnostic cognitive behavioral therapy are
not different regarding therapeutic alliance. Considering the limitations of face-to-face therapy, online therapy can
be used alternatively.

Keywords
anxiety disorder, face-to-face, online, therapeutic alliance, Transdiagnostic cognitive behavioral therapy

• Digital interventions for anxiety in patients with oncological conditions: a meta-analysis

Eliza Atudosie, Evidence-Based Psychological Assessment and Interventions Doctoral School, Babeş-Bolyai Univer-
sity, Cluj-Napoca, Romania
Oana Alexandra David, Department of Clinical Psychology and Psychotherapy; The International Institute for the
Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
Abstract
Purpose: This meta-analysis aimed to assess the efficacy of digital psychological interventions for anxiety among
cancer patients (children and adults), as well as to evaluate the variables that possibly moderate intervention effects.

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Methods: Five databases were searched for the literature from January to February 2024. Two reviewers independent-
ly conducted a quality assessment. All screening steps followed a consensus between the authors to minimize bias
or discrepancy. Effect sizes were reported as the standardized mean difference (Hedge’s g) and estimated using a
random-effects model.
Results: The meta-analysis included 25 randomized clinical trials that satisfied our inclusion criteria, comprising 2464
children and adults with a cancer diagnosis and 28 digital interventions (serious game, mobile application, VR in-
tervention, etc.). Digital psychological interventions were associated with medium significant effects in anxiety (g =
− 0.544; 95% CI, − 0.58 to − 0.07). In subgroup analysis, results suggest that the intervention type significantly moder-
ated the effectiveness of digital psychological interventions in anxiety.
Conclusions: Digital psychological interventions can be effective for improving anxiety in children and adults with a
cancer diagnosis. Clinicians could consider digital psychological interventions as a possible and efficient addition to
better manage some of the anxiety symptoms among cancer patients.

Keywords
digital intervention, cancer, children, anxiety

• Impact of Online Imagery Rescripting on Insight and Metacognition in Anxiety: Assessing changes Before
and After Intervention
Asala Halaj, University College London1, Israel
Hila Sorka, The Hebrew University of Jerusalem, Israel
Elad Zlotnick, The Hebrew University of Jerusalem, Israel
Anthony David, University College London, United Kingdom
Jonathan Huppert, The Hebrew University of Jerusalem, Israel

Abstract
Introduction: Imagery Rescripting (IR) has shown promise as a therapeutic intervention for reducing symptom sever-
ity and improving coping skills in individuals with anxiety. Good insight into anxiety symptoms (i.e., seeing them as
abnormal and requiring treatment) and good metacognition (i.e., ability to reflect upon one’s anxious thoughts) can
play a crucial role in identifying and challenging negative thinking patterns. Good insight and metacognition should
therefore be predictors of outcomes, and their improvement via an intervention might should predict symptom im-
provement. This study aims to investigate the impact of an online IR intervention on insight, and anxiety symptoms,
as well as the association between insight and metacognition.
Methods: Three hundred participants with high trait anxiety were randomly assigned to either a self or other online IR
intervention (150 in each group). Pre- and post-intervention self-report measures of anxiety symptoms, insight, and
metacognition were administered, with a follow-up assessment taken a week after the intervention.
Results: Higher pre- intervention insight levels were associated with higher symptom severity (r > .50, p<0.01). Higher
levels of pre-intervention insight were predictive of higher post-treatment and follow-up symptoms level. Insight
level slightly improved from pre-to post-intervention. In terms of the relation of insight to metacognition, higher
pre-levels of insight were related to fewer dysfunctional metacognitive beliefs. Good insight and metacognition
should therefore be predictors of outcome.
Discussion: The findings indicate that individuals with a greater understanding of their condition prior to interven-
tion tended to perceive their symptoms as more severe. This suggests that insight into one’s condition may lead to
increased awareness of symptomatology. Interestingly, this association persisted even after treatment and during fol-
low-up, indicating the impact of initial insight on outcomes. Additionally, there was a modest improvement in insight
observed from pre- to post-intervention, suggesting that the intervention has the potential to enhance individuals’
understanding of their condition. Furthermore, the inverse relationship between insight and dysfunctional metacog-
nitive beliefs highlights the importance of addressing cognitive patterns in improving insight.
Conclusion: This study may have implications for understanding the nature of anxiety and the mechanisms of insight
in anxiety disorders and their treatment. By highlighting the role of insight and metacognition in anxiety disorders,
this study may help inform the development of new avenues to target insight, ultimately helping individuals with a
lack of insight to benefit from them.

Keywords
Anxiety; treatment outcome; Metacognition; insight; illness awareness

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• Utilizing Virtual Reality as a Novel Therapeutic Modality to Overcome Public Speaking Anxiety
Ana Gallego, University of Jyväskylä, Finland
Simone Gorinelli, University of Jyväskylä, Finland

Abstract
Speaking in public is the most commonly reported fear in the general population (Dwyer & Davidson, 2012; Sawyer,
2016). Public speaking anxiety is considered a social anxiety disorder and refers to the anxiety that an individual expe-
riences when giving a speech or preparing to speak in front of others. In Finland, one third of the students report that
speaking in public is a severe problem for them (Kunttu et al., 2017). However, public speaking is an important skill for
university students to learn and practice as they progress through their education and careers.
To this end, our primary aim is to develop a permanent service designed to empower students to independently man-
age and overcome public speaking anxiety. Thus, our aim is to create an effective, yet cost-efficient service for all the
students at the University of Jyväskylä. To do this, students underwent a VR psychological intervention in a completely
autonomous way. The results are discussed in terms of their implications in clinical practice as well as future research.

Keywords
Virtual Reality (VR); Public Speaking Anxiety; Acceptance and Commitment Therapy; Social Anxiety

• Implementing Virtual Reality Interventions to foster Perspective-Taking in Individuals Exhibiting Aggressive

Behaviors
Ana Gallego, University of Jyväskylä, Finland
Simone Gorinelli, University of Jyväskylä, Finland
Salla Kaikkonen, University of Jyväskylä, Finland
Juha Holma, University of Jyväskylä, Finland

Abstract
Theoretical approaches to aggression have indicated that committing a violent act against others is connected to
a deficiency of empathy or a lack in the capacity of perpetrators to put themselves in the victim’s perspective (Blair,
1995). Indeed, some empirical studies have established a link between aggression and empathy (Follife & Farrington,
2004; Van Langen et al., 2014).
To this end, the primary aim of the present project was to shape perspective-taking and empathy in aggressors
through the use of Virtual Reality (VR). To do this, the offenders accessed a virtual environment in which they embod-
ied a virtual avatar victim of psychological abuse. Before and after the use of VR, we assessed emotional recognition,
empathy, attitudes towards women and violence, and the recognition of violent acts. The results are discussed in
terms of their implications in rehabilitation programs as well as future research.

Keywords
Virtual Reality (VR); Aggression; Empathy; Perspective-Taking; Psychological abuse

Open Paper Symposium 9 – Crisis contexts

Chair: Oksana Martsyniak-Dorosh, Academy of CBT in Ukraine, Ukraine

• Transdiagnostic risk factors for secondary traumatic stress among mental health professionals after Maraş
earthquake in Turkey
Furkan Malkoç, Turkish Ministry of Justice, Turkey
Nihan Osmanağaoğlu, Amasya University, Turkey

Abstract
As the effects of the indirect exposure to trauma has been shown leading to PTSD over the years, the re-conceptual-
ization of trauma in the DSM led to the recognition of secondary traumatic stress (APA, 2022; Figley, 1999). As a result,
offering services to traumatized individuals is increasingly thought to present an occupational hazard (Figley, 1999).
While there are several professions that may be at risk for developing secondary traumatic stress (STS), there are also
several factors that may be contributing to this. These factors may be at an individual level such as having personal
trauma history or at an organizational level such as heavier trauma caseload (Hensel et al., 2015). On the other hand,
the research on psychological factors is quite limited within the context of STS. These factors that typically impede
healthy responses to stress, according to cognitive models, are often accompanied by negative emotional and cogni-
tive responses (Ehlers & Clark, 2000). The distress is a maladaptive reaction that includes strong emotionality, and the
tolerance for distress is defined as the perceived ability or objective capacity to withstand negative physical or emo-
tional states (Simons & Gaher, 2005). Rumination is usually seen as an underlying mechanism for DT, and is defined

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as repetitive, prolonged, and recurrent negative thinking about one’s self, feelings, personal concerns and upsetting
experiences (Watkins, 2008). These factors are usually shared by various mental health problems as a clinical trait
including STS and PTSD (Grisanzio et al., 2018); and recognized as transdiagnostic risk factors. While both distress
tolerance and rumination appears as a transdiagnostic constructs for many psychological problems, the research is
quite limited for STS especially among mental health professionals (MHP) who are at risk for developing STS through
their work. Considering these limitations, this study aimed to examine STS, DT, and rumination among MHP in Turkey
after Maraş Earthquake in February, 2023. The sample consisted of 157 individuals between the ages of 20-67 with
a mean age of 34.79 (sd = 9.51). Out of those 90 were MHP, and 67 were professionals who does not carry any risk in
terms of STS. The Turkish versions of Secondary Traumatic Stress Scale (Bride et al., 2004; Yıldırım et al., 2018), Distress
Tolerance Scale (Simons & Gaher, 2015; Sargın et el., 2012), and Repetitive Thinking Scale (McEvoy et al., 2010; Gülüm
& Dağ, 2012) were used as data collection tools. The collected data was analyzed using the SPSS 21 program. There
were significant negative correlations between the STS and the DTS as well as for DTS and the RTQ. On the other hand,
there was a significant positive correlation between the STS and the RTQ. MHP scored significantly lower on the STS,
higher on DTQ compared to the other group; however, there was no significant difference on RTQ. Those who scored
significantly higher on STS based on mean cut-off appeared to score lower on DTS and higher on RTQ and overall,
rumination significantly mediated the relationship between DT and STS. Findings were discussed based on the liter-
ature.

Keywords
secondary trauma, rumination, distress tolerance

• Supervision Program CBS - Comprehensive Support for Therapists Working in the Context of the Russian
Military Invasion of Ukraine
Oksana Martsyniak-Dorosh, Academy of CBT in Ukraine, Ukraine
Hubert Czupala, Ośrodek Terapii Poznawczych i Behawioralnych, Poland

Abstract
In September 2022, during the ACT2022 conference in Poznań, a symposium titled “Ukrainian Space” was held. Scien-
tists and practitioners shared their experiences from the early days of the Russian military invasion of Ukraine, their
observations on the impact of hybrid warfare on mental health, and the role psychological flexibility training plays in
helping those experiencing the consequences of armed conflict. One of the main conclusions of the symposium was
that even the best foreign trainer and the best protocol or work model cannot replace individuals who understand
the cultural, historical, and current context of those experiencing the crisis. Additionally, the dynamics of a prolonged
war and its scale require a long-term support program for intervention workers on-site.
Over the past 12 months, together with a group of Ukrainian psychotherapists, a CBS supervision training program
has been implemented. The aim was to educate supervisors with the knowledge and competence to conduct indi-
vidual and group supervisions for intervention workers using ACT. Through evaluation, guidelines for comprehensive
CBS supervision training in the future were also developed.
The lecture will present the values, organizational framework, thematic scope of the program, and the results of the
qualitative evaluation of both the trained supervisors and those currently receiving supervision. Conclusions and
proposals for guidelines for future editions of the program will also be presented.

Keywords
ACT, supervision course, CBS, work with Ukrainian psychotherapists

• Evaluating the Impact of Mindful Compassion Care Program to Reduce Burnout in Frontline Nurses Caring for
Patients with COVID-19
Luca Bodini, Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University
of Verona, Verona, Italy
Simone Cheli, Department of Psychology, St. John’s University, Rome, Italy,
Chiara Bonetto, Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, Univer-
sity of Verona, Verona, Italy
Antonio Lasalvia, Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, Uni-
versity of Verona, Verona, Italy

Abstract
The COVID-19 pandemic has exacerbated burnout among frontline nurses, who face severe emotional and physical
stress. Despite various interventions to combat burnout, there is a scarcity of evidence-based protocols tailored for
nurses working directly with COVID-19 patients. This pilot non-inferiority wait-list non-randomized controlled trial
aimed to assess the feasibility and preliminary effectiveness of the Mindful Compassion Care Program (MCCP) in alle-

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viating burnout among these nurses. A total of 33 nurses from a major hospital in Northern Italy, the epicenter of the
pandemic in Europe, participated in the study. The primary outcome was the reduction in emotional exhaustion, with
secondary outcomes including various mental health measures and the feasibility of the intervention. The findings
revealed a significant reduction in emotional exhaustion over time, with mixed results for secondary outcomes, in-
cluding potential improvements in cynicism and perceived stress. Qualitative analysis highlighted high feasibility and
satisfaction, with no drop-outs or missed sessions. This pilot study provides encouraging evidence for the effective-
ness of MCCP in reducing burnout among frontline nurses. The results suggest that MCCP is a promising intervention,
warranting further investigation through larger randomized controlled trials. Detailed methodology, implementation
strategies, and preliminary findings of this study will be presented in the open papers session, offering valuable in-
sights for enhancing the mental well-being of frontline healthcare workers.

Keywords
burnout; mindfulness; compassion; nurses; covid-19

• Therapist views on remote therapy and training in Europe during the pandemic: results from theREMOTEcbt
project
Marija Mitković-Vončina, Serbian Association of Behavioural and Cognitive Therapists (SRABCT); University of Bel-
grade, Faculty of Medicine, Serbia; Institute of Mental Health, Belgrade, Serbia
Marija Lero, Serbian Association of Behavioural and Cognitive Therapists (SRABCT); Serbia; Institute of Mental Health,
Belgrade, Serbia

theREMOTEcbt Consortium, https://bit.ly/theREMOTEcbtConsortium

The SARS-CoV-2 coronavirus (COVID-19) pandemic has resulted in need for transitioning to remote psychotherapeu-
tic services and training, requiring adjustment of both service users and therapists around the world. The project “Eu-
ropean CBT therapists transitioning to remote CBT during the pandemic (theREMOTEcbt)” was initiated to investigate
the various facets of attitudes, experiences and needs on the remote provision of psychotherapeutic services and
training among CBT therapists and trainees, as well as to organize training sessions based on the needs recognized
by the study. The cross-sectional study included certified CBT therapists as well as CBT trainees from various European
countries (associations within the European Association for Behavioural and Cognitive Therapies (EABCT)), who filled
out the anonymous online questionnaire comprising questions on general and CBT–specific attitudes, experiences
and needs related to the provision of remote therapy and training. The key results point out that remote therapy and
remote training in therapy are largely used formats of service, with considerable increase of use during the pandemic.
In addition to general needs (mostly related to technical challenges), specific needs are related to issues such as es-
tablishing interpersonal effectiveness and collaboration, homework review, selection of strategy for change, applying
behavioural techniques. Attitudes towards remote therapy and training were mixed, and the majority of participants
believed that modules on providing remote (online) therapy should be incorporated into the CBT training curriculum.
To address the needs identified by the study, two training events with international participation were organized on-
line within the project, providing the colleagues from various countries valuable interactive opportunity to upgrade
their skills in working remotely (which was reflected by the excellent feedback). Further implications of the project
results are explained in the presentation.
Acknowledgement: The project “European CBT therapists transitioning to remote CBT during the pandemic - theRE-
MOTEcbt” is supported by the European Association for Behavioural and Cognitive Therapies (EABCT)

​Key words
remote therapy, online CBT, online training, COVID-19

• Serbian experience with community group social intervention program for displaced adolescents from Koso-
vo: associations with mental health symptoms and family functioning
Nataša Ljubomirović, Institute of Mental Health, Belgrade; College of Human Development, Belgrade, Serbia

Introduction: Stressful experiences through history have induced the establishment of different social groups and
the need for designing specific services, deliverable to masses. Displacement of youth has been associated with psy-

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chosocial dysfunctions on several levels, as well as with problems in family functioning. Applying best practice com-
munity psychosocial intervention models has been challenging and limited in low and middle income countries due
to low resources. This study was aimed to explore the differences in mental health symptoms and family functioning
between the groups of displaced adolescents from Kosovo (placed in collective centers in Serbia) who have and have
not attended the community group social intervention program. Additional aim was to assess the subjective experi-
ence with the intervention program.
Method: The study group of 46 displaced adolescents (age 11-18) from Kosovo, living in temporary collective centers
in three regions in Serbia, attended the community group social intervention program (with their families) consisting
of psychoeducational interventions, creative interventions and skills training interventions. This group was compared
to the control group consisting of 24 adolescents of the same age, status and living in the same collective centers,
who did not attend the aforementioned intervention program. The participants of both groups filled in the Youth
Self Report (YSR) questionnaire, as well as the Self-Report Family Inventory (SFI) at the end of the study period. The
participants of the study group additionally answered qualitative questions on their subjective perceptions on the
usefulness of the intervention program.
Results: The most prominent symptom scores in both groups were delinquent behavior and attention problems.
Comparing to the control group, adolescents from the study group had significantly lower intensity of withdrawal
and depression, better overall psychological functioning, better motivation to go to school, more family expressive-
ness of warmth, care and closeness, more consistent adult leadership in the family, and lower levels of unresolved
conflicts (p 0.05). The participants from the study group perceived the intervention program as useful, with domains
of usefulness dominantly clustering around increasing knowledge, socialization and self-esteem.
Conclusions: Findings of this study show promising effects of the structured community group social intervention
program for displaced adolescents and their families when it comes to the aspects of mental health and family func-
tioning, as well as the subjective perception of usefulness. Limitations of the study are presented, as well as the direc-
tions for future research and practical implications.
Key words: community interventions, group social interventions, displaced adolescents

• Longitudinal study of psychopathological symptoms in nurses and the general population following the
COVID- 19 pandemic: Implications for CBT multi-level interventions
Catarina Vitorino, University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Inter-
vention (CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal
Maria Cristina Canavarro, University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral
Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal
Carlos Carona, University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention
(CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal

Abstract
Since the beginning of the COVID-19 pandemic outbreak, the whole world has faced a social, economic, and health
crisis that went beyond the concerns about one’s physical well-being and that of significant others. This public health
emergency had short- and long-term effects on the mental health of the general population across the globe. Howev-
er, evidence has been pointing out specific groups that present a higher risk of developing psychological symptoms
with greater intensity, such as nurses. Due to their occupational role, additional challenges were imposed on these
professionals during and in the aftermath of the pandemic (such as inadequate resources and unsafe conditions to
perform their jobs, fear of infecting oneself and significant others, exposure to the constant suffering and death of
their patients), exacerbating previous difficult working conditions. Nonetheless, the results have not been conclusive
about the psychological effects of the COVID-19 pandemic, particularly when comparing both groups. Therefore, the
main goal of the current study was to analyze the longitudinal trajectory of depressive, anxiety and trauma symp-
toms, and fear of COVID-19, comparing self-reports of nurses and the general population, over a period of six months.
The sample included 180 nurses and 158 individuals from the general population, who answered online self-report
surveys at two time points: baseline assessment (T1: between September 2021 and May 2022) and follow-up at 6
months (T2: between May 2022 and December 2022). Self-report measures assessed sociodemographic and clinical
information at T1, and depressive, anxiety, and trauma symptoms, and fear of COVID-19 at both T1 and T2. A mixed
model ANOVA was used to evaluate the effects of group and time on individuals’ mental health outcomes in the after-
math of the COVID-19 pandemic. Significant interaction effects between group and time were explored using simple
effects tests, which compared the effect of the group at each time and the effect of time for each group.
The results showed that nurses-reported symptoms were generally higher than those reported by the general pop-
ulation, and tended to worsen over time, as opposed to the tendency of improvement found in the general popula-
tion. Levels of depressive, anxiety, and trauma symptoms were significantly different between nurses and the general
population over time. Levels of fear of COVID-19 demonstrated a significant decrease from T1 to T2 in both groups.
These findings suggest that nurses were more affected by the pandemic outbreak than the general population.
Therefore, it is crucial to develop resilience-promoting interventions tailored to the unique needs of this vulnerable
group for the specific context they are integrated. These strengths-based cognitive-behavioral therapy interventions

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should target multi-level dimensions (individual, interpersonal, and contextual factors) to integrate and facilitate the
development of constructive narratives about the pandemic, cultivate a safe work environment, decrease psycholog-
ical distress, and promote flourishing during and in the aftermath of the COVID-19 pandemic and future health crises.
Organizational leaders, governments, and decision-makers also need to acknowledge the importance of creating
policies that promote changes at the organizational level and provide adequate support to nursing professionals.

Keywords
COVID-19, depressive symptoms, anxiety symptoms, trauma symptoms, fear of COVID-19, nurses, general population,
longitudinal study

Open Paper Symposium 10 – Anxiety

Chair: Johanne Jeppesen Lomholt, Lomholt, Aarhus University, Denmark

• The Association of Contrast Avoidance and Looming Cognitive Style with Anxiety and Depression: The Medi-
ator Role of Repetitive Negative Thinking
Elif Peksevim, PERLA Psychology and Research, Turkey
Ayse Altan-Atalay, Kadir Has University, Turkey
Büşra Temur, Sabancı University, Turkey

Abstract
Background: Both looming cognitive style and contrast avoidance are cognitive vulnerability factors that play a cru-
cial role in the etiology of various psychological disorders starting with anxiety disorders. Looming cognitive style
refers to biased processing of the mental representation of the threat as becoming bigger and more overwhelming
with every passing minute. LCS has two different subtypes as social and physical looming. Contrast avoidance, on the
other hand, refers to an emotional processing strategy characterized by the generation and maintenance of negative
emotional states to avoid shifts in emotional experiences. According to the interactive-synergistic perspective, cogni-
tive vulnerability factors usually interact with each other and augment each other’s impact, increasing the possibility
of mental health problems among individuals who have both vulnerabilities. The current study aimed to examine
how the interaction between looming cognitive style and contrast avoidance is associated with both anxiety and
depression. Furthermore, the current study aimed to investigate the mediator role of repetitive negative thinking in
this relationship.
Method: The data were collected from 386 (335 women) Turkish individuals between ages 18 and 54 (M= 22.18, SD=
4.25) through self-report measures of looming cognitive style, contrast avoidance, repetitive negative thinking, anx-
iety, and depression.
Results: The results indicated that repetitive negative thinking was significantly mediating the association of both
contrast avoidance and social looming with both anxiety and depression. However, the results for physical looming
did not yield significant results. Moreover, CAS did not moderate the association of neither social looming nor physi-
cal looming with repetitive negative thinking and measures of psychological distress.
Conclusion: In line with the previous studies both looming cognitive style and contrast avoidance appeared to have
robust associations with both forms of psychological distress. However, they do not interact in a synergistic manner
to enhance each other’s effect on mental health outcomes. The findings highlight the difference between social and
physical looming in terms of the variables that explain their association with anxiety and depression. The findings will
be discussed under the light of recent literature.

Keywords
Looming cognitive style, contrast Avoidance, repetitive negative thinking, anxiety, depression

• Incorporating picture books in CBT as an interface between therapists and young adults with anxiety disor-
ders
Haiqi Yang, UAL, United Kingdom
Ian Horton, University of the Arts London, United Kingdom
Alexandra Antonopoulou, University of the Arts London, United Kingdom
Soljana Çili, University of the Arts London, United Kingdom

Abstract
Anxiety disorders are among the most prevalent psychological disorders around the world, but around half of the
patients do not seek help, mainly due to disparities in access to mental health care (American Psychiatric Association,
2022; Hohn and Maricuţoiu, 2024). Since ‘graphic medicine’ (comics and graphic novels about illness) can help readers
understand illness in an engaging way (Williams, 2012), picturebooks about anxiety disorders may be useful tools
for improving individuals’ understanding and management of these conditions in or outside the context of CBT. This

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paper will present the results of a multidisciplinary PhD project which involved input from an illustrator (first author),
graphic narrative researchers (Dr. Horton and Dr. Antonopoulou), a psychologist (Dr. Çili) and therapists. The project
involved the development of picturebooks portraying symptoms of generalised anxiety disorder and social anxiety
disorder, as well as simple techniques for managing some of their symptoms. Because young people were particularly
vulnerable to the mental health impact of the COVID-19 pandemic, and generalised anxiety disorder and social anx-
iety disorder are among the most common anxiety disorders among the age group 18-34 (Varma et al., 2021; Chang
et al., 2019), the picturebooks were developed for an audience of young adults aged 18-34 years.
The effectiveness of the picturebooks in communicating anxiety disorders was examined through two rounds of one-
on-one online interviews with therapists from various countries. I created picturebook stories and storyboards based
on psychology research and my personal lived experience, in which the storytelling structure was inspired by the CBT
process. In the first round of interviews, I showed published comics and picturebooks about anxiety and depression
and my picturebook storyboards to therapists. Their thoughts towards the possible applications of this kind of pic-
turebook and the narrative effectiveness of my picturebooks were collected and analysed using NVivo. Based on the
therapists’ responses, I improved and completed the two picturebooks. In the second round of interviews, the same
therapists were presented with and were asked to comment on the final picturebooks. Their responses suggested
that they generally considered my picturebooks as effectively embodying generalised anxiety disorder and social
anxiety disorder symptoms through visual and textual narration. Furthermore, they believed that my picturebooks
could serve as a visual tool in psychotherapy with emerging and young adults. They might assist therapists in com-
municating more effectively with patients and offer continued support outside therapy sessions. Additionally, these
books may raise awareness among a wider audience about their conditions, potentially encouraging readers who are
suffering from the same conditions to seek treatment.

Keywords
Anxiety disorders, picturebooks, CBT, visual and textual narratives

• Cognitive Distortions and Loneliness as Mediators of the Relationship Between Social Anxiety and Depres-
sion
Marina Trbus, Private psychological practice, Croatia
Ana Petak, University of Zagreb, Faculty of Croatian Studies, Croatia

Abstract
Social anxiety and depression are common internalizing problems among the student population. They often co-oc-
cur, but it remains unclear what underlies their relationship. Cognitive distortions generally contribute to internalizing
problems, while loneliness is also related to social anxiety and depression. Cognitive distortions contribute to the
emergence and maintenance of social anxiety, as well as to social fears and negative expectations of social interac-
tions in depression. The perception of rejection in social interactions contributes to loneliness, anxiety, and depres-
sion. This research aimed to test the relationship between social anxiety and depression with the mediating roles of
loneliness and interpersonal cognitive distortions.
University students (N=228) from various studies in the Republic of Croatia participated in the research. Most of the
sample were female (82%), college undergraduates (74.1%), who attended faculties mostly in the area of social stud-
ies (72.8%). The research was conducted online in the fall of 2023. Participants completed the Depression, Anxiety,
and Stress Scales, the Loneliness Scale, the Interpersonal Cognitive Distortion Scale, and the Interaction Anxiety Scale.
No significant differences were found in depression, cognitive distortions and loneliness regarding the level of study
(undergraduate/graduate) and gender. Social anxiety was more common (t=-2.819, df=226, p<.01) in female students
(M=50.909, sd=12.187) comparing to male students (M=45.122, sd=10.479). All scale results showed significant in-
tercorrelations (r=.305-.480, p<.001). Mediation regression analysis was conducted using PROCESS. Results showed
that social anxiety predicts cognitive distortions (a1=.280, p<.001) and loneliness (a2=.325, p<.001). Cognitive distor-
tions (b1=.155, p<.001) and loneliness (b2=.139, p<.001) predict depressive symptoms. Analysis revealed a signifi-
cant indirect effect of social anxiety on depression through interpersonal cognitive distortions (a1b1=.114, LLCI=.062,
ULCI=.172) and loneliness (a2b2=.119, LLCI=.065, ULCI=.179). Furthermore, no significant direct effect of social anx-
iety on depressive symptoms was found (c’=.028, p>.05). Hence, both loneliness and interpersonal cognitive distor-
tions completely mediated the relationship between social anxiety and depressive symptoms.
The results are discussed in the context of existing literature, with suggestions for practical implications in counseling
work.

Keywords
social anxiety, depression, loneliness, interpersonal cognitive distortions, university students

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• The effect of skills-training on self-efficacy and competence of cognitive behavioral therapy for social anxiety
disorder: a dismantling study.
Jon Fauskanger Bjaastad, Division of psychiatry, Stavanger University Hospital, Norway
Kjersti Lillevoll, UiT, Norway
Toril Nilsen, UiT, Norway
Jane Kjoteroe, UiT, Norway
Asle Hoffart, Modum Bad, Norway
Peter Prescott, NFKT, Norway
Catharina Wang, UiT, Norway
Veronica Lorentzen, UiT, Norway

Abstract
The aim of this study was to investigate the effect of skills-training on self-efficacy and CBT-competence in psychology
students who received a 16-hours course in cognitive behavioral therapy for social anxiety disorder (CT-SAD; Clark &
Wells, 1995). A total of 94
psychology students in year five of their six-year professional training consented to partake in the study. Initially, all
students viewed an eight-hour instruction video in cognitive therapy for social anxiety disorder (Clark & Wells, 1995)
presented by one of the developers of the treatment, Professor David Clark. Thereafter the students were randomized
to one of two eight-hour training conditions. Condition one comprised of video demonstrations of how to develop a
case formulation and carry out a relevant behavioral experiment. In condition two, the students received skills-train-
ing in the form of repeated short live demonstrations followed by practicing the same procedure in role-plays two
and two. Both conditions were led by the same two Norwegian expert clinicians with accreditation in skills-training.
After the course, students role-played a 45 minute session of CT-SAD which was videotaped and rated with the Cog-
nitive Therapy Competence Scale for Social Phobia (CTCS-SP; Clark, Von Consbruch, Hinrichs & Stangier, 2006). The
scale has demonstrated satisfactory psychometric properties (Von Consbruch, Clark, & Stangier, 2012) with good
interrater reliability for mean score, high internal consistency, and good test- retest reliability. In the current study,
satisfactory interrater reliability was established between an expert scorer and two psychologists who rated 94 video-
tapes without knowing which training condition the therapists belonged to. Additional variables that were measured
pre- training, post-training and at 6-months follow-up were self-efficacy, student therapist concerns and satisfaction
with training. Preliminary findings from this study will be presented, along with a discussion regarding possible impli-
cations for training in cognitive behavioural therapy.

Keywords
Skills Training, Competence, Self-efficacy, Social Anxiety Disorder, CT-SAD

• Feasibility study of Cool Little Kids, a targeted intervention for prevention and early intervention of anxiety
disorders in at-risk young children
Johanne Jeppesen Lomholt, Lomholt, Aarhus University, Denmark
Mikael Thastum, Aarhus University, Denmark

Abstract
Anxiety disorders are the most prevalent mental health conditions among children and adolescents, and if left un-
treated, anxiety disorders with an onset in childhood often persist into adolescence and early adulthood. Early inter-
vention and prevention provide important alternatives to modify the developmental trajectory of anxiety disorders.
Cool Little Kids is a targeted prevention and early intervention program designed for parents of preschool-aged chil-
dren. The program focuses on children with behavioral inhibition, which is a highly supported risk factor for anxiety,
as well as other significant risk factors such as parental psychopathology and parental overinvolvement. Studies on
the efficacy of Cool Little Kids indicate that it is possible to produce changes in children’s anxiety symptoms after a
short intervention targeting parents early in the child’s life, suggesting that the program may have significant public
health implications. However, more studies are needed to establish the long-term effect of the program.
The aim of the current study was to examine the feasibility and acceptability of Cool Little Kids in a non-randomized
trial, including both qualitative and quantitative data, in preparation for a randomized controlled trial of its effec-
tiveness. Twelve families participated in the feasibility study and were divided into two Cool Little Kids Groups. Par-
ents completed questionnaires at baseline and post-intervention regarding their child’s anxiety, as well as their own
symptoms of anxiety. Additionally, parents evaluated the procedure and intervention in writing halfway through the
process and participated in a semi-structured interview after the final session, which focused on their participation
in the program.
The participating parents rated their satisfaction with Cool Little Kids high and minimum one parent from each family par-
ticipated in the majority of the sessions. One family withdrew from the group and did not complete the post assessment.
Preliminary evaluation of the Cool Little Kids program showed positive tendencies. There was a significant decrease
in the parents’ rating of the child’s level of behavioral inhibition, and a near-significant decrease in the child’s level of
anxiety symptoms and the impact of the child’s anxiety on the family.

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Based on this feasibility study, adaptations were made to the study procedures prior to the commencement of a ran-
domized controlled trial. The main adaptation to the procedure was additional exclusion criteria, as the complexity of
some of the cases was too high for a 6-session prevention study. Accounting for these adaptations, it seems feasible
to evaluate the effectiveness of Cool Little Kids in a randomized controlled trial.

Keywords
Prevention, Anxiety Disorders, Parent-led cognitive behaviour therapy, Cool Little Kids Program, Early Intervention,
Feasibility Study

Delivering an Internet-based cognitive behavioral (iCBT) intervention for anxious adolescents with different
levels of therapist support: a feasibility study
Nikita Marie Sørensen, Aarhus University, Denmark
Helene Skaarnes, Center for Digital Psychiatry, Region of Southern Denmark
Kim Mathiasen, Aarhus University, Denmark
Mikael Thastum, Aarhus University, Denmark
Johanne Jeppesen Lomholt, Aarhus University, Denmark

Abstract
The present study examined the feasibility of a new Internet-based cognitive behavioral (iCBT) intervention, Cool-
Minds, for adolescents with clinical anxiety disorders when delivered with different levels of therapist support. The
participants’ diagnostic status was assessed using the Youth Online Diagnostic Assessment (YODA) child and parent
versions. Their symptoms were measured using Spence Child Anxiety Scale (SCAS) child and parent versions. 15 ado-
lescents aged 12-17 (M = 13.7) and their parents participated in the study. Participants were randomized to either 1)
iCBT with planned feedback (n = 8), or 2) iCBT with on-demand feedback (n = 7). Adolescents in the planned feedback
condition received written feedback from the therapist after each completed session. Adolescents in the on-demand
feedback condition had to contact the therapist themselves to request written feedback. Parents in both conditions
had to contact the therapist themselves to receive any feedback. Therapists were instructed to use a maximum of 15
minutes per participant providing feedback each week in either condition.
In total, one third of adolescents (n = 5; planned feedback condition = 4, on-demand condition = 1) and more than
half of parents (n = 9) sent messages to their therapist. On average across both conditions, adolescents sent 9.2
(range = 1-23, total = 46) messages to their therapist, while parents sent 4.1 messages (range = 1-11, total = 37). In
the planned feedback condition, participants sent an average of 5,8 messages to their therapist. In the on-demand
condition, one participant sent a total of 23 messages to the therapist.
In total, five adolescents completed the program (defined as completing a minimum of 7 out of 9 sessions). Partici-
pants in the planned feedback condition completed a mean number of 5,6 sessions, and participants in the on-de-
mand condition completed a mean number of 5,8 sessions. Three participants (planned feedback condition = 2,
on-demand condition = 1) dropped out during the treatment period. The two conditions did not differ in the overall
amount of contact or completion, but more adolescents were in contact with the therapist in the planned feedback
condition.
At post-treatment, six adolescents were free of their initial anxiety diagnoses (no diagnosis or subclinical diagnosis)
across both conditions (planned feedback condition = 3, on-demand condition = 3). Differences in anxiety symptoms
from baseline to post-treatment were only statistically significant for SCAS-P scores for the total sample, Z = -2.550,
p = .011, d = .86, and for the planned feedback condition, Z = -2.023, p = .043, d = .91. The results from this feasibility
study indicate that it would be feasible to evaluate the CoolMinds-program in a randomized controlled trial when
delivered with different levels of therapist support.
Keywords
Adolescents, anxiety disorders, cognitive behavioral therapy, internet-based, digital health, feasibility

Open Paper Symposium 11 – Adolescent mental health

Chair: Maruša Naglič, National Institute of Public Health, Ljubljana, Slovenia

• Can brief accessible CBT workshops help improve the mental health of adolescents? Results of the BESST
trial, a confirmatory trial in schools in UK
June Brown, King’s College London, United Kingdom

Abstract
Background
Depression and anxiety are increasingly prevalent in adolescents. BESST investigated the effectiveness of a brief ac-
cessible DISCOVER stress workshop programme for vulnerable 16–18-year-olds. Workshops themselves lasted a day.
Methods

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An England-wide multi-centre cluster randomised controlled single-blinded trial to evaluate clinical-effectiveness
and cost-effectiveness of a DISCOVER workshops compared to treatment-as-usual (TAU)(1:1). We planned to enrol
60 schools and 900 adolescents in the North West, Midlands, South West and London, using a self-referral system to
recruit participants. The primary outcome was depression symptoms (MFQ) at 6-month follow-up. Cost-effectiveness,
taking a National Health Service (NHS) and personal social services perspective was explored using quality adjusted
life years (QALYs). The ISRCTN registration was 90912799. Day-long workshops were delivered by a new professional
group of clinicians called Mental Health Support teams (MHSTs) who are based in schools in the UK, and were special-
ly trained to offer the workshops for this trial.
Recruitment
Between 4th October 2021 and 10th November 2022, 900 adolescents at 57 schools were enrolled, before randomis-
ation of schools. The DISCOVER arm included 443 participants (295 female (67%)) and TAU included 457(346 female
(76%)). The ITT analysis included 415 and 439 adolescents (DISCOVER: TAU). Among participants, 80% students had
not previously sought help from a GP and 46% reported being from minoritised ethnic groups (largest groups were
Asian 17%, Black 16%).
Results
Results from the BESST trial, which evaluated the DISCOVER programme will be reported at the conference. Results
will include clinical effectiveness, cost-effectiveness and a qualitative process evaluation.

Keywords
Accessible, Brief workshops, depression, self-referral, schools

• Recalling and Anticipating Positive Events to Improve the Positive Affect and Mental Health of Adolescents:
A Cluster Randomized Controlled Trial in Secondary Schools
Liesbeth Bogaert, KU Leuven, Belgium
David Hallford, Deakin Univer, Australia
Eline Loyen, KU Leuven, Belgium
Arnaud D’Argembeau, U Liege, Belgium
Filip Raes, KU Leuven, Belgium

Abstract
Building resilience is crucial for adolescents to better deal with challenges and stress, and to ultimately learn to thrive
in life. Via a cluster RCT, we examined the effectiveness of Positive Events Training (PET) to achieve this via increas-
ing positive emotions. PET is a combined group training focusing on the recollection and anticipation of positive
events. Delivered as a universal school-based program, PET was compared with an active control group (CREATive
writing). Effects on resilience, wellbeing, positive emotions, emotional response styles (savoring, dampening), an-
hedonia, depressive symptoms, and autobiographical memory (AM) and episodic future thinking (EFT) indices were
examined. Adolescents (12-16 years; N PET = 95, N CREAT = 93) completed self-report scales at baseline, post-training,
and two-month follow-up. PET resulted in significant enhancements in some AM and EFT skills. Preliminary support
was found for PET resulting in reduced anhedonia at post-training. Exploratory analyses suggested that PET boosts
positive emotions for adolescents with elevated baseline depressive symptomatology. The level of perceived likeli-
hood of generated future events and dampening might be underlying mechanisms. The absence of changes in other
outcomes should be interpreted bearing the universal school-based approach in mind. Future directions to maximize
the demonstrated potential of PET are discussed.

Keywords
resilience; wellbeing; adolescents; positive emotions; emotion regulation

• Comparison of disorder-specific group CBT and generic group CBT in treating adolescents with social anxiety
disorder: A randomized controlled trial
Thea Agersnap, Aarhus University, Denmark
Johanne Jeppesen Lomholt, Lomholt, Aarhus University, Denmark
Morten Berg Jensen, Aarhus University, Denmark
Mikael Thastum, Aarhus University, Denmark

Abstract
Background: Social anxiety disorder is associated with severe distress and long-term negative consequences such as
loneliness, school problems, comorbidity of other anxiety disorders, depression, and substance abuse. Additionally,
social anxiety disorder is one of the most common disorders in adolescence, and if untreated, social anxiety disorder is
associated with chronicity. Generic cognitive behavioral therapy (CBT) is the best-documented treatment and recom-

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mended treatment for adolescents with anxiety disorders, including social anxiety disorder. However, research shows
that adolescents with social anxiety disorder tend to have worse outcomes from generic CBT compared to those with
other anxiety disorders. The reasons for these poorer outcomes in adolescents with social anxiety disorder are not
yet clear. Anyhow, a meta-analysis points to the suggestion that disorder-specific CBT may improve the outcome for
adolescents with social anxiety disorder, similar to what it does for adults with social anxiety disorder.
Aim: Therefore, the current study aimed to compare the effect of a disorder-specific group CBT for adolescents with
social anxiety disorder against a generic group CBT for adolescents with social anxiety disorder. Additionally, we in-
vestigated factors that might predict treatment outcomes to better understand who will benefit the most and least
from the current CBT treatment.
Methods: Ninety adolescents aged 12-17 with social anxiety disorder participated in the randomized controlled
trial. The study had three primary outcome measures. The Anxiety Disorder Interview Schedule-IV C/P (ADIS-IV), a
semi-structured diagnostic interview, was conducted with adolescents and their parents to assess current diagnoses,
such as social anxiety disorder. The second primary measure was the Social Phobia Inventory (SPIN) which measured
the adolescents’ self-reported social anxiety symptoms. The third primary measure was Spence Children’s Anxiety
Scale (SCAS), which measured adolescent’s overall anxiety symptoms reported by both the adolescents and their
parents. All outcome measures were assessed at baseline, post-treatment, and three-month follow-up. Multi-level
modeling was conducted in the statistical analysis for both the main effects and the predictors.
Results: The disorder-specific group CBT and the generic group CBT showed no significant difference over time, with
the only exception being the adolescents’ self-reported overall anxiety symptoms favoring the generic group CBT.
However, we found a significant improvement over time on nearly all outcome measures regardless of treatment con-
dition. Furthermore, the preliminary findings regarding the factors that predict treatment outcomes will be presented
at the conference.
Conclusion: There were no notable differences between the two treatment conditions, however, we did see a signifi-
cant reduction in symptoms over time. Moreover, the results indicated that the group format was a feasible approach.
The conclusions from the predictor analysis will be presented further at the conference.

Keywords
Social anxiety disorder, Cognitive behavioral therapy, Group therapy, Disorder-specific CBT, Randomized controlled
trial

• What Can I Do to Make It Easier? A Multimedia Handbook for Navigation through Adolescence
Maruša Naglič, National Institute of Public Health, Ljubljana, Slovenia

Abstract
The increasing prevalence of distress and anxiety disorders among young people has prompted the development of a
widely accessible, free multimedia self-help handbook. In 2022, we published “What Can I Do to Make It Easier? Skills
for Everyday Life and Sources of Support in Distress” (Slovene: “Kaj lahko naredim, da mi bo lažje? Veščine za vsakdan
in viri opore v stiski”) under the youth mental health program “This is Me”, managed by the National Institute of Public
Health (Slovenia).
Based on the cognitive-behavioral paradigm, the handbook helps adolescents understand the relationship between
thoughts, emotions, and behaviors. It teaches them to recognize common cognitive distortions, develop more re-
alistic thinking, and utilize other self-help strategies at times of distress. The handbook integrates traditional book
content with online resources, using QR codes to guide readers to additional content, worksheets, and guided au-
dio exercises on www.tosemjaz.net. The digital edition (in Slovene) is freely accessible at https://live.editiondigital.
com/e/221cpgqsc/prirocnik-kaj-lahko-naredim-da-mi-bo-lazje#!page1.
The printed edition was distributed for free to all primary and secondary schools in Slovenia (January 2022) and to
health and social services (July 2022) working with young people. In 2023, the Slovenian Year of Mental Health, we
received support from the Ministry of Education and Ministry of Health for a national campaign in which every stu-
dent in the last year of primary school (age 14–15) received a copy. An evaluation of the campaign in January 2024
indicated that pedagogical experts consider the handbook as an important support tool for adolescents. It serves
as a self-help resource for those aged 15 and above and as material for use by professionals in educational settings,
addressing the increased need of adolescents for skills to cope with unpleasant emotions and distress. In four print
runs from 2021–2024, the manual exceeded a circulation of 50,000 copies.
About This is Me: The “This is Me” program (Slovene: “To sem jaz”) is a comprehensive mental health initiative for ad-
olescents, launched in 2001 by the Celje Regional Unit of the National Institute of Public Health. It aims to enhance
psychological resilience by strengthening social and emotional skills and promoting a positive self-image.
The program has two main components:
An online information and counselling platform, www.tosemjaz.net, offering adolescents anonymous, free access to
expert advice. The multidisciplinary network of counsellors includes over 100 professionals who participate in the
program as volunteers.

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Preventive practices in schools include 10 workshops that, among other approaches, are partially based on the
cognitive-behavioral paradigm. They are designed to enhance social and emotional skills of adolescents. This evi-
dence-based model has been validated by experts.
The “This is Me” program has received international recognition as a best practice, most recently in 2024 by the OECD.

Keywords
Adolescents, Multimedia Handbook, Self-Help Strategies, Psychological Resilience

• Embedding and implementing “Taming the Adolescent Mind”: a skill-based intervention in community child
and adolescent mental health service.
Lucy Tan, James Cook University, Australia
Graham Martin, The University of Queensland, Australia

Abstract
Background: The gap between the evidence-based interventions and their successful implementation in the
real world persists. Implementation science plays an important role in address barriers and gaps in the trans-
lation. “Taming the Adolescent Mind©” is a five-session experiential group programme developed for adoles-
cents with mixed mental health difficulties. The development of programme was guided by Third-wave Cog-
nitive-Behavioural Therapy principles of acceptance-based and mindfulness-based practices. The intervention
protocol was previously piloted, subjected to randomised controlled trial and its effectiveness and efficacy results
already published (Tan & Martin 2013; Tan & Martin 2015). The aim of this paper is to present the findings and ev-
idence to embed the programme in a major hospital and community-based adolescent mental health services.
This study, set in a relatively high-resource context in Australia city, can provide insight into the application and facil-
itation of a novel programme in a busy healthcare context

Methods: During 2017-2019, we conducted semi-structured, open-ended interviews and focus groups at an Austra-
lian child and adolescent mental health service, using the guiding framework - pratical robust implementation and
sustanability model (PRISM) to explore internal and external stakeholder influence. We interviewed a total of 33 inter-
nal stakeholders: 4 team leaders, 3 psychiatrists, 4 psychologist interns, and 22 multi-disciplined clinicians (comprised
of clinical psychologists, mental health nurses, occupational therapists and psychiatric social workers). Participants’ (N
= 25) feedback were also collected.
Results: Stakeholders at various organisational levels consistently reported that the need for experiential psycholog-
ical interventions alleviated adolescents’ expressive communication difficulties, and that group interventions lighten
resources and staff’s time. A consistent positive response from adolescents who had attended the group programme
also revealed promise.
Conclusions: Addressing barriers and enablers at multiple levels of a health system and providing centralised educa-
tional training, and support had benefits.

Keywords
Adolescent mental health, Implementation Science, PRISM, Third-wave CBT, Mindfulness-based intervention

• The role of adverse life events, self and other beliefs, and cognitive flexibility in understanding paranoia in
adolescents
Jess Kingston, Royal Holloway, University of London, United Kingdom

Abstract
Adolescence is a developmentally sensitive period for emerging fears about other people’s intentions, and yet to date
there are no conceptual frameworks for understanding paranoid beliefs during this unique life stage. Ascertaining
the mechanisms that underlie paranoia in adolescents is central to developing effective and targeted interventions.
This pre-registered study investigated the relationship between adverse life events, negative beliefs about the self
and others, and cognitive flexibility in understanding paranoia following an exclusion manipulation. Using a novel,
game-based paradigm, cognitive flexibility was assessed via the participants ability to make decisions based on the
performance of another player (flexibility), versus using pre-existing beliefs to govern behaviour (rigidity; Barnby et
al., 2022). Computational modelling was used to generate cognitive flexibility scores. We predicted that exclusion
triggers negative beliefs about the self and others following exclusion, especially in those who have experienced re-
cent negative life events. Further, we anticipated that this would be modified by cognitive flexibility. Six-hundred UK
adolescents (15-17 year olds) were quota sampled (age and gender) using Qualtrics recruitment panels. Participants
completed baseline questionnaires, after which they played cyberball, an online ball throwing game in which 50% of
young people were randomised to be excluded from the game, whereas the remaining 50% received equal throws.

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We are in the final stages of data collection. Findings will be presented, alongside implications for the conceptualisa-
tion of paranoia in young people.

Keywords
paranoia; adolescents; cognitive flexibility; adverse life events; self-beliefs

Open Paper Symposium 12 - Approaches to interventions 2

Chair: David Dias Neto, Associação Portuguesa de Terapias Comportamental, Cognitiva e Integrativa, Portugal

• Comparison of the therapeutic efficacy of Four weeks of inpatient schema group therapy (ISGT) versus ISGT
enhanced by Nature-Adventure-based experiential methods (N-ABST)
Zsolt Unoka, Semmelweis University – Medicine and Health Sciences, Hungary
Estzer Kenézlói, Semmelweis University, Faculty of Medicine, Department of Psychiatry and Psychotherapy, Hungary
Evelyn Levay, Semmelweis University – Medicine and Health Sciences, Hungary
Bálint Hajduska-Dér, Semmelweis University, Faculty of Medicine, Department of Psychiatry and Psychotherapy,
Hungary
János Réthelyi, Semmelweis University, Faculty of Medicine, Department of Psychiatry and Psychotherapy, Hungary
Pál Czobor, Semmelweis University, Faculty of Medicine, Department of Psychiatry and Psychotherapy, Hungary
Rakar-Szabo Natalia, Kétté Alapítvány, Hungary
Gábor Szabó, Kétté Alapítvány, Hungary

Abstract
Introduction: A complex, Nature-, and Adventure-integrated Schema Therapeutic program (N-ABST) and a related
efficacy study were launched in April 2022 at the Psychotherapy Department at Semmelweis University. The partici-
pants had the opportunity to participate in outdoor, experience-based group processes – seven full days a month - in
addition to the Inpatient Group Schema Therapy (ISGT) sessions. According to the study design, 4-week-long ISGT
programs and 4-week-long N-ABST programs took place alternately.
Objectives: We aimed to compare the efficacy in a randomized, controlled design, short and medium terms. The par-
ticipants of the programs and thus the target group of the research were adults, diagnosed mainly with Borderline
Personality Disorder, inpatients in psychiatry.
Methods: This methodological innovation also meant the integration of two therapeutic teams in practice. When es-
tablishing the collaboration, we put emphasis on finding common points and understanding how N-AT contributes
to schema therapy goals. During our joint work, it became clear that the elemental need for contact with Nature en-
riched the schema therapy approach with a new basic need that was not included before. Measurements were taken
before the start of the entire program and at the end of the 4-week cycle. Preliminary results are presented based
on the Personality Inventory for DSM-5 - Hungarian Short Form (PID-5-HSF), and the Derogatis Symptom Checklist
(SCL90).
Results: In the N-ABST group (n=23) the PID5 “Dysinhibition” scale (p < .01, Cohen’s d = .636), and the “Negative Affec-
tivity” scale (p < .05, Cohen’s d = .388) showed significantly lower scores after therapy. In the case of “Detachment,” we
found a tendency to decrease after the therapy. Regarding the comparison of the effectiveness of N-ABST and classi-
cal Schema Therapy - with the current state of analysis - there was a significant difference in the PID5 values for “Suspi-
ciousness” and “Manipulativeness”. The schema therapy reduced the former characteristic to a greater extent, and the
latter to the N-ABST therapy. Based on the SCL90, the N-ABST program resulted in a significant symptom reduction
measured by the following subscales: somatization, obsessive-compulsive, interpersonal sensitivity, depression, and
phobia. Global symptom severity also decreased significantly (p < .05, Cohen’s d = .588).
Conclusions: According to our results, Nature- Adventure Therapy enhanced Schema Therapy seems to be an innova-
tive and efficient method in the psychotherapy of personality disorders. Besides effectiveness, there is a great chal-
lenge to designing sustainable programs and, therefore, serving therapy in the long term.

Keywords
group inpatient schematherapy, Nature and Adventure therapy, borderline personality disorder

• Connection to the Environment with Cognitive Therapy (CONNECT): Exploring trauma, dissociation and voic-
es through targeted psychological intervention using a single-case experimental design
Moya Clancy, University of Glasgow, United Kingdom
Kirsten Atherton, NHS Greater Glasgow & Clyde, United Kingdom
Andrew Gumley, University of Glasgow, United Kingdom

Abstract
Background: When considering pathways from trauma to psychosis, evidence suggests that dissociation plays a piv-
otal role. Adopting an interventionist-causal stance, the current study investigated whether targeting dissociation

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through a psychological intervention (Connection to Environment with Cognitive Therapy [CONNECT]) led to im-
provements in dissociation, Auditory Hallucination Frequency (AH-F) and Distress (AH-D) for people who have expe-
rienced trauma.
Methods: This study utilised a randomised multiple baseline single-case experimental design. Four participants with
dissociation, AH and trauma were randomised to baselines of two, three or four weeks and then received eight ses-
sions of CONNECT. Dissociation, AH-F and AH-D were assessed at baseline, pre-intervention, post-intervention and
1-month follow-up, session-by-session, and daily self-report. Data were analysed using visual analysis, Tau-U analysis
and Reliable Change Indices.
Results: CONNECT led to a significant improvement in dissociation at combined level but did not lead to significant
improvements at individual level. Contrary to our hypotheses, CONNECT did not lead to significant improvements in
AH-D or AH-F at the combined or individual level except for one participant for whom AH-F significantly decreased.
Conclusions: Contrary to our hypotheses reducing dissociation through targeted psychological intervention did not
lead to improvements in AH. Further research is warranted with particular emphasis on interventionist-causal ap-
proaches, digital technology, and network analysis.

Keywords
psychosis, trauma, dissociation, auditory hallucinations, trauma-focused, single-case experimental design

• Empower-Grief: A brief selective intervention to prevent prolonged grief

David Dias Neto, Associação Portuguesa de Terapias Comportamental, Cognitiva e Integrativa, Portugal
Alexandra Coelho, ISPA - Instituto Universitário, Portugal
Sara Albuquerque, Universidade Lusófona, Portugal
Ana Nunes de Silva, Universidade de Lisboa, Portugal

Abstract
The prevalence of prolonged grief disorder, particularly in the context of palliative care, is significantly high. A sub-
stantial portion of relatives and carers remain without any type of care. In this context, the study of selective interven-
tions that have low intensity and focus on the prevention of adverse reactions is paramount. One such intervention is
Empower-Grief - a cognitive-behavioural and acceptance-based intervention divided into six sessions and two boost-
er sessions.
The present study investigates the efficacy of Empower-Grief when compared to the current treatment (pre-post and
6-month follow-up). It also analyzes the predictors of adherence to the intervention and the preventive value of the
intervention. This is an exploratory randomized trial. Participants are adult family members of palliative care patients
who already show risk indicators. They are randomly allocated to the two groups. Measures include self-reports of
general symptomatology and prolonged grief, as well as a set of relevant predictors (e.g., coping and attachment to
the deceased).
The present communication presents the results of the pre-post comparison. The results suggest an equivalence in
the studied outcomes. Both interventions produce significant changes with a large effect size. We also find different
associations between the predictors and symptom change. We explore these results in light of the predictors’ results.
This study contributes to the investigation of brief, evidence-based solutions to prevent prolonged grief. The identifi-
cation of predictors is relevant in the progressive personalization of care to users’ needs.

Keywords
Grief, Prolonged Grief Disorder, Selective intervention

• Feasibility of a Novel Biopsychosocial Treatment for Stress-Induced Exhaustion Disorder

Jakob Clason van de Leur, Uppsala Universitet, Sweden

Abstract
Introduction
With the escalating prevalence of stress-related disorders in Western society, disorders such as Stress-Induced Ex-
haustion Disorder (ED) have garnered increased attention in contemporary scientific and clinical discourse. Despite
various treatment studies, evidence-based treatments for ED and established clinical theories are lacking. Current
treatments are often large-package multimodal interventions (MMI) focused on recuperation, assuming ED stems
from a resource deficiency due to persistent stress. However, this biomechanistic perspective, emphasizing the phys-
iological dimension of stress, conflicts with basic learning principles and contemporary transactional views of stress,
which highlight stress as a contextual process. Consequently, new approaches for ED that are theoretically coherent,
grounded in basic psychological principles, and utilize established clinical methods are needed.

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Aim
This uncontrolled pilot study examined the feasibility, acceptance, and utility of a novel biopsychosocial treatment for
ED based on a contextual behavioral scientific model, emphasizing value clarification and exposure.
Methods
Twenty-six patients with ED were included in a 12-week digital MMI with the biopsychosocial treatment as the prima-
ry component. Self-rated questionnaires and independent clinical ratings were administered before and after treat-
ment and at six-month follow-up. Measures of exhaustion and psychological flexibility were assessed weekly during
treatment.
Results
Participants reported significant improvements in symptoms of exhaustion, anxiety, and depression with large effect
sizes (d = 0.75-1.10), maintained at follow-up. Independent clinical ratings indicated reduced clinical severity and
functional disability, and there were no dropouts, with a high module completion ratio. Few adverse effects were
reported, and ratings on treatment credibility and client satisfaction were high. Mediation analysis indicated that
psychological flexibility mediated improvements in exhaustion symptoms.
Discussion
These results offer preliminary support for the feasibility, acceptability, and utility of this novel biopsychosocial treat-
ment for ED. They also suggest that a more focused and theoretically stringent approach may effectively treat ED,
compared to more extensive MMIs.

Keywords
burnout, stress-induced exhaustion disorder, contextual behavior science, multimodal intervention

The role of psychological flexibility and emotional schemas in designing a digital intervention to cope with
different stressful events: Evidence-, Theory-, and Person-Based Approach
Rita Sebastião, School of Psychology, ISPA-Instituto Universitário; APPsyCI – Applied Psychology Research Center
Capabilities & Inclusion , Portugal
Pedro Rodrigues Ribeiro, School of Psychology, ISPA-Instituto Universitário; APPsyCI – Applied Psychology Research
Center Capabilities & Inclusion, Portugal
Eduardo Sardinha, School of Psychology, ISPA-Instituto Universitário; APPsyCI – Applied Psychology Research Center
Capabilities & Inclusion, Portugal
Cátia Castro, School of Psychology, ISPA-Instituto Universitário; APPsyCI – Applied Psychology Research Center Ca-
pabilities & Inclusion, Portugal
David Dias Neto, Associação Portuguesa de Terapias Comportamental, Cognitiva e Integrativa, Portugal

Abstract
Background: People’s responses to stress vary across individuals and contexts. The COVID-19 pandemic was a source
of shared stress, composed of different stressors, impacting all people’s lives at various levels. Research conducted
during this period highlighted the significance of stress responses in mental health, emphasising the need for peo-
ple to cope with stress effectively. Objective: This study aims to develop a personalised digital intervention to help
individuals cope with diverse stressful events. It focuses on emotional schemas and psychological flexibility to en-
hance mental health. Methods: The intervention development used theory-, evidence-, and person-based approach-
es and was divided into two phases. Phase I involved collating and analysing existing and new primary evidence: (1)
Cross-sectional and longitudinal studies examining the role of emotional schemas and psychological flexibility in the
relationship between stress and mental health; (2) A scoping review of existing digital interventions designed to cope
with various stressful events; (3) A qualitative study exploring user experiences with stress coping. Phase II focuses on
theoretical modelling and intervention development, including creating guiding principles, a logic model, and inter-
vention content. This phase integrates evidence from Phase I with expert consultations. Results: Findings from Phase
I suggested that: (1) stress responses was the strongest predictor of mental health among COVID-19-related variables.
Emotional schemas and psychological flexibility significantly mediated the relationship between stress responses to
COVID-19-related events and mental health; (2) Through thematic analysis, twelve components were identified in
psychological interventions to cope with various stressful events. Barriers and facilitators to the success of these inter-
ventions were also identified, including individual factors, distribution, practical aspects, support, design elements,
materials, and other issues; (3) Six themes were identified by the target user as critical for coping with stress: ac-
ceptance, values and awareness; support; thoughts; skills; behavioural activities; and emotional management. Users
suggested materials and presentation methods as crucial elements for effective intervention. Phase II: Initial guiding
principles and logic model were developed considering that. Conclusions: The findings from Phase I led to several
conclusions: (1) Cross-sectional and longitudinal studies underscore the need for interventions to cope with stressful
events targeting emotional schemas and psychological flexibility to support mental health; (2) The scoping review
supports the development of an intervention using CBT components, namely Acceptance and Commitment Therapy.
And, confirmed that to date, no current interventions are integrating Emotional Schemas Therapy for this purpose,
highlighting a gap in available resources; (3) The qualitative study emphasised the importance of personalising the

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intervention to meet users’ needs, knowledge, and contexts. Thus, the proposed intervention aims to support adults
in managing stress from various sources, tailored to their individual experiences and processes, protecting and pro-
moting their mental health by considering the specific needs and contexts of the users.

Keywords
stress; digital intervention; person-based approach; cognitive behavioural therapy; third-wave cognitive behavioural
therapy; mental health

• The Almamar Pilot Study: Evaluating Transdiagnostic Treatment Options for Arabic and Farsi Speakers
Through AppBased and Face-to-Face Modalities
Birgit Wagner, Medical School Berlin, Germany
Hannah Nilles, Medical School Berlin, Germany
Laura Nohr, Free University Berlin, Germany
Martina Hernek, Free University Berlin, Germany
Sebastian Buchert, Free University Berlin, Germany
Johanna Boettcher, Psychologische Hochschule Berlin, German

Abstract
Background: Language barriers and a lack of cultural adaptation of existing CBT interventions limit the psychotherapy
options available for Arabic and Farsi speakers in Germany. The Almamar program, incorporating the transdiagnostic
Common Elements Treatment Approach, was designed to address these challenges through both online and face-
to-face formats to improve treatment access. This study aims to explore symptom change in primary and secondary
outcomes, assess preliminary findings concerning treatment adherence, treatment duration, and dropout rates.
Methods: In this pilot study, the primary and secondary outcomes were evaluated for 15 adult participants diag-
nosed with PTSD, anxiety disorder, depressive disorder, or a combination thereof. Participants undergo 6-16 tailored
CBT-sessions, which include exercises for cognitive restructuring, exposure techniques, problem-solving, behavioral
activation and reducing behavioral and substance addictions.
Results: We will present both qualitative and quantitative data from the pilot data of the two interventions. Key com-
ponents of the intervention and their integration throughout the treatment process will also be discussed.
Conclusion: The analysis of pilot data will be used to discuss further research directions and the potential integration
of the Almamar program into standard care practices in Germany.

Keywords
PTSD, depression, anxiety, digital intervention, CETA

Open Paper Symposium 13 - Ethics, therapists and researchers

Chair: Ivanka Živčić-Bećirević, University of Rijeka, Croatia

• Measurement of ethical beliefs and behaviours of Albanian psychotherapists

Marta Bej, AACBT, Albania
Kevin Gugushi, AACBT, Albania
Etel Turtulli,AACBT, Albania

Abstract
Psychotherapy in Albania is a new field, still unexplored, which faces new challenges every day. Studies in this area
are modest also because the place of psychotherapy is unstable and unregulated as a profession. In Albania there are
several different groups that practice psychotherapy according to the respective direction. Study Ethical beliefs of
Albanian Cognitive Behavioural Therapists CBT, undertakes to shed light on the ethics and behaviours of Cognitive
Behavioural Therapists in Albania.
The design of the study is quantitative, non-experimental, cross-sectional. Data collection instruments were adminis-
tered to a sample of 32 Psychotherapists, of which only 4 Males and 28 Females.
This study presents a special value for the fact that it evidences the current knowledge of psychologists working in
therapy regarding issues of ethical beliefs and behaviours used by these professionals. Much of the study showed that
the therapists’ ethical beliefs were highly consistent with their behaviour in clinical practice. The findings also showed
that there are always spaces and cases that despite the fact that the code of ethics categorically excludes them as
unethical behaviour, but depending on the specifics of the case make exceptions.

Keywords
ethics; psychotherapy; beliefs, ethical belief, psychotherapist`s behaviors

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• Ethical Reasoning and Ethics Education of CBT Therapists in Europe
Teodora Vuletić, University of Belgrade, Faculty of Philosophy, Institute of Psychology, Serbia, teodora.vuletic@f.bg.ac.rs
Nikola Petrović, University of Belgrade, Faculty of Philosophy, Serbia
Sanda Stanković, University of Belgrade, Faculty of Philosophy, LIRA Lab, Serbia

Abstract
This study was a part of the broader project that concerned the ethical reasoning of CBT therapists in Europe. Previ-
ous studies showed some inconsistencies in the decision-making of psychotherapists when it comes to certain eth-
ical dilemmas. Most results point to a need for exploring cultural differences, as well as elaborating ethical positions
through extensive qualitative analysis. Therefore, we decided to construct seven vignettes for the present study, por-
traying several ethical dilemmas (non-sexual touch, recording the session, taking an emergency phone call, knowing
the client through social media, therapist’s emotional reaction, confidentiality, and advertising whatsoever) and pose
them to CBT psychotherapists in six European countries (Serbia, Croatia, Bosnia & Herzegovina, Slovenia, Great Britain,
and Russia). The first aim was to capture the statistical differences between the answers of participants regarding a
question of agreement with the therapist from the vignette. The differences were tested between groups based on
the country of origin, years of experience, owning a license, finished training, as well as age and gender. The second
aim was to further explore and better understand the reasons, explanations, and beliefs behind these decisions by
asking participants to elaborate on their answers and write down what the therapist could have done differently.
Hence, a thorough thematic analysis was applied. Overall, the sampling method was purposive, and the number of
respondents was roughly proportional to the size of the country. The final sample consisted of 347 participants aged
18-78 (M = 38.60, SD = 10.41, 82.3% female). The results showed only a few significant differences, between groups of
participants depending on their country of origin, for the first [χ2(5) = 15.97, p = .01], sixth [χ2(5) = 27.45, p = .00], and
seventh [χ2(5) = 14.82, p = .01] vignette. Generally, the first vignette was the one that participants mostly complied
with, and the seventh was the one with the least compliance. The thematic analysis resulted in four major themes
and 11 subthemes: I. Explanations for Therapists’ [Lack of ] Acts (1. Appealing to the Authority, 2. The Usefulness of the
Act, 3. The Act as a Risk for Therapeutic Process), II. Positive Evaluation of Therapists’ Acts (4. Therapists Take Responsi-
bility, 5. Therapists are Only Human, 6. Praising the Therapists’ Techniques), III. What Could Have the Therapists Done
Differently (7. In Relation to Themselves – Taking Responsibility, 8. In Relation to Clients – Passing on Responsibility, 9.
In Relation to Process – Refining the Approach), IV. Dependence of the Decision on Numerous Factors (10. Therapists
Did the Best They Could, 11. Cultural Differences). In conclusion, this research pointed to the relevance of understand-
ing and describing CBT psychotherapists’ motives and beliefs rather than supposing differences between perceived
groups. Although this study had its limitations, an implication could be to focus on developing a more accepting and
exchanging psychotherapeutic community.

Keywords
ethical dilemmas, vignettes, cross-cultural study, thematic analysis, practice

• Analyzing therapist-client verbal interactions: What behaviors facilitate and hinder the therapeutic bond?
M. Cristina Guerrero-Escagedo, Universidad Autónoma de Madrid, Spain
Diego Fernández-Regueras, Universidad Autónoma de Madrid, Spain
Ana Calero-Elvira, Universidad Autónoma de Madrid, Spain

Abstract
The therapeutic relationship is currently regarded as a pivotal aspect of psychological therapy. It is estimated that
approximately 15% of psychotherapy outcomes can be attributed to the therapeutic relationship, which represents
the second most significant explanatory factor. Furthermore, many studies support that the therapeutic alliance is a
strong predictor of therapeutic success. However, the specific behaviors that constitute the alliance remain unclear.
In part, this is because most studies use self-report measures to assess alliance strength rather than external obser-
vational measures that help describe which verbal interaction behaviors enhance the therapeutic relationship. To
address this gap, we aimed to examine the components of the therapeutic relationship using a moment-by-moment
analysis, as recommended by the American Psychological Association (APA). Specifically, the objective of our study
was to identify the behaviors and verbal interactions between therapist and client that facilitate or hinder the thera-
peutic bond. To this end, video recordings of 95 individual therapy sessions with adults belonging to 20 clinical cases
treated by 16 cognitive-behavioral therapists were analyzed. These were selected from a total sample of 72 cases, with
the 10 cases with the best and the 10 cases with the worst scores on the Working Alliance Inventory being included. To
analyze the recordings, a system of categories was developed to study the therapeutic relationship through system-
atic observation of the therapist-client interaction. Therapeutic interactions were analyzed using sequential analysis.
The results indicate that there were significant differences in the frequency of various behaviors, including express-
ing empathy, making positive self-disclosure about the therapeutic relationship, and recalling incorrect information

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about the client. Moreover, significant differences were observed in certain behavioral sequences, including joking.
Drawing from our findings, we recommend a set of guidelines to enhance the therapist-client bond. We anticipate
that these results will contribute to making psychological interventions more effective and efficient. Furthermore, the
insights gained may be valuable in training new therapists.

Keywords
Therapeutic relationship; Sequential analysis; Cognitive-Behavioural Therapy; Observational methodology; Thera-
peutic Bond

• Therapists misbeliefs as barriers to use exposure therapy

Ivanka Živčić-Bećirević, University of Rijeka, Croatia
Ines Jakovčić, Teaching Institute for Public Health of Primorsko-goranska County Department for Mental health, drug
prevention and outpatient treatment, Croatia
Gorana Birovljević, Department of Psychology, Faculty of Humanities and Social Sciences, University of Rijeka, Cro-
atia
Josko Jurman - Croatian Association for Behavioral and Cognitive Therapy, Croatia

Abstract
Exposure therapy is highly effective and commonly recommended treatment for anxiety disorders, obsessive-com-
pulsive disorder, and PTSD, yet it remains widely underutilized in routine care settings. Therapists are especially re-
luctant to use specific types of exposure (e.g. interoceptive or imagination exposure) or with some type of problems
(e.g. trauma) or with certain populations (e.g. children, older adults, or pregnant women). Several factors have been
recognized as barriers, such as organizational constraints, insufficient supervisory support, and client characteristics.
Understanding therapist-level factors, among which are therapist beliefs about exposure therapy, may be particularly
relevant as they may be an important focus for change in the training of future CBT therapists. The aim of this research
is to investigate therapist beliefs about exposure therapy in relation to their level of training and experience. We hy-
pothesize that therapist with higher level of training and more experience will use exposure therapy more frequently
and have fewer negative beliefs about it.
Method:
A total of 273 individuals took part in the study, with 89% being females. These participants included psychologists
and medical doctors from Croatia, Serbia, and Bosnia and Herzegovina, with 90% being trainees in CBT and the re-
maining 10% accredited CBT therapists. They completed an online questionnaire that included The Therapist Beliefs
about Exposure Scale (Deacon et al., 2013) along with questions regarding demographic characteristics and thera-
peutic experience.
Results:
Only 14% of all the participants reported using exposure therapy regularly when indicated, with 37% of accredited
therapists falling into this category. Surprisingly, 33% of the participants never use exposure therapy in their practice.
As anticipated, trainees at the basic level exhibited the most negative beliefs about exposure therapy, while accredit-
ed therapist had the least negative beliefs. There was no difference in beliefs between trainees at the second and the
third level of training. Therapists who use exposure therapy more frequently tended to have fewer negative beliefs
about it. Interestingly, negative beliefs about exposure therapy are not related to the years of clinical experience or
the number of weekly sessions with clients. Only 7% of therapists reported negative experiences with applying expo-
sure, such as client refusal or discontinuation of treatment. Most participants expressed a strong need for additional
training and support to integrate exposure therapy more frequently into their practice.
Conclusions:
The results are in line with previous research, confirming the underuse of exposure therapy among CBT trainees and
therapists. It appears crucial to mitigate negative attitudes that function as barriers to the utilization of exposure ther-
apy, as positive experiences are related to fewer negative beliefs. This, in turn, may encourage therapists to integrate
exposure therapy more frequently into their practice. To enhance the dissemination of evidence-based treatments,
it is recommended to include a variety of approaches in the training and supervision of CBT therapists. This can help
overcome their cognitive biases and promote more frequent utilization of exposure therapy. Some forms of training,
such as demonstration and experiential training are suggested. Our future research will focus on validating their ef-
fectiveness.

Keywords
Exposure therapy, therapists misbeliefs, training and supervision

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• What could possibly go wrong? Lessons learned for a first-time PI for a randomized controlled trial
Krister Fjermestad, University of Oslo, Norway

Abstract
This open paper shares the experiences of a first time principal investigator of a randomized controlled trial (RCT).
The aim is for young researchers to learn from the mistakes that were made when planning their own trials. The RCT
compared a manual-based intervention for siblings and parents of children with chronic disorders to a waitlist control
condition. The focus of the presentation is not on the intervention, sample, or main findings but on the lessons learnt
from the multiple mistakes that were made in the planning and excecution of the trial. However, for context, the
RCT included 288 families and the results showed small effects in favor of the intervention group in terms of sibling
mental health and family communication. The trial was conducted across eight sites of which three were primary care
settings and five were hospitals. The focus of the presentation is on mistakes in the planning, data collection, data
analysis, dissemination, and post-RCT implementation stages of a trial. In terms of planning, the message is to tailor
funding applications for calls, but not to promise more than you can keep. The presentation will give examples on
elements that looked good in the proposals that were impossible to follow through with. The presentation will also
emphasize the need to choose well-validated measures with clarification on copyright issues. Examples will be pro-
vided on how measures that exist in multiple “official” versions and with little sensitivity to change can hamper results
later on. In terms of data collection, the need to ensure real management support in clinics so that clinicians do not
end up doing research on their spare time and/or boycotting the trial will be emphasized. Tips on how to enhance
enrolment and be clear on inclusion criteria will be provided, alongside examples of how things may evolve in a bad
direction if one is tempted to loosen up on inclusion criteria or ignore exclusion criteria in the quest for participant
enrollment. Also, reminders will be given on how to ensure data also at follow-up timepoints and to prevent dropout.
Training and follow-up with clinicians will be covered, with tips on how to avoid low fidelity of right out sabotage of
manual elements. Tips will be given on how to keep up team stamina between researchers and clinicians. Relying on
statisticians that know what they are doing at all stages of the project, and tips on making sure they remain faithful
to your project will be highlighted. Finally, there will be a presentation of key team qualifications you should look for
in a team setup to ensure roles and capacities fulfill each other to the maximum. Tips on how to enhance the chance
that your intervention survives the RCT and actually gets used beyond it will be shared. Factors that work pro and
against successful implementation, from a practice perspective will be highlighted. The target audience is early career
researchers who wishes to learn from the crash-landing of a now mid-career researcher who has (hopefully) learnt
from his mistakes.

Keywords
RCT; research design; effect studies; practice examples

• Are cognitive behavioural therapists more prone to burnout than therapists of other orientations?
Andrea Vlašić, Ministry of Internal Affairs, Bosnia and Herzegovina
Amela Bektaš, Bosnia and Herzegovina
Irma Čorbo, JU OŠ Grbavica II, Bosnia and Herzegovina

Abstract
Self-care activities are crucial for mental health professionals, considering the emotional demands of their work. These
activities can buffer the effects of stress and prevent burnout, a state of emotional and physical exhaustion, cynicism,
and reduced effectiveness. While research suggests psychotherapists are susceptible to burnout, little is known about
the specific self-care practices they employ and how these practices differ between therapeutic modalities.
The self-care activities of 122 psychotherapists (mean age = 40.7 years), including 28 CB psychotherapists, were the
subject of this cross-sectional study, examining how these practices related to burnout. We also analysed levels of
burnout among therapists who practised other modalities versus CBT practitioners. The Oldenburg Burnout Inven-
tory (OLBI) was used to assess burnout, measuring two dimensions: Exhaustion and Disengagement. The Self-Care
Scale (SCS) is a 27-item self-report measure designed to evaluate the frequency of self-care behaviours. The scale was
developed by Vlašić (2024) for this study. SCS has good internal consistency (α = 0,854).
The study revealed that psychotherapists engaged in various self-care activities, mostly socialising, reading, humour,
sleeping, and walking in nature. We found low but significant correlations between the total score on SCS and both
burnout dimensions, indicating that therapists who engaged more in self-care reported lower levels of Exhaustion
and Disengagement. The results showed that cognitive-behavioural therapists had statistically higher scores on ex-
haustion than other therapists, while there was no statistical difference in Disengagement or total score on SCS. This
research also revealed that CB therapists are statistically less often involved in personal psychotherapy than therapists
of other orientations. Results showed a statistically significant but low and negative correlation between psychother-
apy and Exhaustion, and no correlation between psychotherapy and Disengagement. This could mean that psycho-

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therapists who are more exhausted are also choosing personal psychotherapy more often. To determine the extent
to which self-care and psychotherapy explain the variance of the burnout dimensions, we conducted two hierarchical
analyses. The results showed that self-care significantly contributes to Exhaustion, but not to Disengagement. At the
same time, psychotherapy does not make a significant independent contribution to explaining the variance in any
dimension of burnout. We performed stepwise analyses to study the independent predictor contribution of self-care
activities to variances of burnout dimensions. The results will be discussed.
These findings highlight the importance of self-care for psychotherapists’ well-being and burnout prevention. Thera-
pists who prioritise self-care seem to be better able to handle the emotional problems of their profession, regardless
of their therapeutic style. Subsequent investigations, including more extensive and heterogeneous cohorts, may in-
vestigate plausible distinctions in burnout vulnerability among distinct therapeutic approaches and pinpoint addi-
tional predictors impacting the well-being of therapists.

Keywords
CBT, burnout, psychotherapy, self-care, mental health

Open Paper Symposium 14 – Mindfulness

Chair: Arnold van Emmerick, University of Amsterdam, Netherlands

• Is there any need for a bigger picture in MBCT practice? Data from a modified 8 week training MBCT program
Mugur Ciumageanu, West University of Timisoara, Romania
Flavia Staicu, West University of Timisoara, Romania

Abstract
Mindfulness based cognitive therapy (MBCT) is an ever-evolving third wave CBT practice, with application both in
clinical settings (for emotional disorders, addictions or impulsive behaviours) and in general settings (aimed at in-
creasing emotional awareness skills and promoting healthy intentional and emotional responses in educational or
occupational settings). The study involved 26 psychology students in a modified 8 week MBCT training program,
with an add-on related to measuring big-picture appraisal and big-picture perspectivation. Mindfulness skills were
measured with the FFMQ (Five-Facets Mindfulness Questionnaire). The session by session dynamic of symptoms was
measured using the BSI (Brief Symptom Inventory), and the big picture appraisal style with the BPAQ (Big Picture Ap-
praisal Questionnaire). The big-picture appraisal intervention proved a useful add-on - further clinical research could
clarify its usefulness on clinical populations.

Keywords
Big picture appraisal, MBCT

• Mindfulness- Based Cognitive Therapy for Life (MBCT-L) for healthcare care students: an RCT
Françoise Jermann, Geneva University Hospitals, Switzerland
Claire Holman, Geneva University, Switzerland
Ben Meuleman, Geneva University, Switzerland
Mariana Magnus Smith, University of Montreal, Canada
Beatrice Weber, Geneva University Hospitals, Switzerland
Paolo Cordera, Geneva University Hospitals, Switzerland
Guido Bondolfi, Geneva University, Switzerland
Serge Rudaz, Geneva University, Switzerland
Camille Piguet, Geneva University Hospitals, Switzerland

Abstract
A growing body of evidence shows that healthcare students are experiencing high levels of stress and mental distress
during their studies. However, during their training, the focus is primarily on acquiring technical knowledge, with the
development of self-care skills often being neglected. Learning to cope with stress is not only essential for personal
well-being, but it is also crucial because stress has an impact on empathy and compassion toward others. Teaching
healthcare students self-care practices is a priority, given that they are the health professionals of the future. In this
RCT, we evaluated the impact of Mindfulness-Based Cognitive Therapy for Life (MBCT-L), a newly manualized group
intervention, on the psychological health of healthcare students. MBCT-L comprises 8 two-hour sessions and a half-
day session. It combines formal mindfulness practices (e.g. sitting meditation), informal practices (doing daily activi-
ties mindfully), new daily habits (e.g. gratitude practice), and CBT elements to manage difficulties and support global
well-being by cultivating joy, compassion, equanimity, and flourishing. A sample of 161 healthcare students (2nd,

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3rd, and 4th year) was randomly assigned to an MBCT-L group or a control group (waiting list). MBCT-L was delivered
by online videoconferencing (Zoom). The primary aim was to evaluate the impact of MBCT-L on perceived stress and
prosocial skills. Moreover, questionnaires were used to assess mindfulness skills, anxiety and depressive symptoms,
compassion, and global well-being. Measures were taken at baseline (t0) and after 3 months (t1). Multilevel ANO-
VAs of Group (MBCT-L, control) × Time (t0,t1) showed significant positive intervention effects for mindfulness skills,
compassion toward self and others, and psychological well-being but not for perceived stress and prosocial skills, de-
pressive and anxiety symptoms. These findings suggest that MBCT-L is an effective intervention enabling healthcare
students to develop essential mindfulness and compassion skills. The latter is essential for better stress management
and increased prosocial behaviors in the future. Notably, MBCT-L improved psychological well-being, which is crucial
for healthcare students to achieve their academic goals and to become healthy professionals.

Keywords
mindfulness, students, stress, compassion

• Evaluating Online Cognitive-Behavioral and Mindfulness Interventions for Adults with ADHD: a Randomized
Controlled Trial
Martin Oscarsson, Stockholm University, Sweden
Alexander Rozental, Uppsala University, Sweden
Ylva Ginsberg, Karolinska Institutet & Stockholm Health Care Services, Sweden
Per Carlbring, Stockholm University, Sweden
Gerhard Andresson, Linköping University, Sweden
Fredrik Jönsson, Stockholm University, Sweden

Abstract
Introduction
Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder, affecting 2-7% of
adults worldwide. Adults with ADHD face increased levels of stress and fatigue, frequently contributing to exhaustion.
They are at higher risk for stressful life events and mental health issues, with a majority of meeting criteria for at least
one comorbid psychiatric disorder. Additionally, adults with ADHD have more sickness absence days compared to
controls, possibly twice or several times as many. Although research on assessing and treating adult ADHD is growing,
many individuals remain undiagnosed and untreated due to lack of recognition, misconceptions, and limited access
to psychiatric care. Internet-delivered interventions offer a promising solution for improving access to care and effec-
tively disseminating psychological treatments. However, their efficacy for adult ADHD remains underexplored.
Methods
This study will involve 240 participants, randomly assigned to one of three conditions: Internet-based cognitive-be-
havioral stress-management; Internet-based mindfulness stress-management; or a wait-list control. Participants in
the intervention groups will engage in twelve-week, twelve-module programs, with clinical support available on
demand. Both interventions have an explicit focus on workplace functioning, but differ in their content. The cognitive
behavioral program is based on cognitive behavioral therapy (CBT) principles, including both tailored and transdiag-
nostic applications. The mindfulness program is based on a well-established skills-training manual for adult ADHD.
Outcome measures include self-reported quality of life (primary outcome), symptoms of ADHD, perceived stress,
symptoms of exhaustion, depression, and anxiety. Additionally, participants from both intervention groups will be
interviewed to explore their experiences with the programs.
Discussion
Previous research indicates a positive attitude toward internet-delivered psychological interventions among adults
with ADHD. A previous single-arm open trial has also indicated the potential of the current cognitive-behavioral
stress-management intervention. This study aims to further assess its efficacy by comparing it to an active control
intervention, thereby accounting for the expectation of benefit and common factors of internet interventions. The
additional inclusion of a wait-list control will help account for spontaneous improvement and regression toward the
mean. If the cognitive-behavioral intervention shows further promise, it could be further developed and potentially
disseminated more broadly, either through routine healthcare systems or as a product. Given the position of ADHD
adults in the labor market and the costs of sickness absence for all social partners, demonstrating effective inter-
ventions for this population could have significant socio-economic benefits, reducing both individual and societal
burdens.

Keywords
ADHD, Internet interventions, Mindfulness, Stress, Quality of life, Randomized controlled trial

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• Efficacy of mindfulness apps: A literature review
Arnold van Emmerick, University of Amsterdam, Netherlands
Tim Schoenmakers, University of Amsterdam, Netherlands

Abstract
Mindfulness apps have rapidly grown in number and are readily, indeed often freely, available to everybody with a
mobile device and Internet access. They possess unique advantages for disseminating mindfulness skills compared
to in-person formats. In the wake of this growth, the number of randomized controlled trials of the effects of mindful-
ness apps on various mental health outcomes and well-being domains has enormously increased, as has the number
of systematic reviews and meta-analyses of these trials.
This paper first discusses the advantages and limitations of mobile and in-person formats of teaching and learning
mindfulness skills. Second, it summarizes scientific research of the effects of mindfulness apps on diverse mental
health outcomes and well-being domains in clinical and non-clinical populations by reviewing in detail five systemat-
ic reviews and meta-analyses of primary studies of these effects.
It is concluded that overall, mindfulness apps have robust small to moderate positive effects on diverse mental health,
well-being, and quality of life outcomes, and show great potential as a means to introduce a large audience to the
benefits of mindfulness skills. There is room for improvement of the quality of primary studies of mindfulness apps
however, which are characterized by considerable risk of bias as well as high dropout rates, low or undocumented
adherence, and scarce follow-up measurements. The same is true for the broad spectrum quality of mindfulness apps
in general, including aspects such as quality of information and content, privacy policy, and data security.

Keywords
Mindfulness; Mobile Health; Apps; Self-Help; Smartphones

• MBCT for Better Stress Management and Burnout Prevention: A Program for Prison and Probation Staff
Bernardica Franjić-Nađ, Juvenile Correctional Institution, Prison System and Probation Directorate, Ministry of Jus-
tice and Public Administration, Croatia
Đulijana Badurina-Setić, Prison System and Probation Directorate, Centre for Diagnostics in Zagreb, Croatia
Jurica Pačelat, Directorate for Human Resources, Ministry of the Interior, Croatia

Abstract
To strengthen the capacity to cope with stress and preserve the mental health of prison and probation officers, during
a four-year education within the framework of the Project of the Croatian Association for Behavioural-Cognitive Ther-
apy (HUBIKOT): “Mindfulness program for coping with stress for employees of the prison system”, trainers of Mindful-
ness-Based Cognitive Therapy (MBCT) were trained.
As part of the activities of the Department for Psychological Support for Prison and Probation Officers, five cycles
of courses for officers were conducted over the last three years. The courses are based on a standardized mindful-
ness-based cognitive therapy program which consists of eight two-hour group workshops over two months and
one delayed maintenance workshop. A system of continuous workshops was introduced to maintain the practice of
mindfulness for all officers who were previously involved in the program.
The implementation of the program was evaluated by examining the satisfaction with the organization of the pro-
gram, the perceived benefit and involvement in the program by the participants, and by examining the effect of
the implementation of the course on changes in the determinants of mental health and dispositional mindfulness
among prison and probation officers. A total of 56 officials participated in the 8-week MBCT (KTPSUS) course through
five consecutive groups. Satisfaction with the course and perceived benefit from the course was examined after the
end of the course using an evaluation questionnaire consisting of 8 questions which the participants answered on a
7-point Likert-type scale. The CORE (Clinical Outcomes in Routine Evaluation) questionnaire of general psychopathic
difficulties was used as a measure of mental health, while the five-factor FFMQ (The Five Facet Mindfulness Ques-
tionnaire) and the one-factor SMQ (Southampton Mindfulness Questionnaire) were used to measure mindfulness as
a disposition. All three standardized questionnaires were used at three measurement points - before participating in
the course, after the course, and three months after the course. The results showed that the participants were satis-
fied with the course, highly involved in the course and that they evaluated it as useful in the domain of dealing with
stress, improving physical and mental well-being, and usefulness in everyday life and work. One-way analysis of vari-
ance for repeated measures compared scores at three measurement points on the CORE-OM, FFMQ, and SMQ scales.
The results show that there was a significant change in the reduction of psychopathological difficulties that were
maintained 3 months after participating in the program, as well as a significant increase in the scores on the scales
of dispositional awareness. The results obtained indicate the usefulness of mindfulness-based programs for officers
exposed to high levels of stress in systems such as prisons, probation, and police.

Keywords
prison system, probation, officers, stress, prevention, mindfulness, MBCT

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Open Paper Symposium 15 - Emotion Regulation
Chair: Kirsti Akkermann, University of Tartu, Estonia

• Beliefs about Emotion and Emotional Eating among Overweight Turkish Adults: The Role of Emotion Regu-
lation Strategies
Esin Engin, İzmir University of Economics, Turkey
Ezgi Tuna Kaykusuz, İzmir University of Economics, Turkey

Abstract
Emotion beliefs are an important component of emotional processing and can be conceptualized as beliefs about the
controllability and usefulness of emotions. These beliefs may have important effects on when and how emotions are
regulated, as well as the effectiveness of the emotion regulation process. Previous studies suggested that believing
emotions are uncontrollable and/or useless may result in the use of less adaptive emotion regulation strategies such
as expressive suppression, and may be a risk factor for the development and maintenance of psychological disorders.
Emotional eating may be a behavior associated with emotion beliefs, though limited research has addressed how
these beliefs are related to emotional eating. Previous research examining the relationship between emotion reg-
ulation and emotional eating found that individuals who have difficulty regulating their emotions tend to engage
in more frequent emotional eating. Therefore, emotion beliefs may predict regulation strategies, which in turn may
increase the likelihood of using eating as a way to deal with emotions.
The present study investigated the mediator role of rumination and thought suppression in the association between
emotion beliefs (i.e., beliefs about controllability and usefulness of emotions) and emotional eating among over-
weight adults in Turkey. A total of 173 participants (91 women, 80 men and 2 who prefer not to say) with a mean
age of 37 (SD = 12.5) participated in the study. The mean body mass index of the participants was found to be 28.6
(SD=4.13). Two mediation analyses were run using the PROCESS macro, Model 4. Findings revealed that believing in
the uncontrollability of emotions may be more strongly linked to emotional eating as compared to believing that
emotions are useless. Results of the mediation analyses indicated that thought suppression and rumination fully
mediate the relationship between controllability beliefs and emotional eating. Furthermore, these strategies partially
mediated the link between usefulness beliefs and emotional eating. The findings suggested that beliefs about emo-
tions may be associated with emotional eating through their influence on maladaptive emotion regulation strategies.
These findings highlighted that beliefs about the uncontrollability and uselessness of emotions and the use of rumi-
nation and thought suppression strategies may be important targets for interventions designed to address emotional
eating among overweight adults.

Keywords
Emotion beliefs, rumination, thought suppression, emotional eating, overweight, BMI

• Emotion regulation and academic burnout among youth: a quantitative meta-analysis

Ioana Alexandra Iuga, Evidence-Based Psychological Assessment and Interventions Doctoral School, Babeş-Bolyai
University, Cluj-Napoca, Romania
Oana Alexandra David, Department of Clinical Psychology and Psychotherapy; The International Institute for the
Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania

Abstract
Emotion regulation (ER) represents an important factor in youth’s academic wellbeing even in contexts that are not
characterized by increased levels of academic stress. Effective ER not only enhances learning and, consequentially,
improves youths’ academic achievement, but also can serve as a protective factor against academic burnout. Studies
have shown varying and intricate relationships between ER and academic burnout. This meta-analysis examines the
connection between ER strategies and student burnout, considering a series of influencing factors.
Data analysis was conducted in a random effects meta-analytic approach, assessing heterogeneity and employing
multiple methods to address publication bias, along with meta-regression for continuous moderating variables (qual-
ity, female percentage and mean age) and subgroup analyses for categorical moderating variables (sample grade
level).
Our results show that whereas ER issues are positively linked with burnout and its aspects, such as emotional ex-
haustion, cynicism, and reduced efficacy, adaptive ER strategies are negatively associated with total burnout scores.
These findings point to ER’s complex involvement in both psychopathology and wellbeing. In order to shape these
correlations, we additionally identified moderating variables such as the sample’s gender composition, grade level,
and mean age.
This study emphasizes the need for more research on ER and academic burnout in order to enable more specialized
analyses, context-specific ER studies, and standardized measuring techniques for the understanding of academic

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burnout. Notwithstanding methodological flaws, our results deepen our understanding of the complex interaction
between ER and student burnout and provide direction for future studies in this area.

Keywords
emotion regulation, academic burnout, youth, meta-analysis

• The Tolerance of Uncontrollability and Psychopathology: The Roles of Maladaptive Emotion Regulation Strat-
egies and Negative Problem Orientation
Gamze Şener, Bahçeşehir University, Faculty of Economics, Administrative and Social Sciences, Department of Psy-
chology, Turkey

Abstract
Exposure to uncertain and uncontrollable situations is a fundamental and challenging experience for everyone. How-
ever, the level of distress caused by such situations may vary depending on several trait-based characteristics. One of
these trait-based characteristics is tolerance of uncontrollability (TOU), which can be defined as the ability to endure
the discomfort resulting from uncontrollable events. TOU has been documented to be a risk factor for anxiety and de-
pression. When low TOU individuals face a situation that is not perceived as controllable, they may resort to strategies
that regulate and enhance the inner perception of control. Repetitive negative thinking (RNT) and thought suppres-
sion (TS) give illusory control in the short term—notably, RNT refers to thinking repetitively about adverse life events,
while TS can be defined as attempts to remove thoughts. However, many studies revealed that these strategies in-
crease distress in the long term. Another concept closely related to tolerance is negative problem orientation (NPO),
which describes individuals’ belief in the effectiveness of their problem-solving skills. Similar to the other variables,
NPO has been documented to be a significant predictor of psychological distress and is able to augment the role of
other risk factors in the prediction of psychological distress. The present study aimed to explore the relationship be-
tween TOU, RNT, TS, NPO, depression, and anxiety. It was anticipated that TOU would be associated with depression
and anxiety, and RNT and TS would mediate these relationships. Moreover, NPO was hypothesized to moderate the
relationship of TOU with other study variables. A sample of 448 participants (360 women) aged between 17 and 56
(Mage= 23.41, SD=5.25) completed measures assessing TOU, RNT, TS, NPO, depression, and anxiety. Findings showed
that higher levels of TOU were associated with low levels of depression and anxiety, but when anxiety was controlled,
the correlation with depression disappeared. While RNT was the mediator in both outcomes, TS mediated only the
relationship between TOU and anxiety. NPO did not show any moderating effect, except for the relationship between
TOU and anxiety. The current study emphasizes that TOU can be a concept specific to anxiety and highlights one of
the mechanisms behind TOU and psychological distress. Furthermore, NPO may have a contribution to the relation-
ship between TOU and anxiety. The findings will be discussed under the light of recent studies.

Keywords
uncontrollability, repetitive negative thinking, thought suppression, psychological distress

• Exploring Digital Emotion Regulation in Young People

Atia Fatimah, Black Dog Institute, Australia
Aliza Werner-Seilder, Black Dog Institute, Australia
Sophie Li, Black Dog Institute, Australia

Abstract
Introduction/Background:
There are growing concerns about the consequences of screentime on mental health, especially for young people.
Screentime is associated with depression, anxiety, insufficient sleep, and reduced physical activity in young people.
However, there is little evidence of positive effects from refraining from using screen-based devices. Conversely, with
its widespread use, digital technology has been increasingly used for emotion regulation, termed digital emotion reg-
ulation. While different profiles of digital behaviours can be helpful or harmful for mental health, research into digital
emotion regulation is yet to explore exactly what behaviours and digital emotion regulation strategies are effective.
This study aimed to determine how young people use digital technology, how this relates to regulation of emotion,
whether these are associated with symptoms of depression and anxiety.
Methods:
Young people aged 17-24 years (N=116) completed an online survey, involving quantitative and qualitative compo-
nents, which assessed participant’s online activity, whether they use specific digital activities to regulate emotion, and
the effectiveness of these strategies. Symptoms of depression and anxiety were also measured.
Results:

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Participants (Mage= 18.75, 70.7% female) reported most frequently spending 2-3 hours per day on their phone and 1-2
hours per day on social media. Over half (62%) reported frequently using technology in response to feeling upset or
distressed and 48.3% reported frequently using technology in response to feeling happy or excited. When upset or
distressed, the most common activity participants reported engaging with was using social media (38.7%). Converse-
ly, when happy or excited, participants were most likely to message others (46.6%).
For participants with clinical symptoms of depression and/or anxiety, time spent on devices and social media did
not differ between non-depressed and non-anxious people. However, when in a negative mood those with depres-
sive symptoms t(53)=2.796, p=.007 and high anxiety symptoms t(56)=2.99, p=.004 used technology more often
to hide their feelings, and those with depressive symptoms also used technology less often to reappraise or think
more positively about the situation t(53)=2.58, p=.013. Relative to non-depressed participants, those with depressive
symptoms also reported that their mood got worse more often t(69)=2.64, p=.010 and their mood improved less
often t(69)=2.58, p=.005 following technology use. Similarly, relative to non-anxious participants, those with anxiety
symptoms reported their mood getting worse more often t(56)=2.434, p=.018 after technology use.
Conclusion:
Study findings enhance our understanding of how young people use technology today. Our results highlighted key
differences in how young people with mental health symptoms use their devices to regulate emotion, and showed
that they engaged in more unhelpful emotion regulation strategies, relative to their non-symptomatic peers. The in-
sights from the study will inform specific advice and strategies to support those with mental health problems in using
devices in a healthier, emotion regulatory way.

Keywords
young people, adolescents, digital technology, emotion regulation, digital emotion regulation

• Preliminary elucidation of an emotionally, behaviorally and interpersonally dysregulated phenotype within

a diverse clinical sample – A latent profile analysis
Kirsti Akkermann, University of Tartu; Centre for Cognitive and Behaviour Therapy, Tartu, Estonia
Helo Liis Soodla, University of Tartu; Centre for Cognitive and Behaviour Therapy, Tartu, Estonia

Abstract
Introduction: Personality traits dispose individuals to psychopathology, impact treatment adherence and prognosis
(Andersen and Bienvenu, 2011). Recognition of transdiagnostic influence of personality traits has given rise to per-
sonality-based profiling. Profiling studies on a diverse range of clinical populations have consistently postulated a
personality profile with emotional lability and behavioral disinhibition, often labeled as the undercontrolled class, to
predict the most severe state disturbances. In this presentation, we aim to elucidate the features of this dysregulated
class to illustrate how the trait-and state-level disturbances commonly attributed to individuals with borderline per-
sonality disorder (BPD) manifest in other clinical samples.
Methods. We used latent profile analysis to describe personality trait combinations in a mixed sample of women with
mental disorders (n = 313) and healthy controls (n = 114). After profile extraction based on entropy, information cri-
teria and interpretability, the best-fitting solution based on impulsivity, perfectionism, anxiety, stress susceptibility,
mistrust, detachment, irritability, and embitterment was related to the state features (depression, state anxiety, disor-
dered eating, and emotion regulation difficulties) to establish clinical significance.
Results: A 5-profile solution proved best-fitting. Extracted profiles included a high functioning, a well-adapted, an
impulsive and interpersonally dysregulated, an anxious and perfectionistic, and an emotionally and behaviorally dys-
regulated class. A large proportion of participants fell into the emotionally and behaviorally dysregulated class (n =
72). Besides exhibiting higher trait levels of dysfunctional impulsivity, negative perfectionism, embitterment, irrita-
bility, detachment and mistrust, this class was distinguishable by high comorbidity – 56.9% of individuals in this class
had three or more comorbid mental disorders. Also, this class included a disproportionately high percentage of PTSD
(65.2% of all PTSD patients) and substance use disorder (35.8%) as well depression and GAD.
Discussion: Our results reveal two significant findings. Firstly, a BPD-like dysregulation pattern is characteristic to pa-
tient populations beyond BPD. Secondly, this phenotype has both trait- and state-level markers. Whether this emo-
tionally and behaviorally dysregulated class forms a qualitatively distinct taxon or whether individuals can exhibit
such state-trait patterns on a continuum deserves further investigation. Regardless, these results are significant for
treatment planning and suggest that patients with both traditionally internalizing and externalizing disorders could
benefit from transdiagnostic interventions explicitly targeting maladaptive emotional, behavioral and interperson-
al responses deriving from above mentioned traits. Further studies to assess whether profile membership predicts
treatment response are warranted. Such research could help evaluate the relevance of the diathesis-stress model in
treating personality profiles as risk and moderating factors, and contribute to personalized CBT conceptualizations
and interventions.
Keywords
personality profiles, transdiagnostic/ dimensional psychopathology, transdiagnostic interventions

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• Emotion Regulation Training for Adolescents With Major Depression: Results From a Randomized Controlled
Trial
Lisa Feldmann, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University
Hospital, LMU Munich, Germany
Carolin Zsigo, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University
Hospital, LMU Munich, Germany
Frans Oort, Research Institute of Child Development and Education, Faculty of Social and Behavioural Sciences, Uni-
versity of Amsterdam, Netherlands
Charlotte Piechaczek, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU
University Hospital, LMU Munich, Germany
Jürgen Bartling, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU Univer-
sity Hospital, LMU Munich, Germany
Christian Wachinger, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU Uni-
versity Hospital, LMU Munich, Germany; Department of Radiology, TUM School of Medicine and Health, Technical
University of Munich, Germany
Gerd Schulte-Körne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU Uni-
versity Hospital, LMU Munich, Germany
Ellen Greimel, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University
Hospital, LMU Munich, Germany

Abstract
Deficient emotion regulation (ER) is one of the risk factors for the development and maintenance of major depres-
sion (MD) in adolescence. However, it has yet to be explored whether a task-based training of ER can have beneficial
effects on symptoms of adolescent MD. The aim of this randomized controlled trial (NCT03957850) was to evaluate
the effects of an experimental ER training on (1) stress- and affect-related measures as well as (2) behavioral and neu-
rophysiological correlates of ER.
We included N=70 adolescents with MD in our study of whom n=36 were randomly allocated to a task-based ER train-
ing and n=34 to a control training. Across four training sessions, the training group was instructed to down-regulate
negative affect to negative pictures via the ER strategy “reappraisal” while the control group was instructed to solely
view the pictures. Perceived stress, severity of depression, affect and rumination were defined as primary outcome
measures, changes in self-reported ER success and neurophysiological responses such as the late positive potential
(LPP) were defined as secondary outcome measures. Moreover, gaze behavior during the training sessions was as-
sessed via eye-tracking to examine the role of visual attention.
While we did not find any significant differential effects of ER training on the primary outcome measures, in the ER
training group we found small to moderate effects on rumination, that were not found in the control group. During
reappraisal, the ER training group demonstrated an unexpected increase in the LPP amplitude but only during the
first, but not during the remaining training sessions. Moreover, the ER training group showed self-ported ER success
during reappraisal that did not change over the four training sessions. Visual attention was not related to changes in
self-reported ER success or LPP amplitudes across the sessions.
The finding on small to moderate effect sizes suggest that a task-based ER training might be promising to reduce
rumination in adolescents with MD. However, this finding needs replication in larger multicenter studies. The increase
in LPP amplitude during the first training session during reappraisal could represent cognitive effort needed to per-
form the task, which was reduced over the training sessions. Future studies should research whether other clinical
and secondary effects can be achieved through training with higher intensity and whether training effects transfer
to daily life.

Keywords
major depression, emotion regulation, training, randomized controlled trial, adolescents

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Open Paper Symposium 16 – Miscellaneous 1
Chair: Torun Grøtte, NTNU, Norway

• Psychological inflexibility as a potential mediator between mental distress and trichotillomania and
skin-picking disorder
Torun Grøtte, NTNU, Norway
Filippa Brovold, NTNU, Norway
Erna Marie Moen, Oslo university hospital, Norway
Benjamin Hummelen, Oslo university hospital, Norway

Abstract
Background: Psychological inflexibility (PI) is an essential construct in Acceptance and Commitment Therapy (ACT).
Previous literature suggest that PI is associated with the presence and severity of symptoms of trichotillomania (TTM)
and skin-picking disorder (SPD). According to ACT theory, individuals with TTM and SPD may pick their skin and pull
their hair to avoid or regulate internal experiences or states of discomfort. The aim of the current study was therefore
to test whether PI mediate the relationship between mental distress (i.e., symptoms of anxiety and depression) and
symptoms of TTM and SPD.
Method: As part of a longitudinal, observational cohort study of ACT-enhanced behavior therapy for TTM and SPD,
147 individuals with TTM and 97 individuals with SPD completed a battery of self-report instruments prior to therapy.
PI was measured with a TTM- and SPD-specific version of the Acceptance and Action Questionnaire (AAQ-TTM; Woods
& Twohig, 2008) which consists of two factors: 1) “AAQ-accept” (i.e., items related to attitudes toward the urge to pick/
pull), and 2) “AAQ-interference” (i.e., items related to the relationship between general functioning and the urge to
pick/pull). Severity of TTM and SPD were measured with the Massachusetts General Hospital - Hairpulling Scale and
the Skin Picking Scale-Revised, whereas severity of anxiety and depression were measured with Patient Health Ques-
tionnaire-9 and General Anxiety Disorder Scale-7.
Results: Correlational analyses showed that higher PI was related to higher symptom severity of TTM and SPD. The
mediation analyses revealed that PI in terms of AAQ-interference fully mediated the relationship between anxiety and
depression and TTM severity, as well as the relationship between anxiety and depression and SPD severity. AAQ-ac-
cept did not act as a mediator in any of the models.
Conclusion: The results provide further support for PI as an essential construct in TTM and SPD. Longitudinal studies
are needed to test the temporal association between PI and symptoms of TTM and SPD, as well as PI’s potential rela-
tion to TTM and SPD treatment outcome.

Keywords
skin picking disorder; trichotillomania; psychological inflexibility; ACT

• The Moderating Role of Psychological Flexibility in the Relationship Between Loneliness and Well-being
Among Young Adults: A Cross-sectional Study
Thouli Koulouri, Utrecht University, Greece
Rinie Geenen, Utrecht University, Netherlands

Abstract
Loneliness is considered a universal constant; an experience one cannot easily escape from. Despite the evidence of its
deleterious effects on mental and physical health across all age groups, the majority of research has primarily focused
on older cohorts, leaving young adults beyond the scope of scientific attention. The current study aims to compensate
for this research inequity by examining whether there is an indication that psychological flexibility protects individu-
als against the negative effects of loneliness on well-being. It was hypothesized that the inverse relationship between
loneliness and well-being would be significantly less pronounced among young adults with high, compared to low,
psychological flexibility. The design of the study was cross-sectional. For the purpose of this research, 162 participants,
between 18 and 30 years of age, were recruited through social media. Data were collected online via self-reported psy-
chological assessments of loneliness (Loneliness Scale), psychological flexibility (FIT-24) and well-being (SF-12) and
were subsequently analyzed using linear regression analysis. According to the results, the two-way interaction between
loneliness and psychological flexibility was not significantly associated with well-being (p = .45). The disconfirmation
of the research hypothesis was attributed to the use of an unsuitable moderator and methodological shortcomings.
Clinical and research implications include the documentation of the actual effects of psychological flexibility on well-
being, which will be accomplished within longitudinal experimental designs, and the investigation of other moderating
variables, including social engagement and emotion regulation styles. The research stands out in terms of novelty and
cultural diversity, but could be improved in terms of methodology. Overall, despite the statistical insignificance that was
observed, findings highlight the profound need to reduce the distress that may derive from loneliness.

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Keywords
loneliness; ACT; psychological flexibility; well-being; young adults

• Influences of Educational Background on the Conceptualization of Mental Disorders: Insights for CBT Practice
Stefan Jerotić, University of Belgrade, Faculty of Medicine & Clinic for Psychiatry, University Clinical Centre of Serbia,
Serbia
Natalija Ignjatović, University of Belgrade, Faculty of Philosophy, Department of Psychology, Serbia

Abstract
Introduction: The contemporary cognitive behavioral approach relies upon the transdiagnostic case conceptualiza-
tion and intervention, which may be understood as an integration of biological, psychological, and social factors.
This comprehensive framework allows clinicians to understand the complexities of patient’s psychological challenges
and to apply transdiagnostic interventions in an idiographic fashion to improve well-being [1]. Although all mental
disorders are considered multifactorial, the weight given to biological versus social factors varies significantly. This
variation influences symptom expression and is crucial for accurate case conceptualization. Furthermore, the impor-
tance given to social vs. biological factors in the development and maintenance of mental disorders can differ based
on the helper’s educational background.
Aim: This cross-disciplinary study aimed to explore how different professional groups, specifically psychiatrists and
psychologists, conceptualize mental disorders with respect to their emphasis on biological versus social factors.
Method: The research was conducted as a cross-sectional study involving psychiatrists (both residents and specialists)
and psychologists. The influence of biological and social factors was rated on a five-point Likert scale of the attribu-
tion of mental disorders. Based on previous research [2], participants assessed the following psychological challenges:
absence of sexual desire, alcoholism, binge-eating disorder, gambling addiction, narcissistic personality disorder, oc-
cupational burnout, schizophrenia, social anxiety, autism spectrum disorder, and ADHD. Differences between groups
were analyzed using the Mann-Whitney U-test.
Results: A total of 131 psychiatrists (71.8% female, average age 40.5 years) and 78 psychologists (82.1% female, av-
erage age 33.4 years) participated in the study. Significant differences were observed: compared to psychiatrists,
psychologists endorsed more social factors for the absence of sexual desire. For binge-eating disorder, psychiatrists
slightly favored biological factors, whereas psychologists leaned towards social factors. In narcissistic personality dis-
order, psychiatrists showed a balanced view of social and biological factors, unlike psychologists who strongly favored
social factors. Schizophrenia saw almost exclusive endorsement of biological factors by psychiatrists, in contrast to
psychologists who endorsed them less strongly. Interestingly, in social anxiety disorder, psychologists endorsed bio-
logical factors more strongly than psychiatrists, who maintained a balanced view.
Conclusion: Our study highlights the need to include both psychologists’ and psychiatrists’ varying perspectives on
mental disorders when creating diagnosis-specific cognitive behavioral therapy (CBT) manuals and training pro-
grams. Recognizing and integrating these differing viewpoints is essential because the way a disorder is understood
can greatly affect the therapeutic strategies and interventions used in CBT. By adapting these resources to accommo-
date diverse professional insights, we can improve the effectiveness and suitability of treatment approaches.

Keywords
conceptualization, mental disorder, biological/social attribution, education, CBT practice

• Seeking psychological help: Stigma, barriers and possible online intervention inhibiting avoidance of get-
ting help
Tereza Hruskova, The Department of Psychology, Faculty of Arts at Masaryk University, Czech Republic

Abstract
Globally, 200 million people experience serious mental health issues, yet only a third seek professional help, often as
a last resort. Adolescents and young adults show higher prevalence rates of mental health problems. Stigmatisation
plays a crucial role in the decision to seek help, manifesting as self-stigma (internal beliefs, low self-esteem, reduced
quality of life) and public stigma (society’s stereotypes and disapproval). Both forms of stigma negatively impact
help-seeking behaviour and attitudes towards mental health services.
Previous research has largely examined help-seeking behaviours, avoidance, and delay separately, aiming to identify
the barriers preventing timely help-seeking. These barriers evolve over time and at different help-seeking stages.
Attitudes are closely linked to both self-stigma and social stigma, influencing whether an individual seeks profession-
al help. Key barriers include stigmatisation, a sense of humiliation, insufficient problem recognition, preference for
self-reliance, and distrust in professionals. Conversely, facilitators include past experiences with mental health issues,
social support, and assistance from others.

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Our current studies address the gap between experiencing mental health problems and seeking professional help
among young adults and teachers in the Czech Republic. Two studies aim to elucidate the individual constructs and
factors involved, enhancing understanding of the help-seeking journey and identifying obstacles.
4500 participants aged 18-35 and 438 teachers completed an online questionnaire in January 2024. Demographic
questionnaire and four scales were measuring attitudes (Attitudes Toward Seeking Professional Psychological Help
– Short Form), barriers (Barrier to Help Seeking Scale), self-stigma (Self Stigma of Seeking Help), and public stigma
(Perceptions of Stigmatisation by Others for seeking help). These scales were translated into Czech language.
The study aimed to (I) determine the validity and reliability of the Czech translations, (II) analysed the scales’ factors
within the Czech population and compare these with the original versions’ reliability and validity, and (III) explore the
relationships between attitudes towards seeking help, avoidance or delay in seeking help, and participants’ demo-
graphic and individual differences, barriers, self-stigma, and public stigma.
In the study of Czech teachers, we observed a statistically significant difference between Self-stigma and Stigma due
to other whereby men reported higher mean stigmatisation compared to women. Both Self-stigma and Stigma due
to others correlated statistically significantly with Well-being and Job satisfaction but not with age and years of teach-
ing experience. We are currently in the process of statistical analysis for the second study of young adults.
This research represents the first of its kind in the Czech Republic, aiming to identify and understand the factors
contributing to the avoidance of professional help-seeking. By exploring the relationships between stigmatisation,
attitudes, and barriers, we hope to reveal whether Czech young adults’ help-seeking behaviours differ from those
observed in other countries, considering cultural variations highlighted in previous research.

Keywords
stigmatisation, barriers, attitudes, seeking help, teachers, young adults

• Logic and Philosophy for Opening up New Perspectives on CBT

Viktoriia Denisova, National Research University Higher School of Economics, Russian Federation

Abstract
Introduction
We all have an ability to reason. Moreover, we communicate with others and exchange some information. The process
of making arguments includes the process of inference from the facts we are aware of. A syllogism is a deduction that
consists of three propositions: two premises and a conclusion. The founder of cognitive behavior therapy Aaron Beck
(1921 – 2021) extensively used deductive arguments to reveal negative self-schemas that are at the core of depres-
sion.
At the CBT World congress 2023 (Abstract book, p.700) I presented the key concepts of logic and its employment for
enhancing of CBT sessions. Now we focus on the idea that philosophy and logic might give a new outlook.
Method
The conceptual analysis is used as the method for revealing philosophic and logic tools for working with clients with-
in CBT sessions. We observe some historical facts regarding logic (Aristotelian logic and Stoics logic school) and its
correlation with cognitive science and cognitive psychology in general. The main discussion includes the theoretical
assumptions that are made by way of analysis of current research where logicians and cognitive psychologists col-
laborate. The logicians and cognitive scientists have completed the conjoint research work and have presented the
findings that are helpful for treating some psychological disorders that are assessed in our research work.
Results
This paper analyzes the stages of the relationship formation between the science of logic and CBT. In our paper
(Denisova V. G., Kovpak D. V., Logic Foundations of CBT, 2023, in Russian) we underlined that logic made a significant
contribution to formulation of the very basic concepts of CBT and has become one of the tools that help to form a
metaposition and critical thinking. The authors of the article emphasize the importance of logical theory for identify-
ing cognitive distortions, irrational beliefs, disputing thoughts, as well as the further development of CBT.
Discussion
From the point of view of logic as a science, when we say that something is “logical”, we consider three logical con-
cepts: terms, propositions and arguments. Therefore, while the therapist uses a logical dispute, he may question the
following:
1. Whether the terms are clear or unclear (ambiguous).
2. Whether the judgments are true or false.
3. Whether the arguments are valid or invalid.
Conclusion
The expression of emotions is associated with the emergence of a thought at one time or another. The identification
of clients’ cognitive distortions is closely related to how the client formulates the thought. Every thought is expressed
in a language that is commonly called natural. Logic studies the forms of thought, connections between them, and

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also operates with artificial languages that reflect the natural language. A clear definition of forms of thought, their re-
lationship and the language of symbols allow us to consider thinking without regard to a set of individual preferences
and assessments. Consequently, logic that appeals to the structure of thoughts, and philosophy that is intercultural as
its essence help in overcoming cultural diversity, structure the session and trace causes and effects.

Keywords
new CBT techniques, logic, philosophy of CBT, cultural diversity, CBT development

• The More You Check, The Less You are Certain-The Paradoxical Effect of Body-Checking
Mor Ben Zaken Linn, University of Haifa, Israel
Noam Weinbach, University of Haifa, Israel

Abstract
Body checking is suggested to play a role in the maintenance of eating disorders. However, the mechanisms that per-
petuate repeated body checking are poorly understood. Drawing parallels with behavior observed in obsessive-com-
pulsive disorder, where repeated checking seeks to alleviate uncertainty but paradoxically intensifies it, the present
study examined the causal effect of repeated body checking on certainty regarding checked body parts. Addition-
ally, the study assessed whether repeated body checking influences certainty about future weight gain after eating.
Seventy-nine healthy female participants initially checked six body parts and were asked which body part they last
checked and how certain they were about it. They then consumed a chocolate bar and rated their expectations of
gaining weight and their level of certainty regarding weight gain. Subsequently, participants underwent a repeated
checking manipulation in which they repeatedly checked their body or a neutral object, based on their assigned ex-
perimental group (body-checking or object-checking, respectively). Finally, all participants completed the six body
parts checking procedure again and answered the same questions from the pre-manipulation phase. The results
revealed that, consistent with the primary hypothesis, actual memory regarding checked body parts was unaffected
by repeated body checking. Still, repeated body checking significantly reduced certainty about memory compared
to neutral object checking. Contrary to the secondary hypothesis, the experimental groups did not differ in certainty
regarding future weight gain after the repeated-checking manipulation. The findings provide the first empirical indi-
cation of the paradoxical effect of body-checking, which increases the feeling of uncertainty and may thus maintain
such behavior among individuals with eating disorders who tend to engage in body-checking behaviors. Possible
interventions to disrupt this proposed vicious cycle between body checking and uncertainty may involve improving
patients’ ability to tolerate and accept uncertainty without taking actions aimed at reducing it, such as body checking.
This approach mirrors strategies seen in third-wave treatments for OCD, focusing on accepting intrusive thoughts
without engaging in compulsive behaviors.

Keywords
eating disorders, obsessive-compulsive disorder, body checking, uncertainty, intolerance of uncertainty, repeated
checking

Open Paper Symposium 17 – Schema

Chair: Oana Cobeanu, Babes-Bolyai University, Departament of Psychology, Romania

• The longitudinal association between stress and mental health in the context of the pandemic through the
lens of emotional schemas and psychological flexibility
Rita Sebastiao, School of Psychology, ISPA-Instituto Universitário; APPsyCI – Applied Psychology Research Center
Capabilities & Inclusion, Portugal
David Dias Neto, School of Psychology, ISPA-Instituto Universitário; APPsyCI – Applied Psychology Research Center
Capabilities & Inclusion, Portugal

Abstract
Stress is a known contributor to psychosocial pathological conditions and reduction of well-being. In the pandemic
context, stress responses were identified as an important factor affecting mental health. Understanding what makes
individuals more resistant to the negative effects of stress over time could suggest new paths for the development
of interventions for stress-related disorders. Among the different factors, modifiable psychological processes may
help to mitigate the mental health impact of stress. Within cognitive behavioural therapy, more meta-experiential ap-
proaches have emphasised the role of thoughts and feelings about emotions (e.g., maladaptive emotional schemas)
in conceptualising the association between stress and mental health. More experiential approaches have emphasised
the willingness to embrace thoughts and emotions while living according to personal values (e.g., psychological flex-
ibility). The literature has highlighted the role of emotional schemas and psychological flexibility as psychological

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processes underlying this relationship in the short term. This two-wave longitudinal study aims to analyse the role
of psychological flexibility and emotional schemas in the relationship between stress responses to COVID-19-related
events and mental health six months later. A total of 276 individuals from the Portuguese general population were
included in this study. They were mostly females (69.9%) between 16–86 years old (M = 47.2, SD = 18.24). Participants
completed self-report measures regarding stress responses, emotional schemas, psychological flexibility, and positive
and negative mental health. A multiple mediation analysis was conducted. The results suggested that negative evalu-
ation of emotions was a full mediator in the longitudinal relationship between stress responses and negative mental
health. A valued action and openness to experience fully mediated the longitudinal relationship between stress re-
sponses and positive mental health. This study adds the importance of different dimensions of the studied psycholog-
ical processes over time, suggesting that negative evaluation of emotions contributes to explaining the relationship
between stress responses and negative mental health. Valued action and openness to experience may contribute to
explaining the relationship between stress responses and positive mental health. This contributes to differentiating
between enduring and transient psychological processes in this relationship across time and pandemic progression.
Integrating emotional schemas and psychological flexibility brings to light some of the processes belonging to dif-
ferent CBT models and contributes to effective and flexible responses across different psychological levels in stressful
contexts, such as the COVID-19 pandemic.

Keywords
stress; emotional schemas; psychological flexibility; positive mental health; negative mental health

• Core beliefs or schemas, which is more compatible with the cognitive structure?
Canan Efe, Private Practice, Ankara, Turkey
Selin Tutku Tabur, Hasan Kalyoncu University PhD in Clinical Psychology, Turkey
Hakan Turkcapar, Social Sciences University of Ankara, Turkey

Abstract
Introduction: According to the Cognitive theory proposed by Beck, core beliefs about oneself, other people and the
world are at the centre of the cognitive structure (Beck, 2011). According to this model, core beliefs hierarchically
create other dysfunctional schemas (underlying intermediate beliefs). According to this theory, core beliefs about
the self are in three main domains: helplessness, worthlessness and unlovability. This makes core beliefs the most
important factor in the development of cognitive processes in psychopathology. On the other hand, according to
another psychopathological clinical model, schema theory (Young et al., 2003), 18 ‘Early Maladaptive Schemas’ (EMS)
at the same hierarchical level lead to different psychopathologies. The main aim of this study is to examine the factor
structure of the YSQ developed according to schema theory and to determine whether the factors obtained support
Young’s schema theory or Beck’s theory that suggests that 3 core beliefs are at the centre of psychopathology.
Method: The study group consisted of 237 subjects (162 female, 75 male) with an average age of 27.7 years. There
psychiatric diagnosis according to the SCID as follows; 53 generalised anxiety disorders, 36 social phobias, 57 panic
disorders, 30 obsessive-compulsive disorders, 5 specific phobias and 56 not otherwise specified anxiety disorders. The
Young Schema Questionnaire (YSQ) was used in this study. Factor analyses were carried out. After deciding on the
number of dimensions, we removed the items with factor loadings below .50 and continued the analysis. Then, we
determined the items that loaded on both factors and removed those with a difference of less than .100 between the
factor loadings and performed factor analysis to the final stage.
Results: The results of the factor analysis, on the 90-item Young Schema Scale, there are 21 factors with an initial ei-
genvalue greater than 1. However, when we looked at the factor loadings, we saw that this was reduced to 3 factors.
We found that there were 3 factors with more than 50% of the variance explained. In the results we found, we see that
the number of items of the 3rd sub-dimension is low. The KMO value was found to be 0.864 after the last analysis. The
3 factors explained 56.47% of the total variance.
Conclusions: Higher order principal component analysis revealed three higher order factors, consistent with previous
findings. As a result, when the factor structure of the 18 schema domains defined by the YSQ is examined, it is found
to be compatible with Beck’s three basic belief groups previously defined in CBT. The results of our study support that
Beck’s core belief theory, consisting of 3 thematic beliefs, is more explanatory than Young’s 18-schema model.

Keywords
schema, core belief, cognitive structure

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• The relationship between perceived parenting style, early maladaptive schema dispositions, strengths and
difficulties in children aged 9-13 years.
Oana Cobeanu, Babes-Bolyai University, Departament of Psychology, Romania
Adriana Maria Popa, Babes-Bolyai University, Departament of Psychology, Romania

Abstract
In schema therapy (ST), early maladaptive schemas (EMS) are assumed to derive from adverse relational experience. The
relative impact of perceived parenting styles on the development of EMS in children, as measured by the Dusseldorf Il-
lustrated Schema Questionnaire for Children (DISC), has not yet been examined. This study is exploring the relationships
between perceived parental warmth (PPW) and control (PPC), EMS, and strengths and difficulties (SDQ) reported by
both parents and children aged 9-13. The participants were 52 children (MA: 12, SD = 1.21, 55% female) and their parents
(MA: 43, SD = 5.06, 49% female). The children completed the DISC, the Authoritative Parenting Index (API), and the SDQ.
Parents completed the SDQ. We used Pearson correlation analysis. Children-reported difficulties (CRD) demonstrate a
positive correlation with EMS (r = 0.29, p < 0.05). EMS exhibit a positive correlation with children-reported prosocial be-
haviors (CRPB) (r = 0.31, p < 0.05). PPW from both parents showed a negative correlation with CRD (r = - 0.43, p < 0.01, and
respectively r = - 0.42, p < 0.01), while parental reports of prosocial behaviors (PB) positively correlated with PPW from
fathers (r =0.47, p < 0.01). There was no significant correlation between PPW and PPC and EMS total score, or between
PPC and PB or difficulties (both children and parents reported). PPW from mothers showed a negative correlation with
the Emotional Inhibition schema (EI) (r = - 0.35, p < 0.05), while PPC from mothers positively correlated with the Vulnera-
bility schema (VU) (r = 0.33, p < 0.05). PPW from fathers showed a negative correlation with the Abandonment/Instability
schema (AI) (r = - 0.42, p < 0.01), and respectively the Self-Sacrifice schema (SS) (r = - 0.28, p < 0.05), while PPC from fathers
showed also a positive correlation with VU, which did not reach significance (r = 0.27, p = 0.051). A multiple regression
was run to predict difficulties in children (as reported by children) only from PPW and EMS. The model reached statistical
significance (R2 = 0.28, p < 0.001). Our results support previous findings that EMS are related to childhood difficulties.
Most of the schemas were positively related to domains of the SDQ that represented difficulties (e.g., peer relation-
ship problem and hyperactivity/inattention areas). CRPB showed a negative correlation with EMS, specifically with AI
(r =-0.42, p < 0.01). The positive correlation between CRPB and several EMS was also expected, and explained by the
fact that children tend to alter their behavior towards compliance, to satisfy their need for security. Our data shows that
there is a connection between perceived parenting styles and specific EMS. The positive association between PPC and
VU indicate towards investigating children ability to perceive the dysfunctional character of EMS. These findings suggest
specific relations between different dimensions of parenting and specific schemas, and respectively children’s strengths
and difficulties. Given the small amount of variation explained by our regression model, other variables should be con-
sidered when analyzing the effect of parenting styles and EMS on children’s difficulties.

Keywords
schema therapy, early maladaptive schema dispositions, perceived parenting, children

• Maladaptive Schemas as An Explanation for Gender Differences in Living Organ Donors

Zulal Törenli-Kaya, Baskent University Faculty of Medicine Psychiatry Department, Turkey Arda Karagol, Baskent
University Faculty of Medicine Psychiatry Department, Turkey

Abstract
Introduction
The decision to become an organ donor was primarily motivated by altruism, driven by the desire to assist others. Rec-
ognizing that organ donation can significantly improve the quality of life and extend the lifespan of another person,
individuals were more inclined to consent to organ donation based on this selfless motivation. Living organ donors
are willing to undergo significant surgical procedures solely toassist another person in reclaiming their health. It was
emphasized that there is a higher likelihood of women being living organ donors compared to men. In the context
of living organ donation, women have accounted for an average of 52.5% of donors over the past six years. This
may be because of women’s being more susceptible to subtle pressures or influences. To explore this imbalance, this
study aimed to examine the differences between female and male living organ donors in terms of early maladaptive
schemas (EMS), which originate from the early childhood experiences and can lead to the formation of maladaptive
cognitions, emotions, social perceptions, and behaviors.
Method
The study included individuals who were living liver or kidney donors between the years 2014 and 2019, who did not
have depressive symptoms, and who had voluntarily participated. Socio-demographic information form, the Young
Schema Questionnaire-Short Form, and the Beck Depression Inventory (BDI) were the assessment tools. The individ-
uals who had BDI scores over 10 were excluded from the analysis.In the study, t-test comparison was conducted with
a total of 51 individuals.
Results

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Among the participants, 26 (51%) of them are female, 46 (90%) of them are married, 30 (58.82%) of them are at least
high-school graduates, neither of the participants have history of a psychiatric diagnosis. The average age of the
participants was found to be 43.98 (SD = 9.50). The number of liver donors was 11 (21.6%) and kidney donors was 40
(78.4%). Twenty-six individuals (51%) became organ donors specifically for their children, with an equal number of
female donors and male donors.
When the EMS of each gender were compared the results revealed that men had significantly higher scores in the
schemas of emotional deprivation, social isolation-mistrust, approval seeking, self-sacrifice, punitiveness, and vulner-
ability to harm. In the study, women did not score higher than men in any schema.
Discussion
The findings suggested that men who are living organ donors exhibit specific early maladaptive schemas (EMS) that
prioritize others’ needs over their own, seeking approval, emotional connection, or avoiding negative reactions. These
schemas, typically associated with women in the literature, align with traditional gender roles that expect women to
be caregivers, nurturers, homemakers, and helpers. The study highlights that men who are organ donors share similar
externally focused characteristics.
Conclusion
The results highlight the importance of understanding the motivations of men who are considering becoming organ
donors and addressing any associated perceptions and EMS through therapeutic interventions. This is crucial to pre-
vent potential mental health issues that may arise in the future.

Keywords
Maladaptive schemas, gender differences, living organ donors

Open Paper Symposium 18 – Trauma

Chair: Marina Letica Crepulja, Faculty of Medicine, University of Rijeka, Rijeka, Croatia; Clinical Hospital Center Ri-
jeka, Department of Psychiatry, Referral Center for PTSD of the Ministry of Health of the Republic of Croatia, Rijeka,
Croatia

• The Impact of Integrated Cognitive Behavioral Therapy and Spiritual Intervention on Post-Traumatic Stress
Disorder in Sexual Abuse Survivors: A Case Study Focused on Sin as a Predominant Theme
M. Furkan Cinisli, Istanbul Sabahattin Zaim University, Turkey
Taha Burak Toprak, Ibn Haldun University, Turkey

Abstract
This case study examines the therapeutic impact of combining Cognitive Behavioral Therapy (CBT) with spiritual in-
terventions on a 22-year-old female university student in Istanbul, diagnosed with Post-Traumatic Stress Disorder
(PTSD) following childhood sexual abuse. The client’s PTSD symptoms included emotional dysregulation, avoidance
of men, intrusive memories, self-harm, sleep disturbances, and self-loathing. These symptoms intensified after she
started university, particularly during interactions with male peers. The client had no prior psychiatric history and
sought therapy due to increasing difficulties in managing her emotions and social interactions. The trauma, which
involved sexual abuse by her brother’s friend at age 11, had been mitigated during high school by attending an all-
girls school. However, the co-educational university environment reactivated her trauma, leading to severe avoidance
behaviors and distress during group projects with men.
The therapeutic process was guided by Ehlers and Clark’s (2000) cognitive model of PTSD, which emphasizes the
reprocessing of traumatic memories to alleviate current perceptions of threat. The treatment involved several stages:
assessment, psychoeducation, cognitive interventions, and behavioral interventions. During the cognitive interven-
tions, a significant focus was placed on addressing the client’s religious interpretations of the trauma, specifically her
beliefs of being sinful and unforgiven by God. Behavioral interventions then encouraged the client to gradually re-en-
gage with male peers in a controlled and supportive manner. Over the course of 20 sessions, the integrated approach
led to a reduction in the client’s PTSD symptoms, improved emotional regulation, and enhanced social functioning,
demonstrating the efficacy of combining CBT with spiritual interventions in treating trauma with religious implica-
tions. This study specifically addresses knowledge and skills that can be applied at the cognitive level for Muslim
victims of abuse.

Keywords
Post-Traumatic Stress Disorder (PTSD), Cognitive Behavioral Therapy (CBT), Spiritual Intervention, Sexual Abuse, Case
Study

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• Post-traumatic stress disorder after sexual trauma: the role of emotional and cognitive reactions
Tubanur Bayram Kuzgun, Istanbul Arel University, Turkey
Ebru Salcioglu, Beykoz University, Turkey

Abstract
Emotional and cognitive reactions during and after trauma significantly influence PTSD. To understand their intricate
relationship, a robust theoretical and statistical method is needed for accurate measurement and theory evaluation.
This study employed such an approach to explore the connections between sense of control and emotional reactions
during trauma, post-trauma feelings of fear, helplessness, shame, and guilt, and PTSD in 601 women with a history
of perceived sexual trauma. Participants completed an online survey using reliable and valid measures of perceived
trauma severity, post-trauma fear from ongoing safety threats, sense of helplessness, trauma-related shame, and guilt
cognitions. A theoretical model was tested using Structural Equation Modeling, which showed a good fit to the data.
The sense of control during trauma predicted distress levels at the time of the trauma. Emotions during trauma direct-
ly affected post-trauma fear, helplessness, and shame, but not guilt cognitions. Fear, helplessness, and shame directly
impacted PTSD and mediated the relationship between emotions during trauma and PTSD. While guilt cognitions
directly affected PTSD, they did not serve as mediators. These findings indicate that emotions during trauma contrib-
ute to PTSD when they lead to chronic fear for safety, a sense of helplessness, and shame. Therefore, trauma-focused
psychological interventions aimed at overcoming fear and shame, reducing helplessness, and restoring a sense of
control could effectively improve PTSD outcomes in survivors of sexual violence.

Keywords
sexual trauma, post traumatic stress disorder

• Guided Written Exposure Therapy for Chinese Posttraumatic Stress Disorder Patients: A Randomized Con-
trolled Trial
Muyang Li, Peking University, China
Ye Zhao, Peking University, China
Zeyu Guo, Texas A&M University (Department of educational psychology), United States
Shijia Fan, Peking University, China
Yu Li, Peking University, China
Yinyin Zang, Peking University, China

Abstract
Background: This study aimed to evaluate the effectiveness of the online Guided Written Exposure Therapy (GWE),
a modification of the Written Exposure Therapy (WET), in reducing PTSD symptoms among Chinese patients. Meth-
ods: Ninety five adult participants with clinical or subthreshold PTSD were randomly assigned to GWE group (n = 65) or
Minimal Contact Control (MCC) group: (n = 30). All interventions were administered online to minimize dropout rates
and reduce barriers to participation. GWE involved increased psychoeducation and guidance for both the therapists
and the participants compared to the original written exposure therapy protocol. Participants were assessed using the
PTSD Symptom Scale Interview-DSM5 (PSSI-5) at baseline, post-intervention, and at 1-month, 3-month, and 6-month
follow-ups. Results: The dropout rate for the GWE group was 13%, and 79.5% of participants were satisfied with the
intervention. Post-test and one-month follow-up PSSI-5 scores for the GWE group were significantly lower than those
for the MCC group. The effects of GWE were maintained during the six-month follow-up period. Discussion: GWE
demonstrated high acceptability, low dropout rates, and sustained effectiveness in reducing PTSD symptoms among
Chinese patients. This culturally adapted intervention shows promise as a feasible and effective PTSD treatment in
China and potentially other underdeveloped regions.

Keywords
PTSD; Written Exposure Therapy; Cultural adaptation; Randomized controlled trial; Online intervention

• The Moderating Effects of Self-Compassion on Post-Traumatic Growth

Marios Adonis, University of Nicosia, Cyprus
Marina Loucaides, University of Nicosia, Cyprus
Nicholas Frantzides, University of Nicosia, Cyprus

Abstract
In recent years self-compassion has received a lot of attention in the literature as an adaptive and protective trait.
Self-compassion is the act of showing kindness and understanding towards oneself when facing failures, hardships,

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or difficulties and recognizing that suffering is a universal experience. These are some of the characteristics that in-
dividuals often lack or are unable to utilize when they are faced with trauma and must deal with its consequences.
The current study explored the possible moderating effects of self-compassion on post-traumatic growth in a general
population sample exposed to trauma.
The study recruited 494 volunteers, which included 299 women (60.5%) and 189 men (38.3%); ages ranged from 18
to 81 years old (M = 34.7). Twenty-six percent had either primary or secondary education, 48.6% had a college or
university education, and 25% had post-graduate education. Participants were asked to complete 1) the Life Events
Checklist for DSM-IV, (Gray, Litz, Hsu, & Lombardo, 2004), 2) the PTSD Checklist, Civilian Version (PCL-C; Blanchard,
Jones-Alexander, Buckley, & Forneris, 1996) α=.93, 3 ) the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun,
1996) α=.97, and 4) the Self-Compassion Scale (Neff, 2003) α=.86.
Three-hundred and forty-six participants (70%) reported being exposed to at least one traumatic event; of those, 67
participants (13.6%) reported being exposed to sexual abuse, and 141 participants (28.5%) reported being exposed
to physical abuse.
Results indicated that women scored higher on trauma symptoms and reported lower levels of self-compassion com-
pared to men. There were no significant differences between men and women on post-traumatic growth.
Pearson correlations showed that trauma symptoms were significantly and negatively related with self-compassion,
while post-traumatic growth was positively related with trauma symptoms. To investigate our hypothesis stating a
moderation effect of self-compassion on the effects of post-traumatic symptoms (IV) on post-traumatic growth (DV),
a simple moderator analysis was performed using PROCESS 3.3 using 5000 bootstrap samples and 95% confidence
intervals, predictors were centered to correct for possible multicollinearity. Only participants that reported exposure
to at least one traumatic event were included in the analyses giving a sample size of 346. Self-compassion was found
to significantly moderate the relationship between post-traumatic symptoms and post-traumatic growth b=0.02,
95%CI [0.02, 0.03] while the overall model predicted 16% of the post-traumatic growth variance F(3, 342)=22.29, p <
.001. Examination of the interaction plot showed a significant enhancing effect of self-compassion on the effects of
post-traumatic symptoms on post-traumatic growth.
The findings of this study suggest that self-compassion relates negatively with post-traumatic symptoms following
trauma, and individuals with higher levels of self-compassion are more likely to grow from the trauma and have pos-
itive outcomes in relation to the trauma.

Keywords
Trauma, Post-Traumatic Growth, Self-Compassion

• Complex posttraumatic stress disorder: Modular, phase-based treatment approach

Marina Letica Crepulja, Faculty of Medicine, University of Rijeka, Rijeka, Croatia; Clinical Hospital Center Rijeka, De-
partment of Psychiatry, Referral Center for PTSD of the Ministry of Health of the Republic of Croatia, Rijeka, Croatia
Aleksandra Stevanović, Faculty of Medicine, University of Rijeka, Rijeka, Croatia; Clinical Hospital Center Rijeka, De-
partment of Psychiatry, Referral Center for PTSD of the Ministry of Health of the Republic of Croatia, Rijeka, Croatia
Mersad Muminović, Faculty of Medicine, University of Rijeka, Rijeka, Croatia; Clinical Hospital Center Rijeka, Depart-
ment of Psychiatry, Referral Center for PTSD of the Ministry of Health of the Republic of Croatia, Rijeka, Croatia
Thanos Karatzias, Napier University, Edinburgh, UK, United Kingdom
Marylene Cloitre, National Center for PTSD Division of Dissemination and Training, Palo Alto VA Health Care Services,
Paolo Alto, USA, United States

Abstract
Background: Complex post-traumatic stress disorder (PTSD) encompasses a specific symptom profile derived from a
synthesis of research results and empirical findings. The addition of complex PTSD to the ICD-11 is based on the evi-
dence that individuals with the disorder have a poorer prognosis and benefit from different treatments as compared
to individuals with PTSD.
The results of the research carried out in our institution showed that 80.63% of patients treated for the consequences
of psychological trauma met the criteria for a probable diagnosis of complex PTSD. All of them had been included
in trauma-focused treatments at least once during their long history of treatment and still complain about problems
in relationships, communication, “bad temper”, guilt feeling etc. They are considered treatment-resistant and insuf-
ficiently stable to tolerate immediate trauma-focused treatment or they refuse to be included in such programmes.
Karatzias and Cloitre (2020) proposed a modular program, and a new treatment protocol was developed (Enhanced
Skills Training in Affective and Interpersonal Regulation - ESTAIR) for the treatment of complex PTSD. ESTAIR is devel-
oped from Skills Training for Affective and Interpersonal Regulation (STAIR) which is an evidence-based cognitive-be-
havioural therapy for individuals suffering from PTSD.
Method: A non-randomized controlled study was conducted in which 60 subjects with complex PTSD participated
(30 subjects in the treatment group and 30 subjects in the control group). The treatment groups (3x10 members) were

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included in tailored modular group treatment based on the ESTAIR protocol comprising modules related to affect
dysregulation, negative self-concept, and disturbances in relationships. In contrast, the trauma-focused module (Nar-
rative therapy) was left as an elective option. The inclusion criteria ensured the comparability of the two groups. The
following measurements were performed: LEC; ITQ; PHQ-9; GAD-7; AUDIT-C; DAST; WHODAS 2.0, and CSQ-8.
Results: Findings will be presented from those who completed the evaluation before and after the treatment in com-
parison with the control group of complex PTSD patients who haven’t attended the ESTAIR programme. Findings will
provide valuable insight in feasibility based on retention at the end of treatment and acceptability of the treatment.
Outcome measures will reveal changes in symptoms of complex PTSD, depression, generalised anxiety, alcohol use
and level of disability and functional impairment.
Conclusions: Overall findings present a contribution to the rising body of knowledge and experience related to the
treatment of complex PTSD and will be discussed with consideration of the previous and ongoing research.

Keywords
trauma, Complex PTSD, treatment

• PTSD among Turkish Earthquake Survivors: The Role of Cognitive Distortions and Religious Coping
Meryem Kahramanlar, Ibn Khaldun University, Turkey
İlknur Aytemür Mneımneh, Ibn Khaldun University, Turkey
Elif Akyüz, Ibn Khaldun University, Turkey
Muhammed Furkan, Ibn Khaldun University, Turkey
Burcu Uysal, Ibn Khaldun University, Turkey

Abstract
Background and Purpose
In 2023, two major earthquakes of magnitudes 7.7 and 7.6 struck eleven cities in southern Turkey, affecting 13.5
million people. In addition to their devastating impact, earthquakes are known to have negative effects on people’s
psychological health. Among the psychological issues faced by survivors, PTSD is the most common, with over 50%
of survivors affected three months post-disaster in the 2023 Turkey earthquake. Chronic PTSD can lead to severe
outcomes, such as substance misuse, isolation, cardiovascular issues, and suicidal tendencies. As a result, it is critical
to examine the factors influencing PTSD following earthquakes in order to improve survivors’ physical and mental
well-being.
Given that 91% of Turkey’s population is Muslim and over half practice their religion regularly, many turn to their faith
as a coping mechanism during distress. However, existing research on the relationship between religious coping and
PTSD shows inconsistent results, which may indicate the role of other processes in this relationship. The present study
aimed to examine the relationship between religious coping styles, cognitive distortions, and PTSD, with a specific
focus on the mediating role of cognitive distortions. Understanding these relationships is essential for developing
effective interventions to support earthquake survivors in Muslim communities.
Method
A total of 169 participants (118 female) aged between 18-to-58 years (M= 28.19, SD=8.90) who directly witnessed the
February 6th earthquake, participated in the study. They completed the Posttraumatic Stress Disorder Checklist for
DSM-5, Religious Coping Scale, and Cognitive Distortions Scale via Qualtrics.
Results
The findings revealed a significant relationship between negative religious coping and cognitive distortions (p=.000,
r=.43), as well as between cognitive distortions and PTSD (p=.000, r=.49). Notably, positive religious coping did not
show a significant relationship with PTSD, whereas negative religious coping did (p=.000, r=.25). After controlling
for gender and age, catastrophizing, a specific type of cognitive distortion, fully mediated the relationship between
negative religious coping and PTSD levels (95% CI [.06, 1.15]). These results suggest that individuals who engage in
higher levels of negative religious coping are more likely to experience cognitive distortions, especially catastrophiz-
ing, which may contribute to posttraumatic stress symptoms.
Conclusion and Discussion
Negative thought patterns have been shown to significantly influence the severity of PTSD symptoms. While the
impact of religious coping on PTSD has been studied, results have been inconclusive. Our study contributes to the
literature by examining the interaction between religious coping and cognitive distortions, and how these factors to-
gether affect the PTSD symptoms experienced by earthquake survivors. These findings could be particularly useful for
mental health professionals working with PTSD patients. Interventions targeting negative religious coping strategies
and cognitive distortions could benefit individuals suffering from PTSD symptoms. Future research should investigate
these relationships in diverse samples and age groups, as well as longitudinal studies to track changes over time.

Keywords
PTSD, earthquake survivors, religious coping, cognitive distortions, catastrophizing

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Open Paper Symposium 19 – Depression
Chair: Selin Tutku Tabur, EABCT, Turkey

• Do Automatic Thoughts and Irrational Beliefs Predict Early Antidepressant Treatment Response in Major De-
pressive Disorder?
Esengül Ekici, Yuksek Ihtisas University Faculty of Medicine, Turkey
Kadir Özdel, Sağlık Bilimleri Üniversitesi, Ankara Etlik City Hospital, Department of Psychiatry, Turkey

Abstract
AIM: Cognitive behavioral approaches vary in their perspectives on core cognitions and their proposed roles in the
development of depression. In this study, we aimed to examine the relationship between early antidepressant treat-
ment response and changes in automatic thoughts and irrational belief levels in patients with major depressive dis-
order.
METHOD: The study was conducted as a 4-week follow-up study consisting of 44 patients who applied to the psychi-
atry outpatients clinic of a hospital and were diagnosed with major depressive disorder according to the diagnostic
criteria of the Structured Clinical Interview for DSM-5 (SCID-5-CV) and were started on a selective serotonin reuptake
inhibitor (SSRI). Sociodemographic Data Form, Beck Depression Inventory, Attitudes and Belief Scale-2, and Automat-
ic Thoughts Scale were used to evaluate the patients. Ethical approval was received for the study from the local ethics
committee, dated 31.03.2023, with decision number 2023/02/06.
RESULTS: Short-term antidepressant treatment applied to patients with depression has been found effective in reduc-
ing both automatic thoughts and irrational beliefs. These scale value reductions were relatively greater in automatic
thoughts than in irrational cognitive beliefs. Additionally, automatic thoughts (β=0.78) and irrational beliefs (β=0.62)
predict depression severity at the beginning of treatment. Changing in both automatic thoughts (β=0.85) and irratio-
nal beliefs (β=0.59) scores with treatment predicts a change in depression severity.
CONCLUSION: With antidepressant treatment, both changes in automatic thoughts and irrational beliefs are essential
in predicting the level of depression treatment response. For this reason, both Cognitive Behavior Theory and Ratio-
nal Emotive Behavioral Therapy models have significant roles’ in explaining depression and changes in depression
symptoms.

Keywords
automatic thoughts, irrational beliefs, antidepressant treatment, major depressive disorder

• The Relationship between Childhood Maltreatment, Preoperational Thinking and Psychopathology

Selin Tutku Tabur, Hasan Kalyoncu University PhD in Clinical Psychology, Turkey
Ercan Akın, Hacettepe University, Department of Guidance and Psychological Counseling, Turkey
Sude Yıldırım, Social Sciences University of Ankara, Turkey
Eylül Aykut, Social Sciences University of Ankara, Turkey
Elif Berfu Hergül, Independent Psychologist, Turkey
Hakan Türkçapar, Social Sciences University of Ankara, Turkey

Abstract
Objective: Childhood maltreatment and preoperational thinking have been associated with anxiety and depression.
This study hypothesizes that preoperational thinking is the cognitive process influenced by childhood maltreatment,
which in turn affects depression and anxiety.
Method: The study included 142 participants examined cross-sectionally: 81 healthy controls, 19 patients with anx-
iety, 22 patients with depression, and 19 patients with other diagnoses. The following instruments were used: the
Childhood Trauma Questionnaire (CTQ), Lübeck Questionnaire of Preoperational Thinking (LQPT), Generalized Anxi-
ety Disorder 7-item (GAD-7), and Patient Health Questionnaire-9 (PHQ-9).
Results: Patients with depression and those with other diagnoses reported significantly more childhood maltreat-
ment than healthy controls (effect sizes: d = 1.49 and d = 1.09, respectively). Additionally, the patient groups exhibited
higher levels of preoperational thinking compared to healthy controls (effect sizes: d = -0.97 for anxiety, d = -1.77 for
depression, and d = -1.64 for other diagnoses). In the full sample, the total CTQ score was significantly associated with
the total LQPT score (β = -.37, p < .005). Preoperational thinking was found to have a significant mediating role in the
relationship between childhood traumas and both depression (β = .16, p < .005) and anxiety (β = .10, p < .005).
Conclusions: These findings suggest important implications for the psychotherapy of depression and anxiety. They
demonstrate that anxiety and particularly depression can be associated with preoperational thinking, which arises
secondary to childhood maltreatment.

Keywords
depression; anxiety; preoperational thinking; childhood maltreatment; cognitive behavioral therapy

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• Technology-based interventions for the treatment of peripartum depression: An in depth systematic review
Andreea Astefanei, Babes-Bolyai University, Romania
Mircea Miclea, Babes-Bolyai University, Romania

Abstract
Background
Web-based interventions have the potential to be effective in reducing peripartum depression and to increase the ac-
cess to treatment by removing existing barriers (e.g lack of time, childcare needs, lack of access to treatment in some
regions ). Previous systematic reviews focus on the efficacy of the interventions, giving little attention to the programs
themselves. The aims of this review are: to conduct an in depth critical analysis of the existing intervention programs,
to provide a comprehensive inventory of the program’s components and structure, to analyze their efficacy and to
offer general guidelines for interventions development.
Methods
A systematic search was conducted in 5 databases from the earliest date available to September 2023. Relevant arti-
cles were included if they reported an internet-based or delivered with technology intervention for depression during
pregnancy or in the first year postpartum. The synthesis and analysis were performed based on each intervention
program, rather than individual studies. A comprehensive analysis of each intervention program was realized in order
to offer all the relevant information about individual approaches. The main analysis consisted on integrating aspects
from all platforms in order to formulate conclusions about which are the better approaches according to the available
data. General summaries focused on structure and content characteristics of the interventions. Based on the analysis,
the requirements of an efficacious and effective online intervention for peripartum depression have been proposed.
Results
18 reports were included covering 11 different interventions. The most common components were: psychoeducation,
cognitive restructuring, behavioral activation, problem solving, communication and relapse prevention. All relevant
aspects were analyzed such as number of sessions, completion rates, extra features or screening procedure and rec-
ommendations have been formulated. In most cases, components aimed at the specific problems of the peripartum
period were not included (e.g. stigma, relationship with the baby, balancing motherhood). Overall, the interventions
are effective, leading to medium or large reductions of depression symptoms. Around half of the women achieve
diagnostic remission.
Conclusions
The clinical relevance is a main focus of the paper, interventions’ structure and content being analyzed in order to
provide guidelines for researchers and practitioners who wish to develop such programs. Guidelines for programs de-
velopment were formulated based on the analysis. Suggestions cover elements relevant for increasing efficacy as well
as treatment adherence. Aspects regarding content as well as mode of delivery are considered. Existing limits in the
field are highlighted as well as changes in the way we report interventions that would increase their clinical relevance.

Keywords
technology-based intervention, ehealth, psychotherapy, systematic review, maternal health, peripartum depression

• Understanding the relationship between Premenstrual Dysphoric Disorder and emotion dysregulation, us-
ing in vivo and trait measures.
Anagha Kaluve, University of New South Wales, Australia
Bronwyn Graham, University of New South Wales, Australia

Abstract
Introduction/Background: Premenstrual Dysphoric Disorder (PMDD) is characterised by distressing premenstrual
mood symptoms, affecting 3-8% of menstruating people, and causing clinically significant functional impairment.
The psychological mechanisms underlying PMDD are poorly understood leading to current treatments that are not
effective or acceptable for all. PMDD is highly comorbid with mood and anxiety disorders, suggesting common un-
derlying mechanisms. One of these explanations may include difficulties with emotion regulation, a transdiagnostic
feature of mental health conditions that encompasses broad deficits in emotional functioning and suboptimal use of
strategies like rumination (repetitive past-focused thinking), reappraisal (changing a situation’s meaning), and sup-
pression (inhibiting emotion expression). While existing research has shown an association between emotion regu-
lation and PMDD, this work has relied on retrospective self-reports (which are prone to bias) and has not compared
PMDD to the milder and more common experience of premenstrual syndrome (PMS). Moreover, past research has
not distinguished the elevated emotion dysregulation in PMDD from that typically seen in anxiety and depression.
Consequently, this research aims to improve our understanding of the association between emotion dysregulation
and premenstrual symptoms.
Methods: Participants were menstruating people meeting criteria for PMDD, PMS, elevated depression and anxiety
(DEPANX), and healthy controls. Trait and in vivo use (following a sad mood induction task) of emotion dysregulation,

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rumination, reappraisal, and suppression was measured via questionnaires. Daily use of rumination and severity of
common premenstrual symptoms was measured via ecological momentary assessment across 1-2 menstrual cycles.
Results: Compared to healthy controls, all groups reported greater in vivo and trait use of rumination, greater trait
emotion dysregulation, and lower trait reappraisal. People with PMDD endorsed higher rumination and trait emotion
dysregulation than PMS or DEPANX group. Greater trait emotion dysregulation, rumination, and reappraisal predict-
ed greater premenstrual distress between groups. Rumination was the largest individual predictor of premenstrual
distress within groups. Ongoing analyses will determine whether rumination fluctuates across the menstrual cycle
differentially across groups.
Conclusion: Together, these results suggest that emotion dysregulation, particularly elevated use of rumination, may
contribute to the onset and/or maintenance of premenstrual distress. Notably, these findings have improved the va-
lidity of current knowledge on how emotional regulation strategies are used by people with PMDD, and has provided
information on whether PMDD differs from clinical, subclinical, and healthy groups regarding the type and/or the lev-
el of use of emotional regulation strategies. Following further studies, these results may also contribute to theories on
the underlying mechanisms of pathology and inform treatment development for impairing premenstrual symptoms.

Keywords
premenstrual dysphoric disorder; premenstrual syndrome; emotion dysregulation; rumination; menstrual cycle; EMA;
anxiety; depression

• Relationship between sexual behavior, family-related factors and mental health in emerging adults
Ana Ivanov, Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia

Abstract
When considering the development, it is essential to incorporate the aspect of sexual development and recognize
various types of sexual relationships because of their different consequences. Friends with benefits (FWB) differ from
other relationships regarding the frequency, and intensity of non-genital and genital behaviours and are defined as
a friendly relationship that includes a sexual rather than a romantic component (Lehmiller et al., 2011). This research
aims to determine the antecedents of FWB originating from family factors and its relationship with mental health.
Social changes such as those in family relationships and structures affect the adoption of different types of affective
attachment, which might lead to changes in the frequency of different non-conventional relationships (Garneau, Ol-
mstead, Pasley , & Fincham, 2013). Consideration of family instability, i.e. its transitions, allows insight into the impact
of those changes and represents a picture of the process more than the current state (Chiu, 2012).
A convenient sample of 1073 heterosexual subjects aged 13 to 26 was collected, 86% were women, and even 74.1%
were current students. One-third (29.9%) went through at least one family transition.  The age of first sexual inter-
course ranged between 12 and 26 and the total number of sexual partners from 1 to 60. Half of the sample (49.3%)
had never been in a FWB, while those who were, mostly had from one to five. A quarter (24.6%) is currently or has
been in a FWB in the last 12 months. In addition to sexual behaviour questions, the DASS and FACES IV questionnaires
were deployed. Correlation analysis was significant between the age of first sexual intercourse and the total number
of partners (r=.304, p=.000), as with the total number of FWB (r=-.174, p=.000). The total number of sexual partners is
related to Cohesion (r=-0.93, p=.002), Flexibility (r=-.09, p=.003) and Disengagement (r=.081, p=.008). The regression
analysis (predictors: DASS, FACES IV, sexual behaviours) was significant R2=.037, F(10, 1062)=4.1, p=.000, but the only
significant predictor was the age of first sexual intercourse. The most important finding is that among the sample with
FWB experiences, there are gender differences on the scales of depression t(262)=2.3, p=.022) and stress t(262)=2.9,
p=.003), where women who take part in FWB tend to experience more depression and distress.
Clarifying FWB’s aspects has theoretical and practical implications for health care and the protection of vulnerable
groups. Regarding mental health, depression could not only be an antecedent but also an outcome of FWB behaviours
(Grello et al., 2006). Some of the guidelines for further research are more in-depth consideration of gender differences
in FWB (Buss & Schmitt, 2016), assessing depression, and including maladaptive schemas in the research to tackle
more subtle psychological impairments. As family transitions are subject to methodological criticism, it would be
desirable to focus on a more detailed operationalization and their role in the formation of affective attachment and
subsequent romantic and sexual behaviours.

Keywords
Friends with Benefits, sexual behavior, family transitions, first sexual experience, risky behaviors, DASS, depression,
distress, FACES IV

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Open Paper Symposium 20 - Psychosis and Bipolar Disorder

Chair: Gillian Haddock, United Kingdom

• First findings on exploring a modified avatar therapy in the treatment of schizophrenia spectrum disorders:
a case study
Lilla Gerlinger, Semmelweis University, Faculty of Medicine, Department of Psychiatry and Psychotherapy, Hungary
Edit Vass, Semmelweis University, Faculty of Medicine, Department of Psychiatry and Psychotherapy, Hungary
Luca Egervári, Semmelweis University, Faculty of Medicine, Department of Psychiatry and Psychotherapy, Hungary
Tünde Kilencz, Semmelweis University, Faculty of Medicine, Department of Psychiatry and Psychotherapy, Hungary
János Réthelyi, Semmelweis University, Faculty of Medicine, Department of Psychiatry and Psychotherapy, Hungary
Lajos Simon, Semmelweis University, Faculty of Medicine, Department of Psychiatry and Psychotherapy, Hungary
Lise Mariegaard, VIRTU Research group, Mental Health Center Copenhagen, University of Copenhagen, Denmark
Louise Birkedal Glenthøj, VIRTU Research group, Mental Health Center Copenhagen, University of Copenhagen,
Denmark

Abstract
AVATAR therapy is an innovative approach to addressing auditory hallucinations in patients with schizophrenia spec-
trum disorder. This therapeutic method blends virtual reality (VR) technology with Cognitive Behavioral Therapy (CBT)
techniques to tackle the challenging symptoms faced by this select group of patients. In our case report we would
like to share the initial insights of a current study investigating the feasibility and applicability of the AVATAR therapy
modified by HEKA-VR.
Persistent auditory hallucinations experienced by patients dealing with the diagnosis of schizophrenia spectrum dis-
order significantly impact their lives. We recruited patients who are under regular psychiatric care and in remission
and assessed the severity of their symptoms, their quality of life as well as their experiences and preconceptions relat-
ed to the method. AVATAR therapy consists of 7 core sessions and two additional sessions, each lasting 50 minutes, led
by a trained psychotherapist following a strict protocol. Prior to the intervention the therapist and the patient create
a virtual person (avatar) according to the patient’s cognitive representation of the dominant auditory hallucination.
Incorporating CBT techniques such as systematic desensitization, the therapy progresses session by session toward
the patient confronting the avatar, which is controlled by the therapist who remains in the same room with the pa-
tient who is wearing a VR headset. In order to maintain a safe therapeutic environment the process is not solely under
the control of the therapist but also adheres to the patient’s comfort level in increasing exposure impact.
Throughout the therapy stages—preparation, avatar modulation, exposure, and confrontation—the patient is guid-
ed in dialogues with the avatar in VR. This includes planning potential future encounters and interventions in case
the auditory hallucinations reappear. An important topic addressed with our patient in the case study along with
questions regarding self-worth and identity was also the unresolved grief felt after the loss of his father, the voice of
whom he identified in the auditory hallucinations. I would like to show the stages of how the patient’s subjective rela-
tion to the representation of the voice has changed throughout the dialogues conducted in the therapeutic sessions
and also share the results of the post-assesment and his feedback on how he perceived the changes he encountered
during the therapeutic process.
Results so far show a decrease in the symptom severity and an overall improvement in the experience of distress
accompanying the auditory hallucinations post-therapy alongside the significant improvement in the content of the
voices. This innovative approach presents promising advancements in schizophrenia care, highlighting the
need for further research and refinement in non-pharmacological interventions to enhance patient outcomes.

Keywords
schizophrenia spectrum disorder, auditory verbal hallucinations, avatar therapy, virtual reality

• From Custody to the Community: Reflections on Implementation of AVATAR Therapy in Real-World Settings
Moya Clancy, University of Glasgow, United Kingdom
Ben Brandrett, University of Glasgow, United Kingdom

Abstract
Background: Approximately 70% of people with schizophrenia spectrum disorders experience distressing voices (au-
ditory verbal hallucinations) which can impact on wellbeing and quality of life. AVATAR Therapy is a novel digital ap-
proach that aims to reduce voice-related distress for people with psychosis, with promising evidence of effectiveness
and implementation (Craig et al., 2018; Garety et al., 2021; Garety et al., in press). AVATAR Therapy has now received
NICE Early Value Assessment recommendation for use in frontline NHS services to gather real-world evidence from a
range of settings. The current paper will explore learning from the early implementation of AVATAR therapy in NHS

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prison and community settings, with particular focus on adaptations needed within marginalised communities.
Methods: Clinicians in NHS Greater Glasgow & Clyde were trained to deliver AVATAR Therapy in NHS community, in-
patient, early intervention for psychosis, and prison mental health service settings as part of the NHSGG&C AVATAR
Therapy Implementation Project. The current paper consists of therapist and supervisor reflections on the implemen-
tation of AVATAR therapy in prison settings with direct comparison to implementation within a community mental
health team setting.
Results: Key themes of working flexibly to deliver the spirit and principles AVATAR therapy treatment targets (Ward
et al., 2020) within a complex real-world prison setting are shared. Examples of barriers and restrictions faced within
the prison regime e.g. individuals in segregation or protection units, unexpected transfers or liberations, prohibition
of digital devices are presented with real-world solutions for how these were overcome to deliver AVATAR therapy in
practice.
Conclusions: Addressing barriers to enable marginalised communities to engage meaningfully with AVATAR thera-
py are forefront priorities for future developments of AVATAR therapy provision. Given the prevalence of psychosis
in prison populations, the current paper may support future directions and informed planning within this setting.

Keywords
psychosis, voices, forensics, prison, implementation

• The interplay between suicide and psychosis; implications for CBTp

Gillian Haddock, University of Manchester, United Kingdom
Patricia Gooding, University of Manchester, United Kingdom
Daniel Pratt, University of Manchester, United Kingdom
Kamelia Harris, University of Manchester, United Kingdom

Abstract
People with severe mental health problems such as psychosis and schizophrenia have high rates of suicidal thinking
and increased risk of death by suicide. Evidence suggests that there is substantial interplay between distressing psy-
chotic symptoms and such suicidal thoughts. Hence, it is crucial to understand and formulate how underlying suicid-
al experiences interact with psychosis in order to develop effective treatments. Therapeutic approaches specifically
designed to address suicide-related experiences and psychosis have been developed and evaluated in a number of
recent trials. This paper will review the evidence supporting interventions for psychosis and suicidality and report on
outcomes from a recent randomised controlled trial of a cognitive behavioural suicide focused treatment for people
with psychosis, the CARMS trial. Findings suggested that people with suicidal experiences could engage with therapy
and reported positive experiences of taking part. There were no significant adverse experiences associated with tak-
ing part in therapy suggesting this approach is feasible and acceptable for people with psychosis.

Keywords
Psychosis, suicidality, CBT, randomised controlled trial

• The content and topography of auditory verbal hallucinations in adults with psychosis: What does a voice
say, and how does it say it? An umbrella review
Anna Callahan, University of East London, United Kingdom
Cassie Hazell, University of Surrey, United Kingdom
Elena Serena Piccardi, University of East London, United Kingdom
Jonathan Souray, Central and North West London NHS Foundation Trust, United Kingdom
David Raune, Central and North West London NHS Foundation Trust, United Kingdom

Abstract
The ‘new age of CBT’ needs to be informed by a much deeper understanding of the exact cognitive structure of ex-
periences which cause distress and disability around the world. Voice-hearing, or auditory verbal hallucination (AVH),
in clinical populations are one such phenomena in urgent need of more detailed cognitive examination. The hetero-
geneity of AVH has led to suggestions that separable, clinically important subtypes could exist, each involving dis-
tinct cognitive mechanisms and requiring tailored CBT interventions (McCarthy-Jones et al., 2014). A detailed under-
standing of voice content and topography – what voices say, and how they say it – therefore has potentially beneficial
implications for cognitive theoretical models and linked CBT interventions.
When it comes to AVH, the efficacy of CBT is limited. One reason for this is that CBT tends to conceptualise voice
hearing as a homogenous experience rather than considering its diversity or potential subtypes (Smailes et al., 2015).
Assessing voice phenomenology in detail can uncover new therapeutic targets and maintenance mechanisms, and

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imply which CBT techniques might be effective (Carter et al., 1995; Chadwick & Birchwood, 1995; Stephane et al.,
2003). Recent trials have shown that CBT tailored to subtypes of AVH (Dodgson et al., 2021) or other therapies which
require working directly with voice content (Longden et al., 2022; Rus-Calafell et al., 2022) are feasible, acceptable, and
can have therapeutic benefit. Voice topography remains hardly targeted at all.
The present umbrella review aimed to produce an evidence-based framework of features of voice content and topog-
raphy in adult psychosis patients. PRISMA guidelines were used. Electronic databases (PsycInfo, PubMed, Scopus and
Science Direct), recent editions/pre-publication journal pages, and book publishers were systematically searched.
Identified papers were screened against inclusion criteria and included reviews critically appraised. Study character-
istics and data relating to voice content or topography were extracted and collated.
42 reviews were identified, representing a wide ranging international body of research. Samples were drawn from 13
countries and diverse clinical settings. A framework of 172 features of voice content and topography was produced,
making this the most comprehensive evidence-based dissection of voice content and topography to date.
Our findings have implications for how AVH are assessed, formulated and treated using CBT. Methodologically, mea-
sures for assessing AVH should include specific and overlooked aspects of voice-hearers’ experiences, allowing hear-
ers to use their own words, rather than boxing these experiences in with researcher- or clinician-imposed categories
based on over-simplified DSM/ICD definitions (Parnas et al., 2024).
Our umbrella review provides specific voice features which could be explored for theoretical and clinical significance.
Our findings could be used to tailor and improve psychological interventions: precision-targeted CBT for specific
features and mechanisms may be an important next evolutionary step for CBTp (Newman-Taylor & Bentall, 2023).
The success of therapies tailored to AVH subtypes (Dodgson et al., 2021) or working directly with voice content (Rus-
Calafell et al., 2022), indicate the possible benefits of interventions which consider the specifics of voice phenome-
nology.

Keywords
voice; hallucination; phenomenology; content; topography; psychosis

• The role of dopamine in predictive coding

Filip Jezdić, University of Belgrade - Faculty of Medicine, Serbia
Milica Nešić, University of Belgrade - Faculty of Medicine, Serbia

Abstract
This paper explores the role of predictive coding in the manifestation of delusions within the context of cognitive
and computational theories of psychosis. Predictive coding, a framework for understanding how the brain processes
sensory information, posits that the brain continually generates predictions about incoming stimuli and compares
these predictions with actual sensory input. The framework emphasizes the significance of prediction errors (PEs),
discrepancies between predictions and sensory input, in learning and updating internal models of the world.
In the context of delusions, aberrations in predictive coding are implicated in the formation and persistence of false or
exaggerated beliefs. Abnormal processing of PEs may lead individuals with delusions to assign abnormal significance
to ordinary events, contributing to the maintenance of delusional beliefs. There is a suggested resistance to updating
prior beliefs based on new information, a key aspect of predictive coding. Delusions may involve the misattribution of
internally generated predictions or thoughts, leading to beliefs that one’s thoughts are externally controlled.
Neurobiological mechanisms underpinning these abnormalities involve changes in neurotransmitter systems, par-
ticularly dopaminergic and glutamatergic pathways. Disruptions in predictive coding processes may interfere with
normal sensory processing, leading to the misinterpretation of neutral stimuli as threatening or significant.
Understanding the role of predictive coding in delusions has therapeutic implications. Cognitive-behavioral therapies
that work with prediction errors and cognitive processing patterns can be employed to help individuals recognize
and challenge delusional beliefs. This exploration of the predictive coding framework contributes to a deeper under-
standing of the cognitive and neural mechanisms underlying delusions, paving the way for targeted interventions
and improved treatment strategies in psychosis.

Keywords
dopamine, predictive coding, Bayesian inference, psychosis, CBT

• Schema Mode States in People Experiencing Psychosis and Bipolar Disorder: A Qualitative Exploration to
Guide Therapy Adaptation
Natasha Vorontsova, South London and Maudsley NHS Foundation Trust, United Kingdom
John Rhodes, University of Hertfortshire, United Kingdom

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Abstract
This paper presents original qualitative research, which is used to guide therapy adaptation in our forthcoming book.
We explore the application of Schema Therapy and its schema mode framework to working with individuals diag-
nosed with psychosis and bipolar disorder. Given the high prevalence of early trauma, negative self-appraisals, and
attachment disturbances in these groups, the question of how to address such foundational difficulties is key for
advancing effective therapeutic techniques. Schema Therapy was formulated to target these issues, focusing on mal-
adaptive schemas—self-defeating emotional and cognitive patterns developed early in life—and modes, meaning
fluctuating self-states involving a range of features such as emotions, thoughts, motivations, and behaviours, which
manifest as a pattern.
We sought to investigate the relevance and utility of the schema mode framework for individuals who have experi-
enced psychosis and bipolar conditions. The theory categorizes modes into child modes, dysfunctional parent modes,
maladaptive coping modes, and the healthy adult mode. This structure helps simplify the understanding and treat-
ment of individuals with complex and changeable presentations by identifying specific modes and their interactions,
thus facilitating a more manageable and personalized therapeutic approach.
We conducted semi-structured interviews with participants diagnosed with either psychosis (N=7) or bipolar disorder
(N=7). The interviews aimed to explore participants’ understanding of schema modes and their manifestations in their
lives. Thematic Analysis was employed to analyze the data, allowing for a flexible yet systematic approach to uncov-
ering participants’ subjective experiences and generating new theoretical insights.
Our findings revealed that participants could relate to the schema mode concept, providing rich descriptions of how
these states of self manifest in their daily lives. The analysis highlighted prevalent themes including links between
modes and symptoms, the interplay between different modes, and the relevance of adverse interpersonal experi-
ences. Notably, individuals spontaneously drew links between mode states and their emotional and interpersonal
struggles. This paper will illustrate the participants’ experiences using their own first-person subjective accounts.
The schema mode model’s emphasis on the multi-self concept presents a valuable tool for clinicians, aiding in the
empathic confrontation of dysfunctional modes and fostering collaboration around change. This approach affords
an understandable model for complexity and changeability, offering significant potential for advancing both clinical
understanding and treatment.

Keywords
psychosis; bipolar disorder; schema therapy; schema modes; qualitative research

Open Paper Symposium 21 – Addiction

Chair: Alba Palazón-Llecha, Mental Health Research Group, Institut de Recerca Sant Pau (IR Sant Pau), Spain

• Can emotion regulation predict the severity of cocaine use disorder? Results from a longitudinal study
Alba Palazón-Llecha, Mental Health Research Group, Institut de Recerca Sant Pau (IR Sant Pau), Spain
Joan Trujols, Mental Health Research Group, Institut de Recerca Sant Pau (IR Sant Pau), Spain
Mercé Madre, Mental Health Research Group, Institut de Recerca Sant Pau (IR Sant Pau), Spain
Santiago Duran-Sindreu, Mental Health Research Group, Institut de Recerca Sant Pau (IR Sant Pau), Spain
Francesca Batlle, Mental Health Research Group, Institut de Recerca Sant Pau (IR Sant Pau), Spain
Núria Mallorquí-Bagué, Department of Psychology, University of Girona, Spain

Abstract
Background and aims
Emotion regulation (ER) is the ability to face emotions focusing on its functionality rather than their control, like
cocaine use, which is an attempt to rapidly alleviate distressing emotions. Recent evidence highlights the transdiag-
nostic role of ER as a factor involved in the etiology and maintenance of psychopathology, including substance use
disorders. However, available studies have been conducted on non-clinical samples and do not focus exclusively on
cocaine-dependent users. Therefore, the present study aims to explore whether ER predict cocaine addiction severity,
craving and severity of withdrawal symptoms. Additionally, it intends to investigate whether abstinence can mediate
the association between ER and the aforementioned cocaine use-related variables.
Methodology
70 Spanish cocaine-dependent users (42.86 years [SD=8.18]; 38,6% women) underwent a 14-day hospitalization for
detoxification at the Addictive Behaviors Unit in the Hospital de la Santa Creu i Sant Pau in Barcelona. During hospi-
talization, participants received medical care, and cognitive-behavioral therapy provided by trained psychologists. At
entry, participants were assessed for ER using the DERS questionnaire, while measures of abstinence (number of days
since last cocaine use), addiction severity (SDS), craving (WCS) and severity of cocaine withdrawal symptoms (CSSA)
were assessed at treatment discharge. Multivariate linear regression analyses using the backward stepwise method
were conducted for the main objective, while mediation analyses were performed for the secondary objective.

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Results
The DERS subscales lack of emotional awareness (LEA) and nonacceptance of emotional responses (NER) significantly
predict SDS (R²=.153; F(2,57)=35.85; p=.009). Additionally, NER similarly predicts CSSA (R²=.132; F(1,52)=7.92; p=.007).
According to the mediation analyses, in the first model, DERS subscale LEA was not a significant predictor of days
since last cocaine use (b=0.448; t=1.218; p=.228), but days since last cocaine use significantly predicted SDS (b=-
0.086; t=-2.962; p=.004). LEA did predict SDS significantly (b=-0.214; t=-2.550; p=.013). There was no significant in-
direct effect of LEA on SDS through days since last cocaine use (-0.039 [LLCI=-0.104; ULCI=0.007]). In the second
model, DERS subscale NER did not significantly predict days since last cocaine use (b=-0.027; t=-.134; p=.893), but
days since last cocaine use significantly predicted SDS (b=-0.096; t=-3.193; p=.002). NER significantly predicted SDS
(b=0.102; t=2.111; p=.039). There was no significant indirect effect of NER on SDS through days since last cocaine use
(0.003 [LLCI=-.029; ULCI=.039]). In the third model, DERS subscale NER did not significantly predict days since last
cocaine use (b=0.047; t=.214; p=.831), and days since last cocaine use neither significantly predict CSSA (b=-0.300;
t=-1.610; p=.113). NER significantly predicted CSSA (b=0.804; t=2.652; p=.011). There was no significant indirect effect
of NER on CSSA through days since last cocaine use (-0.014 [LLCI=-0.140; ULCI=0.121]).
Conclusions
Difficulties in ER, particularly in awareness and acceptance of emotional responses, predict greater severity of addic-
tion and severity of cocaine withdrawal symptoms at detoxification treatment discharge. However, this relation is not
mediated by the number of days since last cocaine use. In terms of treatment implications, these findings suggest
that interventions focusing on developing skills to face adverse emotional states rather than controlling them, such
as third-generation therapies, could improve ER.

Keywords
Emotion regulation, cocaine, addiction severity, withdrawal symptoms, predictors

• Future-oriented interventions as a promising direction in addictions treatment

Dmitri Shustov, I.P. Pavlov’s Ryazan State Medical University, Russian Federation
Olga Tuchina, Psihopolis, Serbia
Tatiana Agibalova, Moscow Research and Practical Centre for Narcology, Russian Federation
Yegor Leonov, I.P. Pavlov’s Ryazan State Medical University, Russian Federation
Alexander Pinegin, I.P. Pavlov’s Ryazan State Medical University, Russian Federation

Abstract
Cognitive-behavioral therapy of addictions is focused on changing learned associations between drug-related stimuli
and subsequent use through various cognitive techniques and skills training. These are largely future-oriented in the
sense that aim at preparing for substance-use triggering situations and preventing relapse. Nevertheless, the research
into cognitive therapy effectiveness as a stand-alone-treatment for addiction provides mixed results. More differential
facilitation of personal and substance-related Future Thinking in addicted patients may help to improve cognitive
therapy effectiveness through non-specific effects such as decreasing delay discounting, overcoming autobiograph-
ical memory overgeneralization and enhancing the coherence of autobiographical narrative and Self through be-
coming aware of implicit cognitive schemata (including implicit alcoholic scripts) underlying explicit Future Thinking.
A series of studies performed by us in 2018-2023 with a total sample of over 700 people with and without addiction
showed that addicted people had shared specific deficits of explicit Future Thinking: overgeneralization of future
events and thwarted future time perspective (up to 7-9 days); as well as implicit FT deficits: increased availability of
intrusive prospective imagery and impaired “final scene” -death – reflection (Shustov et al., 2019; Tuchina et al., 2021,
2022). There were found certain differences in addicted people’s FT: e.g. people with substance addictions ignored
mostly negative short and long-term future events whereas people with gambling addiction are myopic only as to
positive long-term future events (Tuchina et al., in print). It was also shown that FT overgenerality and lack of positive
self-images were associated with addicted people’s risky behaviors during COVID-2019 pandemics, whereas availabil-
ity of positive self-images correlated with healthier COVID-related attitudes (Tuchina et al., 2020).
Given all these findings, several preliminary studies were performed that demonstrated positive effects of future-ori-
ented interventions on the addiction treatment outcomes. For example, one session of FT facilitation intervention
(FTFI) based on the Impact of Future Events Scale (IFES) (Deeprose et al., 2010), aimed at facilitating reflection on the
disturbing and positive aspects of one’s personal future in stimulant users (Tuchina et al., 2023). It seemed to work
well in terms of prolonging the drug-free period after treatment completion, improvement of treatment motivation
and adherence. There are also described cases of episodic future simulation effectiveness for facilitation of recovery
(Leonov et al., 2024, in print).
Conclusions. Our findings about varying FT deficits in patients with addictions as well as potential effectiveness of
future-oriented interventions are in line with other researchers’ findings in this domain but require further studies.
Practical implications would include development and testing future-oriented treatment protocols that would take
into account differential aspects of FT deficits in patients with various types of addiction.

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Keywords
cognitive interventions, addictions, Future Thinking, episodic simulation, script

• Studying effectiveness of vitality-facilitating therapeutic interview for improvement of motivation in alcohol

dependence
Alexander Shustov, Gospitalnaja 10 Clinic, Russian Federation
Dmitri Shustov, I.P. Pavlov’s Ryazan State Medical University, Russian Federation
Alexez Merinov, I.P. Pavlov’s Ryazan State Medical University, Russian Federation
Olga Tuchina, Psihopolis, Serbia

Abstract
Patients with alcohol dependence (AD) have specific deficits in their explicit future thinking that result in impaired
death reflection. They generally discount their risky and other behaviors that could jeopardize their life both in the
short- and long-term. On the other hand, Menninger’s concept of AD as “latent suicide” implies the existence of a
poorly conscious intention to kill oneself through alcohol use which is believed to be part of an implicit alcoholic
life script. The study goal was to test the effectiveness of an intervention (Vitality-facilitating therapeutic interview,
VFTI) tackling on both explicit and implicit facets of Future Thinking underlying self-destructive tendencies in al-
cohol-dependent people. It was hypothesized that through enhancement of death reflection, VFTI would enhance
patients’ motivation in terms of Prochaska and DiClemente’s transtheoretical model of change.
Method. The sample (N=68) included 2 groups of male patients with AD admitted to a narcological hospital. The
groups were quasi-randomized: patients (n=37) who were admitted on Tuesday and Thursday received VFTI; patients
(n=31) who were admitted on Monday and Wednesday received a shortened treatment-as-usual (TAU) narcological
interview of the same duration. Right after the admission and before the discharge, every patient filled out the out-
come measure: the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) that assesses patients’
motivation across three dimensions: recognition of disease; ambivalence about disease and treatment, and taking
active steps to treatment. VFTI is a brief variant of a semi-structured interview aiming at diagnosing self-destructive
tendencies in individuals with AD. It consists of 17 questions associated with self-destructive behaviors and aiming at
enhancement of mortality salience (reminders of one’s mortality) and death reflection. While answering these ques-
tions, patients reconsider their dangerous behaviours; they emotionally respond to some of them and gain insight
into the links between alcohol use and self-destructiveness. The groups received no other psychosocial interventions.
Results. The groups did not differ as to the SOCRATES motivation levels at the admission. At the discharge, in contrast
to TAU Group, VFTI Group demonstrated significant (p<.05) improvement in across all SOCRATES dimensions: They
improved disease recognition (Z=-3.49; p=.0001) and increased readiness to take treatment steps, and decreased
their ambivalence as to whether begin treatment or not. The groups also demonstrated between-group differences
with VFTI outstripping TAU as to the levels of recognition (U=296; p=0.03) and taking steps (U=266.5; p=0.01) at the
discharge (ps<.05).
Conclusion. VFTI indeed promoted alcohol-dependent patients’ progress through the stages of change and can be
used to enhance recognition of the necessity to start long-term therapy and rehabilitation of addiction.

Keywords
alcohol dependence, Vitality-facilitating therapeutic interview, SOCRATES, motivation, death reflection

• Studying life script components in alcohol use disorder to inform cognitive treatments of addiction
Olga Tuchina, Psihopolis, Serbia
Dmitri Shustov, I.P. Pavlov’s Ryazan State Medical University, Russian Federation
Tatiana Agibalova, Moscow Research and Practical Centre for Narcology, Russian Federation
Alla Kholmogorova, Moscow State University of Psychology and Education, Russian Federation

Abstract
Future thinking (FT), i.e. the capacity to create mental representations of plausible future events and store them as
“memories of the future” heavily relies on autobiographical schemata. Developing reflection on the implicit memories
of the future, including one’s life script scenes, may be a promising means to achieving recovery for “difficult” patients
with chronic mental disorders.
The study goal was to explore whether reflection on life script and its components (life script semantic scaffolds, e.g.
“the final - death - scene”) exert­ed a positive effect on alcohol dependence (AD) remission duration.
Method. A three-stage cross-sectional study at a hospital for addiction treatment (2019—2020) included 96 males
with AD and without dual diagnosis; the mean age was 44.1 (SD = 10.1) years.
Measures. (1) Interviews and documentation analysis for Socio-demographic, clinical and remission data; (2) Explicit
FT (temporal distance, valence, vividness, specificity, thematic content, importance for identity): Self-Defining Future
Projections task; “Life Line”, and “Cultural Script” task. (3) Life script characteristics: the semi-structured “Script Ques-

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tionnaire”. Qualitative data was processed by means of quantitative content analysis based on relevant guidelines.
Results. The study confirmed the hypothesis that the patients’ capacity to reflect on the implicit FT dimension (life
script) is one of the factors influencing remission duration in AD. Stage 1. Assessing explicit FT deficits. The patients
with AD had no fundamental differences in quantitative, content-related, and phenomenological variables of the
explicit FT dimension: their explicit FT was characterized by marked difficulties with simulating the future; a truncated
time perspective; low differentiation or overgeneralization; mainly interpersonal orientation; and deficits in death
reflection. Stage 2. Hierarchical cluster analysis based on life script characteristics: Two patient groups were identified
that differed only in their capacity to become aware of the content of their implicit FT dimension (life script), and these
differences became the key factors associated with the remission duration in these patients. Stage 3. Multiple linear
regression analysis of association between implicit and explicit FT and remission variables. In particular, the capacity
to reflect on the content of the life script had a bidirectional effect on the remission duration. The factors representing
reflection on voluntary simulations of the end of one’s life journey (death reflection) and reflection on the individual
and family autobiographical experience had a favorable effect on the remission duration variables. The factors that
hindered remission included variables indicative of hereditary burden of AD in the family, and variables indicative of
impaired reflective processes engaged in the patients’ FT (spontaneous death projections and FT overgeneralization).
Conclusions. The study provides a rationale for working with the patients’ FT, which might include training patients to
simulate specific future images; extension of the temporal horizon; facilitation of the capacity to inhibit occurrence of
spontaneous future projections triggering alcohol cravings or self-destructive behaviours. It also shows that facilita-
tion of death reflection and reflection on both family past and personal future autobiographical experience may be
an important target of combined treatment of alcohol dependence.

Keywords
alcohol dependence, future thinking deficits, explicit and implicit cognitions, life script, death reflection

• Effect of a new therapy combining mindfulness in virtual reality and physical activity on mindfulness skills
and alcohol attentional biases in patients treated for alcohol use disorder
Lila Barillot, Université de Poitiers, Université de Tours, CNRS, CeRCA, Poitiers, France
Armand Chatard, Université de Poitiers, Université de Tours, CNRS, CeRCA, Poitiers, France
Marcello Solinas, Laboratoire de Neurosciences Expérimentales et Cliniques, Université de Poitiers, INSERM, U-1084,
Poitiers, France
Jaafari Nematollah, Unité de Recherche Clinique Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers, France

Abstract
Despite current treatments, 50 to 80% of patients treated for alcohol use disorder (AUD) relapse. New therapeutic
strategies are needed to promote long-term abstinence. Mindfulness practice is a promising approach to target the
mechanisms of addiction: it could improve emotion regulation and reduce alcohol attentional bias, a known risk fac-
tor for AUD. Combining this approach with physical, sensory, and cognitive stimulations is also an interesting lever to
reduce stress and relearn to engage in rewarding activities alternative to drug taking. This technique of environmen-
tal enrichment through complex stimulation has proven effective in animal models of addiction. However, no human
study has yet evaluated the effectiveness of a therapy based on multimodal stimulation for addiction. The aim of this
study is to examine the effect of a new therapy that combines mindfulness in virtual reality (VR) with cognitive and
physical activity on alcohol attentional bias.
A randomized controlled trial is conducted, involving 135 patients treated for AUD. The experimental group under-
goes six therapy sessions, during which they practise mindfulness for 20 minutes in a multisensory VR environment
designed to learn mindfulness and use it to regulate craving induced by virtual cues or stress. Participants then com-
plete 20 minutes of indoor cycling, combined with cognitive training exercises. The control group only follows stan-
dard treatment for AUD. In both groups, mindfulness skills and attentional biases towards alcohol cues are assessed at
inclusion (T1) and after the therapy sessions or standard treatment (T2). The experimental group is expected to have
improved mindfulness skills, and a greater reduction in alcohol attentional biases compared to the control group.
Preliminary results from 67 participants show an increase in mindfulness skills at T2 compared to T1, which is greater
in the experimental group than in the control group. We also observed a greater reduction in attentional bias towards
alcohol cues in the experimental group than in the control group.
These promising results suggest that EE sessions could reinforce the effects of AUD treatment and have a positive
impact on addiction. The reduction in attentional biases towards alcohol could reduce craving and consumption,
thereby encouraging abstinence.

Keywords
addiction, treatment, mindfulness, virtual reality, attentional biases, stimulation

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Open Paper Symposium 22 - Digital CBT 2
Chair: Esther Mertens, Max Planck Institute for the study of Crime, Security and Law, Netherlands

• Study of psychological change in face-to-face and videoconferencing psychotherapy as perceived by thera-

pists and clients
Diego Fernádez-Regueras, Universidad Autónoma de Madrid, Spain
Ana Calero-Elvira, Universidad Autónoma de Madrid, Spain

Abstract
Information and Communication Technologies (ICTs) have demonstrated significant utility in enhancing the delivery
of health services. Online psychotherapy delivered via videoconference has emerged as the primary alternative for
continuing psychological treatments following the COVID-19 pandemic, underscoring the critical need for robust
scientific evidence to understand its functioning. This study investigates the dynamics of psychological change in two
treatment modalities: face-to-face (F2F) and videoconferencing psychotherapy (VCP), providing a robust methodolog-
ical framework for this exploration. The primary objectives are to compare the pace of therapeutic progress between
these two modalities and to propose explanatory hypotheses for any observed differences. Our hypotheses posited
that psychological change, as assessed by therapists and clients, respectively, would follow a non-linear trajectory
and occur more rapidly in F2F therapy compared to VCP. We analyzed session-by-session data from 113 participants,
comprising 57 in F2F and 56 in VCP, yielding a total of 2552 therapy sessions. Employing a non-manipulative longitu-
dinal design, we utilized multilevel growth curve modeling to fit various models to resemble the observed trajectories
of change. The amount of variance explained in the outcome variance by the selected models proved to be high:
therapists’ marginal r²for generalized linear mixed models (GLMM) = .54; clients’ marginal r² for GLMM = .53. Findings
confirmed our hypotheses, showing that psychological change is indeed non-linear in both modalities, as the growth
curve coefficients for trajectories different from linear were significant in both therapists’ assessments (estimate =
-.04, t = -5.70, p < .001) and clients’ assessments (estimate = .13, t = 10.70, p < .001). The negative estimate for change
in therapists’ assessments indicates a deceleration in the slope of change (the pace of change slows down as therapy
progresses), whereas the positive coefficient for clients’ assessments indicates an acceleration in the slope of change
(they perceive a faster change as therapy progresses). Change proved to be faster in F2F therapy, as hypothesized,
since the interaction between change trajectory and the modality of treatment was significant and positive based
on both therapists’ assessments (estimate = 1.78, t = 2.14, p < .001) and clients’ assessments (estimate = 2.65, t =
4.83, p < .001), implying that clients in F2F therapy improved 1.78 and 2.65 points faster per session than those in
VCP, respectively. We developed several hypotheses to explain these findings, focusing particularly on aspects of the
therapeutic alliance, as an emerging number of publications highlight the need to adapt its treatment dynamics from
F2F to VCP. This study underscores the need for ongoing research to further elucidate these processes and to refine
the methodologies used in such investigations.

Keywords
Videoconferencing Psychotherapy; Face-to-face Psychotherapy; Online interventions; Pace of Change in Therapy;
Longitudinal Designs

• The DID-Guide: Developing Digital Mental Health Interventions

Esther Mertens, Max Planck Institute for the study of Crime, Security and Law, Netherlands
Jean-Louis Van Gelder, Max Planck Institute for the study of Crime, Security and Law, Germany

Abstract
Due to the new opportunities technology offers to improve mental health, the development of digital mental health
interventions has increased rapidly in the last years. A key aspect of developing digital mental health intervention
is the translation of theory of change into specific technological features. Even though the development of features
that can actually establish change is crucial for digital interventions, detailed guidance on how to approach this trans-
lation are lacking. Therefore, we developed the Digital Intervention Development Guide. The DID-Guide takes the
Behavioral Intervention Technology framework as a starting point and elaborates on 1) theoretical mechanisms, 2)
intervention conceptualization, and 3) choice of delivery technology.
In the presentation, I will focus on the steps that address the translation of theory into features of a digital interven-
tion, with particular attention to development for smartphone applications and virtual reality. I will elaborate on con-
ceptualization of the intervention to enable storytelling, the choice of delivery technology, and steps for converting
conceptual ideas into technological features. These steps will be illustrated with a case example of a recently devel-
oped mental health intervention delivered through a smartphone application or virtual reality.

Keywords
Digital Intervention development; guidelines; smartphone application; virtual reality

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• Presentation of an Online Programme for Expats dealing with Cultural Adaptation Issues
Valerie Ventureyra, Private practice, France

Abstract
Introduction:
In an ever more globalized world, where mobility, cultural curiosity and international opportunities are continuously
increasing, temporary or longer-term expatriation (the migration of individuals by choice in pursuit of professional
opportunities, as opposed to out of economic need or political asylum, as is the case of refugees) is becoming more
common. The phases of adaptation to a novel environment in the case of expatriation have been well-defined, as
have been the difficulties that expats often face when arriving and attempting to assimilate in a new culture (social
isolation due to linguistic barriers, lack of cultural codes; anxiety and stress linked to adaptation to everyday life; and
even a lack of purpose and meaning in the experience, particularly when a spouse has followed a husband or wife
abroad without maintaining a professional activity). Expats may not always seek professional psychological help for
such issues. Often these difficulties are transient and do not require psychotherapy or counselling. However, it may be
beneficial for expats to recognize the different phases of adaptation, be presented with techniques and methods to
better cope with some challenges and be screened for underlying psychopathology (depression, PTSD, social anxiety)
that would benefit from therapy.
Methods:
A seven phase programme to accompany expats in their journey abroad and assist them in the process of assimilation
in the new culture, and even thrive from it, was developed, including an evaluative phase using validated question-
naires (for culture shock, depression, anxiety) and a detailed description of the phases of cultural adaptation (hon-
eymoon, rejection, isolation, assimilation and flourishing). The following part of the programme includes CBT-based
interventions for stress management, social integration and the exploration of purpose and meaning in the expatria-
tion experience. At the end of the programme participants are reassessed with the same questionnaires presented at
the beginning of the programme. (Participants scoring high on the screening questionnaires are encouraged to make
an appointment with a mental health professional for further assessment.)
Discussion:
The relevance of such an online programme in the era of online guided “self-help” programmes, and at a time of gen-
eralization of remote work, giving rise to new forms of expatriation, such as digital nomadism, will be discussed in
light of adaptation to and flourishing in a new culture and environment.

Key words
Expatriation; Culture Shock; Online Programme; Adaptation

• Prediction of early dropouts and non-responders to therapy through supervised machine learning models:
new digital developments in evidence-based therapy
Silvia Grazioli, Artificial Intelligence and Data Analysis Lab, Metacognitive Therapy Lab, Department of Psychology,
Sigmund Freud University, Milan, Italy; Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan,
Italy
Stefano de Francesco, Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy Child &
Youth Lab, Department of Psychology, Sigmund Freud University, Milan, Italy
Ludovica Giani, Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy Child & Youth Lab,
Department of Psychology, Sigmund Freud University, Milan, Italy
Simona Scaini, Child & Youth Lab, Department of Psychology, Sigmund Freud University, Milan, Italy Cliniche Italiane
di Psicoterapia dell’Età Evolutiva, Studi Cognitivi, Milan, Italy
Rossana Piron, InTherapy, Gruppo Studi Cognitivi, Milan, Italy
Sandra Sassaroli, Sigmund Freud University, Milan, Italy Studi Cognitivi, Cognitive Psychotherapy School and Re-
search Center, Milan, Italy
Giovanni Maria Ruggiero, Sigmund Freud University, Italy
Gabriele Caselli, Sigmund Freud University, Milan, Italy Studi Cognitivi, Cognitive Psychotherapy School and Re-
search Center, Milan, Italy

Abstract
Introduction: The clinical efficacy of cognitive-behavioral therapy is well-established, however, there remains a subset
of patients who do not derive benefit from it. It is a relevant ethical mandate to address treatment-resistant patients,
including those who do early dropouts and those who do not respond to CBT. Indeed, there is evidence that approxi-
mately one out of four patients drop out of therapy before the fifth session, and the same rate is true for non-respond-
ers. Therefore, the present research aims to explore this area, to develop predictive models on those two relevant clin-

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ical aspects. Specifically, we will consider the most cutting-edge technologies, including digital platforms for clinical
data collection and artificial intelligence (such as supervised machine learning). The goal is to provide mental health
professionals with predictive tools capable of early identification of patients at risk of dropping out of therapy or not
responding to treatment, to adapt therapeutic strategies in a timely and targeted manner.
Method: This study, conducted in collaboration with the InTherapy service of the Studi Cognitivi group, utilizes the
digital platform “Greta” for remote data collection concerning the therapy process. The data include patient demo-
graphics, pre-treatment symptoms, psychosocial functioning, and diagnostic information. Supervised ML models
were developed to obtain a predictive model regarding early dropouts, and a predictive model for non-responders
to therapy.
Results: The best predictive models obtained regarding early dropouts (with a predictive accuracy of 92%) and non-re-
sponders to therapy (with a predictive accuracy of 72%) will be illustrated.
Conclusion: The introduction of such a clinical and research approach, known in the literature as computational psy-
chotherapy, represents a significant development in evidence-based therapy within the Italian context. The high ac-
curacy achieved by the predictive models underscores the potential of integrating AI into the therapy process. Future
developments foresee the integration of these models within the Greta platform, to provide clinicians with relevant
predictive information regarding the potential outcome of therapy.

Keywords
Dropout, Non-Responders, Machine Learning, Computational Psychotherapy

• Development of Cognitive Behavioral Therapy Based Weight Control Mobile “Bi’Kilo” Application and Testing
its Effectiveness: A Pilot Study
Leman Deniz Tarlacık, Agri Patnos State Hospital, Turkey
Uğur Doğan, Muğla Sıtkı Koçman University, Turkey
Ömer Özer, Anadolu University, Turkey
Aslıhan Dönmez, Private practice, Turkey
Esin Engin, Izmir Economy University, Turkey
Ercan Altınöz, Eskisehir Osmangazi University, Department of Psychiatry, Turkey

Abstract
Introduction:
mHealth applications can facilitate overcoming barriers to treatment access and can provide cost-effectiveness. As-
sessing the various psychological aspects and related areas of overweight and obesity is crucial in treatment. The aim
of this study is to test the effectiveness of the CBT-based weight control mobile application Bi’Kilo in four key areas
associated with obesity.
Methods:
The project is supported by TUBITAK 1001-The Scientific and Technological Research Projects Funding Program with
the project number 122S049. Participants consist of adults with overweight and obesity.
Bi’Kilo mobile application consists of video animation-based psychoeducation content, mobile applications aimed at
reinforcing learned skills, and self-monitoring. The psychoeducation content focuses on healthy eating and lifestyle
recommendations. Bi’Kilo includes features such as Eating Records, Mindful Eating, Thought Cards etc.
During the follow-up phase, participants are encouraged to continue the practices they have previously learned.
Participants were randomized into a study group that could access all the contents of the Bi’Kilo and a control group
that could only access psychoeducation content. Anthropometric (Weight, BMI, WHR, BF%, VAI) and biochemical (Glu-
cose, Insulin, HOMA-IR, Leptin, Ghrelin) measurements were taken, along with psychometric evaluations related to
eating attitudes and behaviors (EEQ, mYFAS 2.0, MEQ) and cognitive tests (CANTAB-CGT, RVP, SWM, SST, MOT). All
participants were assessed at baseline at week 6 and week 10.
Out of the 77 participants who applied for the study, 38 completed at least two measurements (Control=17, Study=21).
Findings:
The average age of the participants included in the study is 40.3. In the study group, 57.9% were women and 42.1%
were men. There were no significant differences between the groups in terms of age, gender, BMI, duration of educa-
tion, and relationship status.
Significant changes were observed between the groups in terms of BMI, weight, MEQ-Awareness and MEQ-Mindful-
ness variables during follow-up. However, no significant differences were found between the groups in terms of other
psychometric evaluations, biochemical parameters and cognitive tests and cognitive assessments during follow-up.
In our study, although we found significant differences between the groups in some psychometric evaluations, we
observed changes in opposite directions in some parameters between the groups. We concluded that this change
may not be statistically significant due to the small number of participants who completed the study. Therefore, we
evaluated the parameter of change over time, calculated by subtracting the initial measurement values from the final
measurement values. So, we found a significant difference between the groups in the emotional eating change.

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Conclusion:
As a result, the Bi’Kilo, the first CBT-based weight control application in Turkish, was developed and its effectiveness
was tested in a randomized controlled study. The findings indicated that, the Bi’Kilo has been found to be effective
in weight control, emotional eating, and eating awareness behaviors in overweight and obese individuals. However,
the Bi’Kilo didn’t provide significant changes in biochemical measurements and cognitive functions. Further studies
in this area will contribute significantly to the literature.

Keywords
weight control, mobile health, cognitive behavioral therapy, obesity

Open Paper Symposium 23 – REBT

Chair: Sanda Stanković, University of Belgrade, Faculty of Philosophy, LIRA Lab, Serbia

• Enhancing Therapeutic Depth: Integrating Emotional Expansion in REBT

Zohra Master, Inner Planet, India

Abstract
In clinical practice, emotions are often perceived as static entities, traditionally addressed within the confines of cog-
nitive assessment and disputation of core irrational beliefs. This paper posits that expanding the role of emotions
can significantly enhance therapy adherence and client satisfaction by fostering both cognitive (intellectual) and
experiential (emotional) transformations in clients. Traditional Rational Emotive Behavior Therapy (REBT) has largely
confined itself to a narrow spectrum of eight negative emotions, limiting the depth of emotional exploration in ther-
apeutic settings. Consequently, clients often demonstrate a limited emotional vocabulary when articulating their
concerns.
This study advocates for a two-step approach to widen the emotional vocabulary within therapeutic practices:
Step I: The expansion of emotional vocabulary utilizing tools such as The Emotion Wheel (Willcox, G. 1982) aims to
expose clients to a broader range of specific emotions linked to distinct cognitive processes. For instance, while the
emotion of shame might typically highlight generalized judgments from others, emotions such as withdrawal or dis-
respect can pinpoint more specific internal or external judgments, respectively. This differentiation not only enriches
clients’ understanding of their emotional states but also enhances their ability to pinpoint specific cognitive anteced-
ents. An additional benefit of this expanded emotional engagement includes fostering clients’ empathy towards their
current emotional states, which can aid in managing secondary emotional reactions such as shame or guilt associated
with primary emotions like anger, thus facilitating a smoother therapeutic process.
Step II: Drawing on principles from Emotionally-Focused Therapy, this phase focuses on facilitating clients’ connec-
tions with these expanded emotional experiences to elicit richer cognitive insights.
By enhancing the emotional vocabulary used in therapy and aiding clients in forging deeper connections with their
emotions, practitioners can encourage more profound emotional and cognitive exploration. This approach holds par-
ticular promise for clients who struggle to articulate their core irrational beliefs (Bs), those who articulate circumstan-
tial triggers (Cs) but find it challenging to link them to underlying cognitions, those unable to identify their emotional
triggers, and clients who depend solely on intellectual understanding without achieving authentic change.
This paper will outline evidence-based strategies for integrating a more comprehensive emotional framework into
REBT, discussing the implications for practice, and aiming to establish a more holistic and effective therapeutic ap-
proach.

Keywords
emotions, paradigm shift, experiential change in clients

• Application of REBT, ACT, and CFT techniques to work with the client during the divorce procedure: A case
study
Nermin Mulaosmanovic, Filozofski fakultet Tuzla, Bosnia and Herzegovina

Abstract
Marriage dissolution entails adjusting to new life circumstances that necessitate quick decisions on a wide range of
issues. Such rapid decision-making can result in high levels of stress, especially if the divorce process is fraught with
ongoing arguments and emotional tension. People going through a divorce may experience a range of emotions
and struggle to understand and regulate them. In addition to extremely unpleasant emotions, activities linked with
pleasure and positive sentiments are required. This paper provides a case study of a 32-year-old client. Broken marital

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relationships, disagreements, refusal to accept the situation, rage, and depression are all reasons for seeking psycho-
logical treatment. REBT, ACT, and CFT modality approaches were used. REBT (rational-emotional-behavioral therapy)
is a multifaceted therapy that promotes the use of approaches in cognitive, emotional, and behavioral domains. ACT
(Acceptance and Commitment Therapy) is a context-specific form of cognitive behavioral therapy that employs mind-
fulness and behavioral activation to teach people how to live in the present moment, committed to their important
life values and goals, and less focused on painful emotions, thoughts, and experiences. CFT (Compassion Focused
Therapy) places a strong emphasis on the compassionate mind, with the goal of assisting people in developing a
manner of reacting to their experiences with emotional warmth, safety, and tranquility, via compassion for others as
well as compassion for oneself. The work’s goal was to demonstrate the effectiveness of combining REBT, ACT, and
CFT approaches in working with a client going through divorce in order to build adaptable patterns of thoughts, emo-
tional reactions, and behavior in this stressful scenario. During the treatment sessions, general and particular goals
were established, and they were met over a three-month period (10 sessions). REBT techniques were used in the pro-
cess, including questioning the absolutist demand, role playing, REI, imagination, metaphors, and presentations. The
act matrix and mindfulness were used from ACT techniques, whilst many selves, sympathetic letter, and inner critic
were used from CFT approaches. The results of the therapeutic work indicate that the application of REBT, ACT, and
CFT techniques was effective, as evidenced by a decrease in the number of conflicts between partners, a decrease in
anxiety and depression on an emotional level, as well as improved communication and functioning.

Keywords
REBT, ACT, CFT, techniques, divorce

• Empowerment through Rational Emotive Behavioural Therapy: Strengthening Women’s assertiveness

Mia Popić, EABCT, Serbia

Abstract
The paper examines individual protective factors that can help women overcome gender stereotypes in the domain
of leadership: self-efficacy, self-acceptance, general assertiveness and androgyny.
The research was conducted through two studies. In Study 1, respondents of both sexes participated, and its goal
was to examine the existence and content of gender stereotypes in the field of negotiation using a quantitative and
qualitative analysis of content on a sample of students from the Republic of Serbia. In addition, the goal of Study 1
was to examine the interrelationship of the examined variables, as well as to examine the difference in the expression
of individual protective factors with regard to gender and gender type. The results of Study 1 showed the presence
of gender stereotypes, which were classified into 10 categories by thematic analysis. Furthermore, the results of the
Study show that all the examined protective factors are significantly more developed in androgynous and masculine
gender identity compared to undifferentiated and feminine ones. Additionally, in Study 1, it was shown that masculin-
ity was associated with all measured variables, unlike femininity, implying that typically masculine traits are important
for self-perception as a confident, self-accepting, and assertive person.
The qualitative analysis conducted in Study 1, which determined the presence of gender stereotypes, was the ba-
sis for conducting the experimental Study 2, in which the influence of individual protective factors on negotiation
assertiveness in women’s negotiations was examined. Study 2 is an experimental study in which the respondents
played a specially created negotiation game in which their negotiation assertiveness was measured through the
amount they demanded in the negotiation. The aim of study 2 was to examine the influence of protective factors on
negotiation assertiveness in a situation with and without stereotype threat. The question about the understanding of
male superiority in the domain of negotiation, which was used in Study 1 as the subject of qualitative analysis, was a
manipulation of stereotype threat in Study 2, where the respondents who were in the experimental group in Study
2 answered that question. The results of Study 2 show that none of the examined protective factors had a positive
effect on negotiation assertiveness, which potentially implies that other, contextual factors have a more significant
role in negotiation assertiveness. On the other hand, the results show that the respondents who were in a situation
of stereotype threat, unlike the respondents in the control group, were significantly more assertive in negotiations,
which clearly shows that stereotype awareness contributes to greater negotiation assertiveness.

Keywords
gender stereotypes, stereotype threat, negotiation skills, leadership, protective factors, self-efficacy, unconditional
self-acceptance, assertiveness, androgyny.

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• Possibility of a “Bit” Useful Tool? Quantitatively representing Cognitive Load in REBT: An Information Theory
Approach for REBT Therapists
Ilija Novaković, Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia

Abstract
This study aims to provide Rational Emotive Behavior Therapy (REBT) practitioners with a quantitative tool for assess-
ing cognitive load in clients, particularly when irrational beliefs occur. Regarding the nature of irrational beliefs (Ellis
& Dryden, 2007), which are characterized by their rigid and absolutistic stance, we acknowledge that they inherently
involve higher estimations of certain outcomes occurring or not occurring. By integrating principles from information
theory and Miller’s Law, we quantify the cognitive load induced by irrational and rational beliefs, helping therapists
estimate the mental burden on their clients.
Using Norwich’s (1981) estimation that Miller’s magical number corresponds to 2.5 - 4 bits per chunk, we calculate the
total cognitive load in bits, assuming an average cognitive load of 7 chunks at the moment the belief is applied. This
approach builds on Shannon’s (1948) foundational work in information theory to measure (in bits) how surprising an
event is, based on its probability of occurring in the eyes of observer (I(x)=−log2​(p(x)).
Our findings reveal that the irrational belief results in 11 bits upon failing an exam, while the rational belief results in
1.937 bits. When combined with the cognitive load of 7 chunks (assumed average cognitive load at the moment of
belief application), the total cognitive load for the irrational belief ranges from 28.5 to 39 bits, significantly exceeding
the lower cognitive capacity limit of 17.5 bits and surpassing the upper limit of 36 bits. In contrast, the total cognitive
load for the rational belief ranges from 19.437 to 29.937 bits, which remains within the cognitive capacity limits but a
little closer to the upper limit.
We believe that these insights have potential to be useful for REBT therapists, providing a method to estimate the
cognitive load clients experience during moments of irrational belief. By understanding the potential range of these
loads, therapists can better tailor their interventions to reduce cognitive overload and emotional distress, promoting
rational thinking and emotional well-being. This could be easily applied in practice by using basic logarithmic calcu-
lators, or have ready in advance their probability to bit sheets. We also believe that due to the mathematical nature of
this method, it could be also used as an illustration to clients of how our beliefs can affect our overall cognitive load
and thus facilitate the process even in more skeptical clients. Overall, this study also underlines the utility of informa-
tion theory in therapeutic settings, offering a novel intersection of cognitive psychology and REBT.

Keywords
Cognitive Load, Irrational Beliefs, Information Theory, Miller’s Law, Rational Emotive Behavior Therapy (REBT), Surpri-
sal, Self-Information, Cognitive Capacity, Emotional Well-Being

• Men’s and women’s irrational beliefs differentially predict housework, child care, and emotion work
Sanda Stanković, University of Belgrade, Faculty of Philosophy, LIRA Lab, Serbia, sanda.stankovic@f.bg.ac.rs
Tatjana Vukosavljević-Gvozden, University of Belgrade, Faculty of Philosophy, Serbia

Distribution of housework, child care, and emotion work are important aspects of relationships, that can affect intima-
cy and quality of the relationship, but also individual physical and mental health. These types of work in relationships
have generally been neglected in Rational emotive and cognitive- behavioral therapy (REBT) research. In this study,
we investigated on the couple level whether irrational beliefs affect the distribution of housework and childcare, and
the level of emotion work, and whether this is different for women and men. The sample consisted of 276 heterosex-
ual couples in Serbia that lived together for a maximum of 10 years, had children, and lived alone with their children.
We measured irrational beliefs with GABS (Bernard, 1998), and the distribution of routine housework, distribution of
childcare, and the level of emotion work, with a selection of items used in previous research. We did path analysis
following the Actor Partner Interdependence Model (APIM; Kashy and Kenny, 1999; Kenny, 1996) for each irrational
belief and outcome separately. The irrational beliefs measured were demands for achievement, approval, comfort,
and fairness, and self-depreciation and depreciation of others. Our findings show that women’s irrational beliefs are
related to the distribution of housework and their level of emotion work. The more strongly the woman endorses
irrational beliefs she does a greater share of housework and less emotion work. Men’s irrational beliefs on the other
hand are associated with their share of childcare - the more irrational the man is, he does a smaller share of childcare.
The differing results for men and women will be discussed from the gender perspective. The implication for practice is
that therapists should address the three types of work in relationships with their clients, keeping in mind the gender
differences.

Keywords
relationships, rational-emotive &amp; cognitive-behavioral therapy (REBT), irrational beliefs, housework, emotion
work, childcare, APIM

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• The link between Prejudices and Attitudes towards RE&CBT Theory and Methodology
Zorica Marić, Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Ivana Peruničić-Mladenović, University of Belgrade, Faculty of Philosophy, Serbia

Abstract
Objective: Rational-emotive behavioral therapy (REBT) belongs to a group of cognitive therapies well-known for their
evidence-based approach to treating a variety of psychological complaints. The results of numerous studies have
demonstrated the high validity of both RE&CBT’s theoretical and practical background. Some empirically supported
concepts are cognitions that significantly produce negative consequences (emotions and behavior), in which the
therapist utilizes a structured approach as well as applies interventions and techniques in order to help clients to
overcome their psychological disturbances. However, some therapists modify the application of RE&CBT methodolo-
gy. This study aims to investigate the factors (personal and professional) related to therapy modifications in order to
examine the possible link between therapy modifications and prejudice towards RE&CBT.
Method: The sample consists of both RE&CBT certified therapists and trainees who completed a questionnaire con-
sisting of items measuring the acceptance of RE&CBT theory and methodology, proneness to modifying RE&CBT
interventions as well as prejudice towards RE&CBT. The analysis was conducted on fifty participants. The results pre-
sented here in the abstract are preliminary.
The results indicate that proneness to modifying therapeutic interventions is significantly linked to not only prejudice
towards RE&CBT but lower acceptance of RE&CBT’s core theoretical and methodological background as well.
Conclusion: Our results show that modifying empirically validated interventions and methods is linked to both preju-
dice and a negative bias towards RE&CBT. Furthermore, special concern is recommended when applied interventions
skew from standard procedures.

Keywords
RECBT, psychotherapy, interventions, prejudice

Open Paper Symposium 24 - Diversity and Inclusion

Chair: Manjola Collaku, Western Balkans University, Albania

• Evaluating Narrative Enhancement and Cognitive Therapy (NECT) Efficacy in Reducing Self-Stigma Among
Mental Health Patients: An Italian Pragmatic Multicenter Randomized Controlled Trial
Luca Bodini, Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University
of Verona, Verona, Italy
Antonio Lasalvia, Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, Uni-
versity of Verona, Verona, Italy,
Chiara Bonetto, Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, Univer-
sity of Verona, Verona, Italy

Abstract
Self-stigma refers to the internalization of negative prejudices and stereotypes by patients with mental disorders,
such as the beliefs of being dangerous, aggressive, or incapable of working. This phenomenon has detrimental effects
on various aspects of life, including adherence to therapeutic pathways, self-esteem, quality of life, and increases in
feelings of despair and suicide risk. In response to these issues, the Narrative Enhancement and Cognitive Therapy
(NECT) was developed. NECT is a group-based intervention consisting of 20 one-hour sessions aimed at reducing
self-stigma in individuals with mental disorders. Numerous international studies support NECT’s efficacy in improving
self-stigma and other psychological aspects. Despite this evidence, interventions to reduce self-stigma in Italy are
not regularly implemented and often lack a solid empirical foundation. This presentation in the open papers session
will introduce a study aiming to evaluate the efficacy and feasibility of NECT in 416 patients from 26 mental health
centers in Northeast Italy. The study is designed as a pragmatic multicenter randomized controlled trial with two par-
allel arms. Efficacy will be assessed by comparing baseline and post-treatment differences in various psychological
dimensions, including the level of self-stigma (or internalized stigma), self-esteem, hope, empowerment, recovery
perception, mental well-being, and stigma stress. This project may be presented in the open papers section, provid-
ing detailed insights into its methodology, implementation, and preliminary findings. This research aims to enhance
knowledge about optimal treatments for patients with mental disorders burdened by high self-stigma, ultimately
improving their recovery outcomes.

Keywords
stigma; NECT; narrative therapy; cognitive therapy

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• Adapting Cognitive Behavioral Therapy for Clients with Low Educational Levels: An Albanian study
Manjola Collaku, Western Balkans University, Albania
Erinda Bani, High School, Albania

Abstract
This study investigates the challenges and strategies involved in adapting Cognitive Behavioral Therapy (CBT) for
clients with low educational levels. The study focuses on the experiences of CBT psychotherapists operating in Al-
bania, a context that provides unique cultural and educational considerations. Through an in-depth questionnaire
administered to CBT practitioners, the research highlights the specific difficulties therapists face when working with
clients who have limited educational backgrounds. Key challenges include conducting assessments that accurately
capture the clients’ cognitive and emotional states, as well as delivering psychoeducation in a manner that is both
understandable and engaging for this population.
The study identifies effective strategies employed by therapists to overcome these challenges, thereby enhancing
client comprehension and engagement. Additionally, the importance of employing simplified language and clear
communication techniques is emphasized, as these strategies are crucial for facilitating therapeutic progress and
ensuring that clients can actively participate in their treatment.
By exploring these aspects through the lens of practicing psychotherapists, the paper provides a comprehensive un-
derstanding of the practical adaptations necessary for delivering effective CBT to clients with low educational levels.
The findings underscore the necessity of culturally and educationally sensitive approaches in psychotherapy, offering
valuable insights for clinicians seeking to optimize their therapeutic interventions and improve outcomes for this
underserved population. This research contributes to the broader field of mental health by highlighting the need for
adaptable therapeutic practices that meet the diverse needs of all clients, regardless of their educational background.

Keywords
Cognitive Behavioral Therapy (CBT), Low educational levels, Psychotherapy adaptation, Psychoeducation techniques,
Albanian psychotherapists, Mental health strategies, Client comprehension

• “Feeling like I could take a big breath”: evaluation of a supervision group for Indigenous Māori and culturally
diverse health professionals within a cognitive behaviour therapy training course
Emily Cooney, Otago University, New Zealand
Elle Brittain, Massey University, New Zealand
Fiona Mathieson, Otago University, New Zealand
Rongo Patel, Otago University, New Zealand

Abstract
Cognitive behaviour therapy (CBT) is a Western psychological intervention originally developed in North America
and Europe for individuals experiencing anxiety and depression. Learning CBT may involve additional challenges for
students who identify with Indigenous or minoritised cultures and ethnicities. Challenges may include navigating the
interface between their own cultural identities and experiences and the Western-centric processes and assumptions
of CBT (Beck & Naz, 2019; Fernando & Fernando, 2017).
These issues also affect service users. In the UK, Black, Asian and minority ethnic (BAME) communities are less likely
to voluntarily seek support for mental health problems (McManus et al., 2016). Qualitative investigations of BAME
mental health access have identified barriers including cultural naivety, discrimination and mistrust (Memon et al.,
2016). Available evidence suggests that ethnic minority under-representation within the mental health workforce
may contribute to this (Scior et al., 2016).
Historically, New Zealand clinical psychology programmes have been slower to attend to bicultural practice, incor-
porate this in teaching content, and ensure Indigenous Māori representation in faculty, than social work and medical
programmes (Abbott & Durie, 1987). There is a risk that without intentional, active and deliberate steps to counteract
this systemic racism, this bias will also leach into other places in which CBT is taught.
Internationally, the murder of George Floyd, and the ensuing global reckoning with structural racism has led to great-
er efforts by professional bodies to acknowledge their own racist behaviour (e.g. APA, 2021). In CBT therapies there
has been a sharpened focus on cultural responsivity (or lack thereof ), and the development of anti-racism guidelines
to address inequities for BAME communities (e.g. Lawton et al., 2021; Pierson et al., 2022).
The Department of Psychological Medicine at Otago University, Wellington, has taught CBT to allied mental health
professionals for 25 years. Following concerns that Indigenous Māori and minoritised ethnicity students may be un-
der-represented in the CBT course studentship, and over-represented in non-completion rates, the programme un-
dertook several actions to address potential inequities. One initiative was to trial a reflective and supportive group
supervision process for Indigenous Māori and culturally diverse CBT students. The aim was to create a space for di-
verse students to meet and reflect the interface between their cultures and the expectations and practices of CBT, in
developing their own identities as culturally responsive CBT practitioners.

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The current study uses a mixed-methods design to evaluate this initiative, using data from two sources:
(1) A thematic analysis of the responses from anonymous online student evaluations of the group.
(2) A comparison of the proportions of White and non-White early course withdrawals since the supervision group’s
inception with the proportions of those withdrawals for the two preceding years.
Results indicated that respondents found the initiative valuable, supportive, and relevant to their CBT development.
Notably, all Indigenous Māori and culturally diverse students completed the course last year.
These findings have implications for enhancing the appeal of CBT training courses to Indigenous and ethnic minority
students, and creating learning environments that are culturally responsive, and that meet ethnic minority commu-
nity needs.

Keywords
Diversity, Supervision, Equity

• Assessment of the cultural validity of measurement tools with First Nations people
Maddison O’Gradey-Lee, Black Dog Institute, Australia
Jennie Hudson, Black Dog Institute, Australia

Abstract
Background: Internationally, there has been a significant focus on the cross-cultural appropriateness of psychometric
tools. Assessment is a crucial step in the development of effective interventions as it quantifies the current need and
the areas of focus for research or interventions. However, there is a lack of methodological rigour when it comes to
cross-culturally validating a measure or intervention, especially with First Nations people. Cultural validity measures
the appropriateness and applicability of a construct for a specific cultural group. It is often discussed in reference to
determining if a construct developed in one cultural group is applicable, meaningful, and equivalent in another cul-
tural group. First Nations people conceptualise and define mental health and well-being in vastly different ways than
the biomedical models most commonly used in the development of assessment tools. Conducting research involving
First Nations people without due consideration for cultural validity can have harmful effects. This may include perpet-
uating the ongoing dynamics of colonization and misdiagnosis, resulting in inaccurate prevalence data and poorer
treatment outcomes overall. A specific tool to assess cultural validity is required to address this significant gap in the
literature.
Method: The First Nations-Cultural Validity Assessment Tool (FN-CVAT) was developed to assess cultural validity in a
meaningful way for First Nations people in Australia. The tool was designed by First Nations researchers with guidance
from cultural and lived experience experts and pilot-tested by a group of eight clinicians and researchers. The tool was
then refined utilising feedback from the pilot testing.
Results: The FN-CVAT includes 10 criteria within three overarching themes (Psychometric properties, Cultural Psy-
chometric properties, and Cultural competency of staff/ethics). The score determines whether the measure meets
the 10 criteria, with higher scores indicating greater cultural validity. The FN-CVAT demonstrated adequate reliability
evidenced by intraclass correlations.
Conclusion: This is the first tool to assess the cultural validity of measurement tools from the perspective of First Na-
tions people. The FN-CVAT prioritises First Nations’ research values using a methodological approach that is accept-
able within both non-Indigenous and Indigenous research practices. Culturally valid measurement is the cornerstone
of culturally valid research and assessments in clinical practice. Given the importance of measurement tools in re-
search and clinical practice, it is hoped that the FN-CVAT can improve the quality of measurement tools and research
with First Nations people, ultimately improving clinical outcomes for First Nations people. Further, as more research
happens in the field, the FN-CVAT may serve as a development guideline for future measurement tools that prioritise
cultural validity and also increase the transparency of reporting on cultural validity.

Keywords
cultural validity; assessment; Indigenous; multicultural competence

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Open Paper Symposium 25 – Behavioral medicine
Chair: Przemyslaw Babel, Jagiellonian University, Institute of Psychology, Pain Research Group, Poland

• Improving CBT Protocols for Chronic Pain: Translating Basic Science to Clinical Practice
Przemyslaw Babel, Jagiellonian University, Institute of Psychology, Pain Research Group, Poland

Abstract
Chronic pain affects approximately 20% of the global population, leading to significant financial costs, which exceed
$635 billion annually in the US alone. Traditional pain management methods, including pharmacotherapy, physio-
therapy, and invasive interventions, often prove insufficiently effective. Given that pain perception is influenced by
biological, psychological, and social factors, and is shaped by life experiences, psychological therapies hold consider-
able promise. However, while meta-analyses on the effectiveness of psychological therapies support the efficacy of
CBT, the reported effect sizes are small or very small, highlighting the need for improvement. This talk will summarize
recent experimental studies on the impact of learning processes, such as verbal suggestion, classical conditioning,
observational learning, and operant conditioning, on pain modulation. We will discuss the implications of these find-
ings for clinical practice, with a particular focus on enhancing pain-reduction-oriented psychotherapy.

Keywords
CBT, chronic pain, learning, verbal suggestion, classical conditioning, operant conditioning, observational learning,
modeling, reinforcement

• The effect of Ultra-Brief Cognitive Behavioral Intervention on emotional disorders in multiple sclerosis
Alina Schenk, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
Cosmin Octavian Popa, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu
Mures, Romania
Cojocaru Cristiana, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures,
Romania
Stefan Marian, West University of Timişoara, Romania
Rodica Balasa, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, Ro-
mania
Smaranda Maier, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Ro-
mania

Abstract
Background: Multiple sclerosis (MS) represents a neurodegenerative autoimmune disease characterized by almost
all neurological symptoms that could severely impact the patient’s wellbeing throughout its evolution. Thereby, the
high prevalence of emotional disorders is not uncommon. The main objective of this research was to investigate the
effect of an Ultra-Brief Cognitive Behavioral Intervention on alleviating depressive and anxiety symptoms, using tech-
niques targeting the dysfunctional psychological mechanisms involved in their onset. At the same time, evaluating
the impact on fatigue as the most common debilitating MS symptom and overall perceived health condition was a
secondary objective.
Methods: In this pilot study, 31 patients with MS (Mage=42 years, SD=12.2) received an online U-BCBI. Assessment
was conducted in three time points, namely pre-intervention, as well as two weeks and two months afterwards.
Results: Depression and anxiety clinical symptoms reduced substantially after the U-BCBI with B= -7,58, 95%CI(-12.84,
-2.31 ), p<.01,respectively with B= -15.17, 95%CI(-18.31, -12.02),p<.001at post-test and B= -8.08, 95%CI(-13.60, -2.56),
p<.01, respectively with B= -19.45, 95%CI(-22.88, -16.03), p<.001 at follow-up. Regarding dysfunctional psycholog-
ical mechanisms, irrational beliefs levels improved at post-test with B= -25.86, 95%CI(-46.10, -5.61). At two months
follow-up negative dysfunctional thinking decreased with B= -6,89, 95%CI(-13.59, -2.18),p<.01. UBCBI positively influ-
enced the perception of health in MS patients at post-test with B= -0.77, 95%CI(-1.20, -0.33),p<.01, and follow-up with
B= -0.86, 95%CI(-1.63, -0.09),p<.05, while the impact on dysfunctional attitudes and fatigue did not reach statistical
significance.
Conclusions: U-BCBI could be considered a feasible approach for MS patients at high risk for emotional disorders and
dysfunctional thinking style.

Keywords
multiple sclerosis; cognitive behavioral intervention; ultra-brief; emotional disorders; dysfunctional psychological
mechanisms; fatigue; perceived health

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• A micro-longitudinal examination of the relationship between repetitive negative thinking and fatigue using
ecological momentary assessment
Nusaibah Islam, University of New South Wales, Australia
Bronwyn Graham, University of New South Wales, Australia

Abstract
Background:
Fatigue is amongst the most frequent complaints received by health professionals and is associated with significant
functional impairment. Nevertheless, the aetiology of fatigue remains poorly understood. Physiological factors (e.g.
poor sleep) are often perceived as the primary cause of fatigue, yet studies report these factors do not fully account
for fatigue. Emerging evidence suggests repetitive negative thinking (RNT) is associated with fatigue in both general
and clinical populations, however majority of these studies utilise retrospective questionnaires which are subject to
recall bias. Hence, we prospectively explored the bidirectional relationship between RNT and fatigue while controlling
for relevant physiological and psychological factors. This included examining momentary RNT and fatigue, as well as
the association between previous day RNT and current day fatigue, and previous day fatigue and current day RNT.
Methods:
University students received SMS notifications 3 times a day (morning, midday, and evening) for 2 weeks with ques-
tionnaires assessing their current physical and mental fatigue, RNT and stress. Sleep duration and quality were as-
sessed daily via the morning questionnaire. Linear mixed models tested the within- and between-persons relation-
ships between RNT and fatigue.
Results:
Greater momentary RNT predicted greater momentary physical and mental fatigue, both within and between indi-
viduals. Poorer subjective sleep quality predicted greater physical and mental fatigue, yet shorter sleep duration only
predicted physical fatigue. Greater stress and being biologically female significantly predicted greater fatigue. Con-
versely, only momentary physical and mental fatigue, and stress, predicted RNT, both within and between individuals.
In the lagged analyses, greater RNT on the previous day predicted greater physical and mental fatigue on the fol-
lowing day. Conversely, only physical fatigue levels on the previous day predicted RNT the next day, with previous
day mental fatigue not emerging as a predictor of next day RNT. These results were consistent across within- and
between-person analyses.
Conclusion:
These results imply a central role for RNT in fatigue, even after controlling for commonly perceived physiological
causes of fatigue (e.g. sleep duration). Moreover, momentary RNT accounts for both within and between-person in-
creases in momentary fatigue i.e. fatigue increases as RNT increases relative to one’s own average levels of fatigue
and RNT, and the group’s average levels of fatigue and RNT, respectively. Likewise, fatigue predicted both within- and
between-person increases in RNT, suggesting the relationship between momentary fatigue and RNT is bidirectional.
This bidirectional relationship is further evidenced by the lagged analyses which suggest that RNT may worsen phys-
ical and mental fatigue, while only physical fatigue may exacerbate RNT. Ongoing work is identifying whether there
is a causal relationship between RNT and fatigue by determining whether fatigue can be reduced via manipulations
that reduce RNT.

Keywords
Fatigue, repetitive negative thinking, ecological momentary assessment

• Cognitive fusion as a mediator in the relationship between personality traits and perceived distress in chron-
ic pain
Cojocaru Cristiana, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures,
Romania
Cosmin Octavian Popa, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu
Mures, Romania
Alina Schenk, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
Stefan Marian, West University of Timişoara, Romania
Bogdan Andrei Suciu, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures,
Romania
Simona Szasz, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, Roma-
nia
Horatiu Popoviciu, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures,
Romania

Abstract
Background: Chronic pain is defined by disability and increased risk for anxiety and depressive disorders. Personality
and cognitive fusion are personal characteristics that impact the adjustment to chronic pain, influencing the subjec-

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tive perception of physical and emotional distress. Cognitive fusion was found to function as a key process involved
in the onset and maintenance of psychopathology. In this context, the aim of this study was to explore the mediating
effect of cognitive fusion in the relationship between personality and distress.
Methods: This cross-sectional study included 108 participants (aged M=56.7, SD=11.3) diagnosed with rheumatic
diseases involving chronic widespread pain. The instruments for the evaluation of personality traits as conceptualized
by the Five Factor Model, cognitive fusion and distress levels were administered by the healthcare staff. Multiple me-
diation models were conducted for estimating the indirect effects on each distress variable.
Results: Cognitive fusion mediated the relationship between personality traits and distress variables. Specifically, Ex-
traversion and Emotional Stability had an indirect impact conducted by cognitive fusion on pain intensity [Extraver-
sion: (z=-2.09, p=.04, 95% CI:-0.04, 0.00); Emotional Stability: (z=-2.36, p=.02, 95% CI: -0.07, -0.01)], anxiety [Extraver-
sion (z=-2.45, p=.01, 95% CI:-0.06, 0.01); Emotional Stability (z=-2.93, p=.003, 95% CI: -0.10, -0.02)] and depression
[Extraversion (z=-2.44, p=.02, 95% CI:-0.05, -0.01); Emotional Stability (z=-2.91, p=.004, 95% CI: -0.05, -0.02)]. Also,
cognitive fusion mediated the indirect effect of Agreeableness on anxiety (z=-2.10, p=.04, 95% CI: -0.05, -0.02) and
depression (z=-2.09, p=.04, 95% CI: -0.05, 0.00).
Conclusions: Cognitive fusion constitutes a core process involved in the relationship between personality and distress
levels in chronic pain. This outcome could further document the assessment and intervention approaches in chronic
pain. Particularly, the application of tailored third-wave cognitive-behavioral interventions could alleviate the associ-
ation between pain and emotional disorders and promote an optimal psychological adaptation.

Keywords
chronic pain; personality; cognitive fusion; anxiety; depression; pain-related distress

• Efficacy of acceptance and commitment therapy (ACT) in comparison with Treatment as Usual (TAU) on the
pain aspects and Quality of Life in patients with fibromyalgia
Zahra Dadbin, Islamic Azad University, Science and Research Tehran Branch, Islamic Republic of Iran
Neda Ali Beigi, University of Social Welfare and Rehabilitation Sciences, Islamic Republic of Iran
Razieh Mokhberian, Rasta private clinic, Islamic Republic of Iran
Mehdi Ghadimzad, Private work, Islamic Republic of Iran
Kamran Azma, AJA medical science university, Islamic Republic of Iran
Fariborz Bagheri, Islamic Azad University, Science and Research Tehtan Branch, Islamic Republic of Iran

Abstract
Introduction: Research on the use of Acceptance and Commitment Therapy (ACT) for patients with Fibromyalgia are
limited. Fibromyalgia is a chronic musculoskeletal syndrome characterized by widespread pain, hotspots, fatigue, and
sleep disturbances that also affects the psychological aspect of the individual; There are evidences to suggest that
ACT is effective in alleviating pain interference, pain acceptance and quality of life.
This is the protocol to evaluate the effectiveness of ACT compared to treatment as usual (TAU) for patients with fibro-
myalgia.
Methods: A total of 32patients with fibromyalgia disorder in the city of Tehran randomly assigned to TAU (control
group) or ACT + TAU (intervention group). The inclusion criteria were the existence of all the diagnostic criteria of
fibromyalgia according to ICD-11, also a confirmed diagnosis by a specialist, education level at least 5 years, age be-
tween 30 and 50 years, the normality of routine laboratory examinations, the absence of other causes of pain and be-
ing psychological minded. Exclusion criteria were: the presence of comorbid diseases causing secondary fibromyalgia
such as: rheumatoid arthritis, thyroid malfunction, vitamin D deficiency, the presence of other comorbid diseases
disrupting the treatment process such as hypertension, hyperglycemia and diabetes, patients with severe psychiatric
disorders that require medication or are currently on the psychological treatment, patients who have received psy-
chological treatment for this disease for less than 4 months. Participants assessed before and after treatment
Multidimensional pain questionnaire (Cranes et al,1985) was used to measure pain. Five subscales of this question-
naire was disturbance in daily functioning, pain intensity, social support, control over life and emotional distress.
Fibromyalgia questionnaire (FIQR) (Dr. Burkhart, 1991) were applied to evaluate the impact of this disease on the
performance of patients and SF 36 questionnaire is used to evaluate quality of life.
Acceptance and commitment therapy were applied in 8 sessions (120 minutes) for the experimental groups. The re-
search data were analyzed using repeated measurements and follow-up tests.
Results: The primary outcome was the mean change from baseline on the pain questionnaire and FIQR and SF-36.
Secondary outcomes include changes in pain aspects and quality of life. The results showed that the combination of
acceptance and commitment therapy with medication was more effective than drug therapy alone (p≤0/005).
Conclusion: In order to improve patients with fibromyalgia, it is possible to use the treatment of acceptance and com-
mitment along with medication. ACT may be used to help patients cope with the pain associated with their condition
and enhance their quality of life whether pain exist.

Keywords
Fibromyalgia, Acceptance and Commitment Therapy, Pain Severity, Quality of Life

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• Effects of a Combined Neuropsychological and Cognitive Behavioral Group Therapy on Young Adults with
Fragile X Syndrome
Alice Montanaro, Bambino Gesù̀ Children’s Hospital, Italy

Abstract
Background:
Fragile X Syndrome (FXS) is the most common cause of inherited intellectual disability (ID) and autism spectrum disor-
der (ASD) due to the full mutation in the FMR1 gene located on X chromosome. Even though there is a comprehensive
understanding of the cognitive and behavioral characteristics of FXS and the families’ need for tailored interventions,
empirical investigations into the efficacy of behavioral treatments for people with FXS are still scarce. This gap is
especially pronounced in studies involving adolescents and young adults. Considering the high prevalence of
psychiatric issues in ID and the strong association between neurodevelopmental disorders, social exclusion and
poor long-term quality of life (QoL), research on the efficacy of behavioural intervention in this field become still
more relevant. This study aimed to investigate the effectiveness of a combined neuropsychological and cognitive-
behavioral group therapy (nCBT) among young adults with FXS and ID.
Method:
Ten young adults diagnosed with FXS took part in the second stage intervention of “Corp-osa-Mente” (CoM II), a group
nCBT program previously outlined by Montanaro and colleagues in an earlier study [2023], with the participants be-
ing the same as in the previous research. This report details the outcomes of an additional twelve-month group sec-
tions aimed at enhancing the ability to manage emotions and the socio-communicative skills of these young adults,
by using cognitive restructuring techniques and neuropsychological trainings. Caregivers completed standardized
measures of adaptive functioning, emotional and behavior problems, executive function, communication skills and
family QoL at pre-treatment (T0) and post-treatment (T1).
Results:
CoM-II showed decreases in depressive and anxiety symptoms from T0 to T1, along with increased socio-pragmatic
and communication skills from pre-test to post-test intervention. Additionally, our analysis revealed improvements in
the adapative behavior of participants and in the family QoL.
Conclusions:
To our knowledge, the current study is the first study to evaluate the effectiveness of a nCBT based intervention for
young adults with FXS and ID. These preliminary findings underscores the feasibility of a group intervention that
integrates cognitive-behavioral and neuropsychological techniques to target the different clinical manifestations of
FXS in a unified method. This approach holds promise for this population and should be further pursued, mostly with
growth when life becomes more demanding and there is a documented cognitive/adaptive decline in FXS pheno-
type. However, it is recommended to undertake additional methodologically rigorous studies, such as randomized
controlled trials (RCTs), to substantiate these results.

* Montanaro FAM, Alfieri P, Vicari S. “Corp-Osa-Mente”, a Combined Psychosocial–Neuropsychological Intervention for

Adolescents and Young Adults with Fragile X Syndrome: An Explorative Study.Brain Sciences. 2023; 13(2):277. https://
doi.org/10.3390/brainsci13020277

Keywords
fragile x syndrome; rare genetic syndromes; CBT; intellectual disability; mental health; psychosocial treatment

Open Paper Symposium 26 - Education-related mental health issues and interventions

Chair: Sarah Jakobsen, Aarhus University, Denmark

• Cognitive Behavioral Interventions for School Attendance Problems: A Systematic Review and Meta-Analysis
Sarah Jakobsen, Aarhus University, Denmark
Johanne Jeppesen Lomholt, Aarhus University, Denmark
Mikael Thastum, Aarhus University, Denmark

Abstract
Purpose: School attendance problems (SAPs) are heterogeneous with respect to etiology and problem manifesta-
tions. In all cases, lack of appropriate intervention can have detrimental consequences for a young person’s academic
success, socio-emotional development, and general life chances. Cognitive behavioral therapy (CBT) tailored to SAPs
has emerged as a promising intervention with the potential to reduce absenteeism and co-occurring mental health
problems often seen in youths with SAPs. The purpose of the present study is to provide a comprehensive overview
of the CBT protocols being used for SAPs and to conduct a quantitative synthesis of evidence on its effect.
Methods: Eligible randomized controlled trials (RCTs), quasi-experimental trials (QEDs), and pre-post studies evalu-
ating CBT for SAPs were retrieved from systematic searches in four databases (PsycINFO, PubMed, Scopus, and ERIC).

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Meta-analytic methods will be used to determine (a) the between-group effect (including only RCTs) and (b) the with-
in-group effect. The primary outcome is school attendance, and secondary outcomes are anxiety, depression, and ex-
ternalizing symptoms. An updated search is planned for June 2024, after which the meta-analyses will be conducted.
Preliminary results: Nine pre-post studies, one QED, and six RCTs were deemed eligible for inclusion, with a total of
624 youths receiving CBT and 117 youths in comparison groups. In cases where the RCT compared variations of CBT
(50%), only relevant intervention arms were included and treated as pre-post studies. The majority of studies em-
ployed an outpatient clinical setting (80%), an individual delivery format (100%), and a CBT protocol developed to
target SAPs associated with internalizing symptoms (73.3%). There was substantial variability in treatment length and
case severity at intake. The presentation in September will include results of the quantitative synthesis.
Despite growing efforts to develop and evaluate CBT interventions for SAPs, the field suffers from a lack of robust
controlled studies and from inconsistencies in comparators, outcome measurements, and definitions of the target
population.

Keywords
School attendance problems, absenteeism, cognitive behavioral therapy, systematic review, meta-analysisematic er

• Linking motivation for PhD studies and psychological distress: Testing the mediating effect of self-regulatory
abilities
Catarina Cardoso, University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Inter-
vention (CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal
Maria Cristina Canavarro, University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral
Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal
Marco Pereira, University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention
(CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal

Abstract
Background: Evidence suggests that different types of motivation for doctoral studies are associated with different
types of mental health outcomes. Autonomous motivation of PhD students has been associated with fewer symp-
toms of depression and anxiety, while controlled motivation has been associated with increased levels of psycholog-
ical distress. Emotion regulation difficulties and procrastination, which is often seen as a type of avoidance, may play
an important role in psychological distress. However, little is known about their role in PhD context. The aim of this
study was to examine whether the association between motivation for PhD studies and psychological distress (i.e.,
symptoms of depression, anxiety and stress) are mediated by emotion regulation difficulties and procrastination.
Methods: A sample of 521 PhD students (77.2% female, mean age = 31.97 years) completed a web-based question-
naire that collected sociodemographic, clinical and PhD-related data, as well self-report questionnaires assessing mo-
tivation (Motivation for PhD Studies Scale), psychological distress (Depression Anxiety and Stress Scale-21), emotion
regulation difficulties (Difficulties in Emotion Regulation Scale-Short Form) and procrastination (Irrational Procrasti-
nation Scale). A parallel multiple mediation model was used.
Results: Our results demonstrated significant and negative associations between autonomous motivation and de-
pressive symptoms and stress, and positive associations between controlled motivation and all psychological symp-
toms. We also found evidence of parallel mediation, where emotion regulation difficulties and procrastination me-
diated the association between autonomous and controlled motivation and depressive symptoms of PhD students.
Specifically for controlled motivation, difficulties in emotion regulation exerted a stronger mediating effect. The asso-
ciation between autonomous and controlled motivation and symptoms of anxiety and stress were mediated only by
emotion regulation difficulties.
Conclusions: Our findings indicate that procrastination and particularly emotion regulation difficulties play a signif-
icant role in explaining the association between motivation for doctoral studies and psychological distress. These
findings suggest that PhD students may benefit from interventions that specifically focuses on strategies that pro-
mote emotion regulation skills and reduce procrastination, such as the Unified Protocol, a CBT-based transdiagnostic
treatment that target emotion regulation. The enhancement of self-regulatory abilities may help to reduce psycho-
pathological symptoms, improving their individual well-being as well as their academic productivity.

Keywords
motivation for PhD studies; emotion regulation difficulties; procrastination; depressive symptoms; anxious symp-
toms; stress symptoms; PhD students

• Feasibility and Preliminary Efficacy of Web-Based Self-Help Program on Repetitive Negative Thinking for
College Students: Randomized Pilot Study
Seher Cömertoğlu Yalçın, Cansagligi Foundation Center for Contextual Behavioral Science, Turkey
Melike Nursultan Akkaya, Cansagligi Foundation Center for Contextual Behavioral Science, Turkey
Fatih Yavuz, Istanbul Medipol University, Turkey

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Abstract
Repetitive negative thinking (RNT), encompassing worry and rumination, is a transdiagnostic process linked to var-
ious psychopathologies (Ehring & Watkins, 2008; Harvey et al., 2004). Therapy approaches targeting RNT, such as
metacognitive therapy (Wells, 2009) and RFCBT (Watkins, 2016), have shown promise. Recently, RNT-focused ACT
developed by Ruiz and colleagues (2016a, 2018a) has gained attention for its brief and effective interventions.
The concept of “minimum intervention needed for change” (MINC) emphasizes the necessity for brief, effective inter-
ventions that can be realistically implemented in mental health services (Glasgow et al., 2014). Analyzing transdiag-
nostic processes like RNT supports the development of such interventions (Ruiz et al., 2020).
This research aims to develop a web-based self-help protocol focused on ACT for RNT in Turkish and to assess its ef-
fectiveness and feasibility.
Methods
All instruments are self-report measures assessed online. Except for the Demographic Information Form (T0) and the
System Usability Scale (T1), all measurements were repeated: before the program (T0) and after the program (T1).
Use measurements used are as follows: Demographic Information Form, Perseverative Thinking Questionnaire (Al-
tan-Atalay and Saritas-Atalar, 2021) DASS-21 (Sariçam,2018), Cognitive Fusion Scale (Kervancıoğlu et al., 2023), Values
Questionnaire (Aydın & Aydın, 2017, Acceptance and Action Questionnaire-II (Yavuz et al., 2016), System Usability
Scale (Çağıltay, 2011).
Participants:
Participants were undergraduate psychology students from a private Medipol University in Türkiye, compensated
with course credit. Eligibility required internet access and a smartphone, while exclusion criteria included self-harm
thoughts, psychotic disorders, substance abuse, and current psychological treatment. Eligible participants were con-
tacted via Telegram and Google Forms, informed about the process, and given consent forms and baseline question-
naires.
Forty-three participants completed these forms and were randomly assigned to the intervention group (IG) (22 partic-
ipants) or the control group (CG) (21 participants). The IG started immediately, while the CG, unaware of their waitlist
status, received the program after the final assessment. All CG participants completed pre- and post-tests. Of the 22
IG participants, 68.18% completed all assessments, leading to an analysis based on the 22 CG participants and the 15
IG participants. Participants were older than 20 years (M = 22.58), with 83.3% females (n = 30) and 16.7% males (n = 6).
Results:
For both IG and CG data, skewness and kurtosis values between -2 and +2 indicated a normal distribution (George &
Mallery, 2010), allowing for parametric tests. A paired sample t-test for IG showed significant differences in pre- and
post-test scores of ‘perseverative thinking’ (p = .003), ‘depression’ (p = .023), and ‘stress’ (p = .018). ANCOVA revealed
significant differences between the intervention and CG in ‘perseverative thinking’ (p = .005), ‘depression’ (p = .031),
‘anxiety’ (p = .031), ‘stress’ (p = .002), and ‘cognitive fusion’ (p = .02). The SUS scores for usability and acceptability av-
eraged 74.66 (SD = 8.70), above the average score of 68, indicating the protocol is ‘good’ and ‘acceptable,’ and can be
understood and applied self-guided.

Keywords
Repetitive negative thinking, Acceptance and commitment therapy, Digital psychological interventions, Feasibility,
Effectiveness

• Efficacy of the CBT Stress Management Training Program for Medical Students
Mikhail Budnikov, I.M. Sechenov First Moscow State Medical University, Russian Federation
Oleg Glazachev, I.M. Sechenov First Moscow State Medical University, Russian Federation
Elena Dudnik, I.M. Sechenov First Moscow State Medical University, Russian Federation
Sheena Soperna, I.M. Sechenov First Moscow State Medical University, India

Abstract
Medical students face higher risk of depression, burnout and suicidal ideation in comparison with peers (Schwenk et
al., 2010). Mental health risks for them have increased even more with negative factors associated with the COVID-19
pandemic (Lyons et al., 2020).
The study participants were 46 first year medical students (5 male, 41 female, 18-25 years old) of Sechenov university.
We assessed stress level (PSS-10), self-efficacy (GSE), anxiety (Spielberger State-Trait Anxiety Inventory, GAD-7) and
depression (PHQ-9). The participants we randomly assigned to the experimental (n=23) and control (n=23) groups.
The experimental group participated in the online CBT Stress Management training program. The 5-week program
included 5 weekly sessions and action plans (home assignments) to practice new skills. The structure of the program
included psychoeducation, relaxation and emotion regulation techniques training, cognitive restructuring, exposure
exercises, problem-solving skills training, cost and benefit behavioral analysis, positive activities planning, values fo-
cused exercises and mindfulness.
We conducted the assessment 1 week after the training completion and repeated it in 12 months. To assess the effects
of the intervention on each scale results we used ANCOVA with the pre-test score as a covariate.

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In the posttest participants from the experimental group showed significant decrease in stress level (η²p = 0.22),
situational (η²p = 0.179) and trait anxiety (η²p = 0.339), anxiety level in GAD-7 (η²p = 0.263) and in depression (η²p =
0.11) in comparison with the control group. Thus, we revealed the large effect sizes for stress level, situational and trait
anxiety (STAI), anxiety (GAD-7) and medium effect size for depression level.
In 1-year follow-up we did not find significant differences for PSS between the groups, although the positive effects
in 1-year follow up were still revealed for situational (η²p=0.193), trait (η²p=0.130) anxiety (STAI), GAD-7 (η²p=0.095)
and PHQ (η²p=0.128). So we still found large effect size for situational anxiety and medium effect sizes for trait anxiety
in STAI, GAD-7 and PHQ-9.
The study results showed that the program was effective for decrease of anxiety and depression in medical students
and the participation was still beneficial in 12 months after the program completion.

Keywords
Stress, medical students, anxiety, depression, CBT, stress management

• UNIPDES - An Internet-Based Transdiagnostic Intervention for College Students’ Psychological Symptoms:

Evaluation of Its Development, Usability and Effectiveness Study Protocol
Ömer Özer, Anadolu University, Turkey
Gizem Öztemür, Middle East Technical University, Turkey
Burak Köksal, Tokat Gaziosmanpaşa University, Turkey
Uğur Doğan, Muğla Sıtkı Koçman University, Turkey
Sedat Batmaz, Ankara Social Sciences University, Turkey
Recep Gür, Eskisehir Osmangazi University, Turkey
Ahmer Altinok, University of Groningen, Netherlands
Ali Ercan Altınöz, Eskisehir Osmangazi University, Turkey

Abstract
Challenges of independent living and increase in life responsibilities that come with university years can cause several
challenges for many students. These hardships are closely related to depression, anxiety, and problems in adjust-
ment. Numerous biases or a lack of university resources hinder the process of seeking help, which eventually causes
detrimental impact on students’ well-being. This protocol was created to assist college students in overcoming these
obstacles and to assess, in comparison to control group, the impact of an internet-based guided and unguided trans-
diagnostic internet-based program (UNIPDES) on depression, anxiety, and adjustment levels. The calculated sample
size for study will include 330 students, and the participants will be selected from five different universities located in
Turkey. Participants will be randomly assigned to either guided, unguided, or control groups. Guided and unguided
group participants will receive six weeks intervention and the waitlist control group will receive the unguided ver-
sion of the program after twelve weeks of randomization. Assessments will take place at baseline, post-test (8 weeks
post-baseline) and follow-up (12 weeks post-baseline). Data will be analyzed with mixed-MANCOVA. The primary
outcome is change in depression, anxiety, and adjustment levels. Additionally, students’ reasons for dropout will be
assessed qualitatively. The results from this study can build evidence for the effectiveness of transdiagnostic guided
and unguided internet-based intervention for treating depression, anxiety, and adjustment problems of students.
UNIPDES can provide a flexible, easy to access and cost-effective treatment for the problems that students com-
monly face. Trial registration is registered at ClinicalTrials.gov Protocol Registration and Results System (Trial number:
NCT06245200).

Keywords
internet-based intervention, transdiagnostic cognitive behavioral therapy, university students

Open Paper Symposium 27 – Miscellaneous 2

Chair: Elena Naumtseva, National Research University Higher School of Economics, Russian Federation

• The link between irrational beliefs and employee well-being

Jana Prljević, Dormitory of High School Students “Jelica Milovanović”, Serbia

Abstract
Introduction: This study will examine the link between irrational beliefs of employees and their well-being at the
workplace. Irrational beliefs are grounded in the theory of Rational Emotive Behavior Therapy (REBT), where their
negative impact on an individual’s well-being is confirmed, because they are extreme, illogical and rigid. Albert Ellis,

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the founder of REBT, argued that absolutistic demands are at the core of emotional disturbance, while awfulizing, low
frustration tolerance and depreciation are most often derived from absolutistic demands. Another model was pro-
posed by DiGiuseppe, who argued that irrational beliefs should be considered independent of each other, due to the
lack of empirical support for the hypothesis that demands play a central role. In this paper, both models will be tested,
in order to examine the individual impact of each of the irrational beliefs, as well as their joint impact on well-being.
Aim: The primary goal of this work is to examine the link between irrational beliefs and employees well-being in sever-
al different companies in Serbia. This study will examine the direct impact of each belief on well-being, but also what
effects they lead to when they interact. The second goal would be to examine the impact of irrational beliefs on each
separate element within the PERMA model of well-being, in order to conclude which aspects of well-being are most
affected and where interventions could be directed.
Materials and Methods: The target sample of this research is the population of employees from several different com-
panies with operations in Serbia. It consists of employees over the age of 18. The smallest sample collected will be 200
employees. Respondents will fill out the questionnaire in online format. Predictor variables are irrational beliefs, which
will be operationalized through the iPBI questionnaire (Irrational Performance Beliefs Inventory).The criterion variable
is the experience of psychological well-being and will be operationalized through the PERMA-Profiler questionnaire.
Quantitative analysis will be used to examine the relationship between the measured variables.
Results: The research is ongoing. The final results will be presented at the congress.
Discussion: This research is expected to show the link between irrational beliefs and employee well-being, i.e. wheth-
er irrational beliefs have a negative impact on the well-being of employees. This would be one of the more recent
researches on this topic, and thus would provide additional importance for further expanding the application of
irrational beliefs in the business context. One of the outcomes would be determination which irrational beliefs most
affect the well-being of employees and in which way the theoretical propositions of REBT could be applied in order
to improve their mental health. The research will also contribute to uncovering the impact that irrational beliefs have
on specific aspects of well-being. The findings of this research would provide a significant scientific contribution for
the psychotherapy, as well as for a better understanding of the mental health of employees, work and organizational
psychology, and also for clinical psychology.

Keywords
irrational beliefs, employee well-being, REBT, PERMA model

• “Change talks”: coaching support for organizational change in line with cognitive-behavioral approach
Elena Naumtseva, SN Consulting, Russian Federation

Abstract
The CBC model «CHANGE TALKS» is focused on building readiness and inclusion of employees in the implementation
of organizational change.
The recipients of the coaching model are employees in situations of organizational change.
The model was developed in line with the cognitive-behavioral approach. It includes descriptions of Change Interfer-
ing Thoughts (CITs) and Change Enhancing Thoughts (CETs)
Research shows that the following factors are important for involving employees in implementing changes in a com-
pany:
1. A sense of subjective control [Martin et al., 2005; Naumtseva, 2020a,b, Wanberg, Banas, 2000]
2. Beliefs about self-efficacy in a situation of change [Holt et al., 2007, Naumtseva, 2020; Rahi, 2021]
3. Beliefs about personal valence [Armenakis et al., 1993, Holt et al., 2007; Naumtseva, 2020].
4. Beliefs about appropriateness for the organization [Holt et al., 2007, Naumtseva, 2020]
5. Beliefs about management support for change [Holt et al., 2007, Naumtseva, 2020a,b];
6. Shared norm about support for change among colleagues [Naumtseva, 2020a,b]
The “CHANGE TALKS” model is based on these 6 factors.
The “Change talks” model is applicable in coaching, work stress management programs, and leadership programs.
It can be used to increase the level of resilience, subjective control over the situation, reduce stress and increase the
readiness of employees for organizational change.
Model stages:
1 CHANGE CONTEXT
Purpuse: forming a perception of management support for the change
concluding a contract for the implementation of changes in the organization
2 PRE-CHANGE
Purpuse: formation of a sense of subjective control in a situation of change
3 NO CHANGE
Purpuse: review of an alternative solution from the perspective of different stakeholders; formation of motivation for
personal changes
4 POST-CHANGE

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Purpuse: formation of a positive Vision_of_oneself_after_changes,creating a positive personal valence for change,for-
mation of appropriateness for the organization
5 CITS & CETS: PRODUCTIVITY IN THE SITUATION OF CHANGE
Purpuse: identify which beliefs hinder productivity in a situation of change. At this stage, the coach helps the client
notice the connection between thoughts, emotions and actions, and helps to reformulate them.
6 THROUGH CHANGE
Purpuse: search for resources in situations of change, formation of self-efficacy in situations of change, creating a
perception of support for change among colleagues
7. STEPS
Purpuse: forming an action plan in a situation of change
Expert assessments
5 expert-coaches with management experience from 2 to 20 years (average experience 12.4 years) were involved at
this stage. Average experience 7.8 years.
Each expert received a form with 5 criteria. A 10-point scale was used for assessments (10 points = maximum compli-
ance, 1 = minimum).
Results of expert assessments:
1) Compliance of the model with the stated request: M=9.8, SD=0.4
2) Consistency of model blocks: M=9.8, SD=0.4
3) Sequence and logic of model blocks: M=9.6, SD=0.9
4) Relevance: M=9.6, SD=0.9
5) Variety of techniques used: M=9.0, SD=2.2
All experts noted the relevance of the model to modern conditions of development of organizations, compliance with
the request, and consistency of the model blocks.
Recommendations for improving the model concerned individual blocks of the model and the name.

Keywords
cognitive-behavioral coaching, organizational change, readiness for change

• Applying RE&CBT model for navigating the layoffs in the workplace

Milena Dolenc, Outfit7, Serbia

Abstract
In today’s rapidly growing industries, combined with the unstable environmental factors, frequent organisation-
al changes are an inevitable part of the business environment. The biggest challenge in managing organisational
changes is managing employees’ emotions. In this presentation, we will focus on corporate layoffs as one of the
most stressful organisational change and outline the most common irrational beliefs that accompany emotional as-
pects of employees’ and their superiors’ reactions to layoff. We will present current practices and it’s results, for ap-
plying RE&CBT model for navigating the layoff process. Furthermore, we will present the application of the RE&CBT
model of emotion management as an integral part of the layoff process in the organisation. The paper focuses on
two aspects: 1) training managers for identifying and navigating their reactions and building their resilience in order
to support employees going through the layoff and 2) developing employees’ emotional responsibility, aiming to
encourage individuals to consciously choose between functional and dysfunctional emotional reactions in situations
of organisational change, both leading to personal and organisational well-being. We will also discuss the role of
management and human resources management departments in effectively implementing this model. During the
presentation, we will showcase one practical example of using RE&CBT model in the layoff process, it’s results, as well
as necessary prerequisites and potential risks of it’s implementation.

Keywords
RE&CBT model, workplace, layoffs

• Psychometric Properties of the Bullied Cognitions Inventory (BCI) in a Turkish Sample

Ahmet Altinok, Department of Experimental Psychology, University of Groningen, Netherlands
Fulya Turk, Department of Psychological Counselling and Guidance, Yildiz Technical University, Istanbul, Turkey
Eda Yilmazer, Department of Psychology, Beykoz University, Istanbul, Turkey
Zeynep Hamamci, Department of Psychology, Beykoz University, Istanbul, Turkey

Abstract
Background: Bullying is associated with several acute and chronic mental health problems. This phenomenon can
occur in both work and school settings, thereby potentially affecting various aspects of life extensively. Despite the
growing research interest in bullying from a cognitive behavioural therapy perspective, there is a lack of measure-

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ment tools to evaluate irrational beliefs resulting from being bullied. In this study, we aimed to test the recently devel-
oped Bullied Cognitions Inventory (BCI) in a Turkish sample.
Method: Initial analysis was conducted with 264 adults, aged 18 to 54 (M = 21.42, SD = 5.02). Data collection is still on-
going. The sample included 173 (65.53%) females and 92 (34.47%) males. Data collection tools included the BCI, the
Multidimensional Bullying Victimization Scale, the Posttraumatic Stress Disorder (PTSD) Checklist, and the Liebowitz
Social Anxiety Scale. Structural validity was tested using Confirmatory Factor Analysis (CFA), and criterion validity was
assessed using the Pearson Correlation Coefficient.
Results: Confirmatory Factor Analysis (CFA) results demonstrated that the structure with 15 items and four subscales
fit the current data well. The first-order model fit indices were: χ²/df (169.52/84) = 2.02, p < .001, CFI = .93, TLI = .91,
SRMR = .062, GFI = .78, RMSEA = .063 [.050, .077], indicating a good fit (see Figure 1). Pearson correlation coefficients
showed that the subscales and total scores of the BCI were positively correlated with the subscales of the mentioned
scales (see Table 1).
Conclusion: The preliminary analysis indicates that the Turkish adaptation of the Bullied Cognitions Inventory (BCI) is
a valid and reliable instrument for assessing cognitions related to bullying.

Keywords
bullying; scale adaptation; cognitions; irrational beliefs

• Examining the Influence of Situational Factors on Reappraisal Efficiency among Turkish Adult Participants:
An Exploratory Study
Meryem Kahramanlar, Ibn Khaldun University, Turkey
Burcu Uysal, Ibn Khaldun University, Turkey
Ayse Altan-Atalay, Kadir Has University, Turkey

Abstract
Background and Purpose
Emotion regulation (ER) encompasses the processes we utilize to influence our emotions. Among ER strategies, cogni-
tive reappraisal (CR) is notably effective, as emotions often stem from appraisals of events. Frequent CR use correlates
with positive outcomes like reduced negative emotions, stronger social connections, higher academic achievement,
enhanced psychological well-being, and fewer psychopathological symptoms. Despite existing research, gaps remain
in characterizing different reappraisal instances based on a theoretical framework and predicting their effectiveness
across contexts. The reAppraisal Framework distinguishes between two different reappraisal mechanisms to shift ap-
praisal: reconstrual (changing situation interpretation) and repurposing (changing the goal which the interpretation
is compared to). Given that reappraisal is not a unified strategy and its effectiveness varies depending on contextual
factors such as controllability of the stressor, this study aimed to examine: a) the role of appraisal dimensions in deter-
mining the type of emotion experienced (sadness or anxiety), and b) the effectiveness of reconstrual and repurposing
in reducing short-term emotions (sadness and anxiety) depending on perceived control (low/high).
Method
Seventy-one participants (ages 18-30, M = 24.12, SD = 3.05) recalled and documented two incidents eliciting anxiety
and sadness via Qualtrics as retrospective memories. Participants rated 8 different emotions on a 1-5 scale for each
memory and described how their perspectives on the events had changed. Then, they rated their current appraisals
via 10 items, and perceived control on a scale from 0 to 100. Qualitative data on their current perspectives were coded
as reconstrual, repurposing, or no reappraisal in accordance with the reAppraisal Framework. Perceived control rat-
ings were categorized into high and low groups using median split.
Results
Linear regressions predicting sadness and anxiety scores from appraisal items explained a significant portion of the
variance. Sadness increased with relevance (B = .26, p = .05) and low outlook certainty (B = -.32, p < .05). Anxiety in-
creased with low controllability (B = -.022, p < .05), high incongruence (B = .20, p < .05), high accountability (B = .32, p
< .05), and low emotional coping (B = -.34, p < .05).
Participants either utilized repurposing (33.3%) or did not engage in any of the strategies (44.4%) for sadness mem-
ories whereas they mostly used reconstrual (48.6 %) for anxiety memories. Univariate ANOVAs revealed significant
main effects of reappraisal type and perceived control on both sadness (F(5) = 8.41, p < .05) and anxiety (F(5) =3.43
, p < .05). Specifically, there was a significant difference between no reappraisal group and both reconstrual and
repurposing groups, while no significant difference was found between utilization of reconstrual and repurposing.
Although the interactions were not significant, there was a trend showing that when perceived control was higher,
the tendency to use reconstrual linked to lower sadness and anxiety scores compared to the utilization of repurposing
and no reappraisal.
Conclusion
The current study enhances our understanding of different reappraisal techniques, including reconstrual and repur-
posing, and delineates the specific contexts in which these strategies are most effective. This insight can inform the
development of targeted interventions.

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Keywords
appraisal, cognitive reappraisal, reAppraisal Framework, context, sadness, anxiety

• Introduction to the theory of the novel enneagram personality typing system (epts) and its associations with
cognitive behavioral therapies
Sena Ece Ilgin, Marmara University Research & Training Hospital, Turkey
Ömer Yanartaş, Marmara University Research & Training Hospital, Turkey
Layali Abbasi, Al-Balqa Applied University, Jordan

Abstract
The Enneagram Personality Typing System (EPTS) categorizes individuals into nine distinct personality types with
unique coping and defense mechanisms. It is widely used in various fields, but has received limited attention from
academia since many consider it pseudoscience. Our research shows correlations between EPTS and Myers–Briggs
Type Indicator and Big Five personality theory systems. To establish cross-cultural validity, a test was developed and
applied in different cultures. In this panel, the relationship between the Enneagram personality theory, personality
belief and schema therapy, as well as the relationship between cognition and flexibility, and the results of the studies
will be shared.

Keywords
enneagram, personality, schema, belief

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TD1: A digital platform to facilitate wellbeing and flourishing

for individuals and employees
Tammie Ronen
Tel-Aviv University, Israel
Yair Dangoor
Tel-Aviv University, Israel

Abstract
During the last decades, the importance of functioning better became clear to individuals, employees and organiza-
tions. However, not everyone can access therapy and learn to function better. Technical developments have enabled
the improvement and application of digital programs to enhance knowledge and skills. Our company, Buzzlife, is
engaged in imparting skills to improve wellbeing; reduce reactions to stress, anxiety and burnout; and prevent the
development of future problems by creating resiliency and prosperity for the individual, the employee and the orga-
nization. We developed BbetterE (https://bbettere.com/en/), a unique online digital platform with a variety of online
digital programs, to impart abilities and skills to deal with stress, fear and anxiety, increase levels of happiness and
satisfaction as well as strengthen personal and organizational resilience and improve the level of wellbeing in the
organization and its employees. The participants will be able to view and experience how to use our digital program
for skill enhancement that is:
Backed by theoretical models and research
Based on cognitive behavioral approaches
Tested successfully in extensive pilots
Custom-made practices and evaluations
Holistic approach
User friendly
Affordable cost
Learning Objectives: Using digital aids to identify, practice and apply skills to reduce stress and increase life satisfac-
tion.

Keywords
digital platform, change process. improving wellbeing, skills

TD2: My Hospital Buddy Ida: An Augmented Reality-Assisted Psychotherapy

Application for Children with Cancer
Pelin Karaturhan
Koc University, Turkey
Aslihan Özcan Morey
Koc University, Turkey
Tuba Mutluer
Koc University, Turkey
Herdem Aslan
Koc University, Turkey
Romina Markaroğlu
Koc University, Turkey
Asim Evren Yantaç
Koc University, Turkey
Kemal Kuşcu
Koc University, Turkey

Abstract
Technical and Scientific Background: Augmented Reality (AR) technology adds a virtual layer to our physical sur-
roundings that can be seen through lenses or cameras. This technology can provide information in an immersive,
enjoyable, and engaging way, and it also has significant applications in psychiatry and psychotherapy. AR technology
can be utilized for controlled exposure to phobias, teaching and practicing meditation and relaxation techniques
for anxiety disorders, controlled exposure for trauma processing for post-traumatic stress disorder, as well as for skill

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training in Cognitive Behavioral Therapy (CBT) and motor and cognitive rehabilitation. Children with cancer face nu-
merous challenges during their treatment, and applications of CBT are proven to be effective in teaching psychosocial
skills. Therefore, we aimed to combine both CBT and AR technology to develop a new approach to the unique psycho-
logical needs of children with cancer.
Key Features of the Technology: My Hospital Buddy Ida brings together a virtual AR character, Ida, a mobile applica-
tion, and a CBT-based structured exercise workbook designed to deliver a psychotherapy program customized for
the needs of children undergoing cancer treatment. The workbook consists of 12 chapters designed to be delivered
by a psychotherapist. Each chapter is designed with a CBT-based approach and includes psychoeducational content
(information regarding the diagnosis, hospital environment, and treatment process), exercises that teach CBT skills,
and homework. Each chapter has one or two image triggers that trigger Ida’s animation. The user opens the Ida app,
goes to the relevant chapter through the user interface, opening the device camera. When the camera is pointed to
the image trigger, Ida character is seen virtually on top of the workbook. Ida is designed as a child that also goes to
the hospital. She talks about her experiences with medical procedures and hospitals, as well as her emotions, in a way
relevant to that chapter’s topic. The AR interface also shows certain spaces from the hospitals, such as patient room
and MRI room, and hospital staff, such as nurses.
Implications for Everyday Clinical Practice of CBT: Ida is designed to be a character that children can relate to. Engag-
ing with Ida while applying the workbook can entertain children while learning psychosocial skills and support the
experiential nature of CBT through, for example, Ida showing breathing exercises. Therefore, it can increase a patient’s
motivation and adherence to therapy. Thus, it can help children better understand and retain psychosocial skills. This
application is scalable worldwide and easy to use. Therefore, it can result in more children getting psychosocial sup-
port, which they are deprived of in many hospital settings. Furthermore, interacting with Ida can provide emotional
support to children through a sense of companionship, increasing comfort and reducing isolation and anxiety. Lastly,
this application can be adapted to various psychological and physiological disorders, such as diabetes and anxiety,
with the same infrastructure by adapting the content and changing the virtual character based on specific needs.

Keywords
Augmented Reality, CBT for children, Technology-assisted CBT, Pediatric Oncology Support

TD3: Counsel Compass, the all-in-one platform designed specifically for

mental health professionals
Nina Miljković
Counsel Compass, Serbia
Vladimir Đačić
Counsel Compass, Serbia
Bojana Naumovski
Counsel Compass, Serbia

Abstract
Welcome to Counsel Compass, the all-in-one platform designed specifically for mental health professionals. Our plat-
form is your virtual administrative assistant, streamlining your efforts so you can focus on what matters most—your
clients.
Key Features:
Client management: Keep all client information at your fingertips. Our comprehensive client portfolio includes con-
tact details and session history, along with session records and notes, patient journal entries and custom forms. You
can tailor your practice with customizable intake forms, session notes, and assessments, making it easy to retrieve
crucial information when you need it.
Schedule: Easily manage your appointments with an intuitive calendar interface. Send automatic reminders and con-
nect with clients remotely using our Zoom integration, offering a seamless telehealth experience.
Billing: Simplify your financial processes with integrated billing tracking and invoicing. Generate invoices and view
detailed financial reports for each client. With everything in one place, you’ll save time and reduce errors.
By centralizing your practic’s administrative tasks, Counsel Compass helps you and your team maintain an organized,
efficient, and client-focused practice. Experience the peace of mind that comes with knowing everything you need is
right at your fingertips.

Keywords
Client management, Custom forms, Session history, Scheduling, Calendar, Billing tracking, Session notes,

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POSTER PRESENTATIONS

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PO1 Prevalence and Differential Profiles of People with Adverse Childhood

Experiences in Treatment for Substance Use Disorder
Javier Fernandez-Montalvo
Universidad Publica de Navarra, Spain
Leire Leza
Universidad Publica de Navarra, Spain
Jose J. Lopez-Goñi
Universidad Publica de Navarra, Spain
Alfonso Arteaga
Universidad Publica de Navarra, Spain

Abstract
Background: Adverse childhood experiences (ACEs) are potentially traumatic experiences that can cause negative
consequences for people´s health and well-being. They are prevalent in people with substance use disorder (SUD).
The aims of this study were to determine the prevalence of ACEs in a specific sample of people with SUD and to anal-
yse the specific characteristics of these patients according to sex.
Methods: In this cross-sectional study, the sample consisted of 215 people (177 men and 38 women) seeking treat-
ment for SUD in two clinical centres in Spain.
Results: The prevalence of at least one ACE was 84.7% (83.6% men and 89.5% women). Women reported a higher
prevalence of family mental health problems and sexual abuse than men. The group with ≥ 3 ACEs showed a higher
severity profile for the addiction severity and psychopathological variables than the groups with 0 ACEs and 1-2 ACEs.
Logistic regression showed that problems related to the group with ≥ 3 ACEs in the total sample were psychiatric and
legal problems and lifetime suicidal ideation (in men, family/social problems and lifetime suicidal ideation; in women,
employment/support problems).
Conclusions: This study supports the high prevalence of ACEs in people with SUD and the cumulative effect of ACEs:
as the number of ACEs increases, the severity of the variables studied increases. In addition, sex is a relevant factor. The
implementation of assessments and treatment for ACEs is necessary in SUD treatment programmes given their high
prevalence and strong impact on this specific population.

Keywords
substance use disorder; adverse childhood experiences; prevalence; differential profile; sex

PO2 Acculturative Stress and Markers of Wellbeing: A scoping review and

meta-analysis.
Claudiu Negosanu
Evidence Based Assessment and Psychological Interventions Doctoral School, Babes-Bolyai University, Cluj-Napoca,
Romania
Daria Sîntoma
Evidence Based Assessment and Psychological Interventions Doctoral School, Babes-Bolyai University, Cluj-Napoca,
Romania, Romania
Aurora Szentagotai-Tatar
Department of Clinical Psychology and Psychotherapy; The International Institute for the Advanced Studies of Psy-
chotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania

Abstract
Introduction: In the current, unstable global context, emerging research in the area of Acculturation and Acculturative
Stress (AS) reveals the individual and group psychological toll of conflict-driven migratory outflows. With the renewed
scientific interest for this multifaceted, worldwide phenomenon, the overall effect magnitude of Acculturative Stress
on key psychological problems has not yet been explored and consolidated in a unitary study. To our current knowl-
edge, the present meta-analysis is the first study aiming to explore the relationship between AS and key markers of
wellbeing in immigrant populations, including refugee and displaced groups.
Methods: For the three synthesised outcomes – Acculturative Stress correlations with Depression (1), Anxiety (2) and
Loneliness (3), 15.410 records have been identified through database (PubMed, PsychInfo, Scopus, Proquest, Web of
Science, Science Direct, Springer) and manual searches. After screening, from 372 eligible studies, 79 studies have
been included for outcomes 1 and 3, while the analysis for outcome 2 is currently ongoing. Pooled Fisher’s Z-trans-

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formed correlation coefficients have been calculated for each outcome, along with subgroup and meta-regression
moderation analyses.
Results: For the completed outcomes 1 and 3, significant associations were found between AS, Depression and Loneli-
ness. The analysis results were robust and no publication bias was found. Moderator analyses only showed statistically
significant effects on the pooled estimate for AS Measures (also a main source of heterogeneity) and Study Location.
Conclusion: In contrast with rising instability followed by economic and political population displacement move-
ments, a notable scarcity of research concerning AS effects on vulnerable populations was found for studies conduct-
ed in Europe, particularly in the area of AS and Loneliness. However, globally, the studies synthesised for outcomes
1 and 3 (AS correlations with Depression and Loneliness) showed strong positive effect sizes. Given the Cognitive,
Behavioural and Emotional underpinnings of Acculturation and Acculturative Stress, this study, along with further
research, could address these gaps and contribute to an increased awareness, Acculturative Stress-specific psycho-
therapeutic interventions and more inclusive social policies.

Keywords
acculturation, acculturative stress, anxiety, depression, social isolation, loneliness, discrimination, immigration, refu-
gee, social inclusion, migration

PO3: What shapes the relationship between mindfulness and wellbeing: the
effect of gender and experience with psychotherapy
Zorica Kojić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)
Tamara Jovanović
Faculty of Sciences, University of Novi Sad, Serbia
Natalija Opačić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)
Stela Tumbas
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)
Sandra Bijelić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)
Stanislava Popov
Faculty of sport and psychology -TIMS, Novi Sad, Serbia

Abstract
Defined as the conscious direction of attention to the present moment without judgment, mindfulness has garnered
considerable attention for its association with reduced stress, anxiety, and depression, thereby enhancing overall
well-being (Kabat-Zinn, 2003; Brown & Ryan, 2003). While research has consistently linked mindfulness to improved
self-awareness, emotional regulation, and mental health (Brown & Ryan, 2003), further investigation is warranted to
explore how individual factors such as gender and therapy experience may modulate this relationship (Baer, 2003;
Davidson et al., 2003). This study engaged 331 students from three faculties in Serbia, with 31.1% studying psycholo-
gy. Of the participants, 18% were male, with a mean age of 23.9 years. Employing a questionnaire, the study assessed
sociodemographic variables including gender, age, and experience with psychotherapy. Mindfulness as a trait-like
tendency was evaluated using the Five Facet Mindfulness Questionnaire (FFMQ; Baer, 2006), while life satisfaction
was measured using the Satisfaction with Life Scale (SWLS; Diener, 1985). The SWLS gauges overall life satisfaction
through five items measuring global cognitive judgments of one’s life satisfaction. The FFMQ, on the other hand,
measures mindfulness across five facets: Observing (α = .74), Describing (α = .87), Acting with Awareness (α = .88),
Non-judging of Inner Experience (α = .85), and Non-reactivity to Inner Experience (α = .79). Correlational analyses
revealed gender differences in the relationship between mindfulness facets and well-being. Among men, only Act-
ing with Awareness showed a positive correlation with well-being (r = .293), while among women, all facets except
Observing were positively correlated with well-being (rdescribing = .223, racting = .242, rnon-judging = .226, and rnon-reactivity =
.250). These findings underscore the nuanced interplay between mindfulness facets and gender in shaping well-be-
ing outcomes, emphasizing the need for gender-sensitive mindfulness interventions. Furthermore, participants who
had never attended therapy demonstrated a positive correlation between well-being and all mindfulness facets. Con-
versely, among those who had attended therapy (N=83), a stronger positive correlation was observed only between
well-being and Non-reactivity to Thoughts (r = .328). This suggests that therapy enhances the ability to non-react to
thoughts, thereby increasing life satisfaction levels. While these findings highlight the potential benefits of therapy in
cultivating specific aspects of mindfulness and enhancing overall well-being, caution is warranted due to the limited
sample size, especially in the case of men and those who attended therapy. Future research with larger and more di-

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verse samples is needed to corroborate and extend these findings. Additionally, longitudinal studies could elucidate
the causal pathways underlying the relationship between mindfulness, therapy experience, and well-being, further
advancing our understanding and informing targeted interventions in clinical and counseling settings.

Keywords
mindfulness, gender, therapy experience, well-being

PO5 Α case-control study for assessing anxiety, depression, resilience and

Early Maladaptive Schemas in patients with locally advanced and metastatic
lung cancer undergoing immunotherapy.
Maria Macheimari
Hellenic Centre of Mental Hygiene and Research, Greece
Vasiliki Efstathiou
Department of Psychology, School of Philosophy, National and Kapodistrian University of Athens, Greece
Anna Koumarianou
Hematology Oncology Unit, Fourth Department of Internal Medicine, Attikon University General Hospital, National
and Kapodistrian University Of Athens, Greece
Katerina Kampoli
Attikon General University Hospital of Athens, Greece
Eirini Theochari
General Hospital Asklepieio Voulas, Greece
Athanasia Papadopoulou
Papadopoulou, Second Department of Psychiatry, Attikon University General Hospital,National and Kapodistrian
University of Athens, Greece
Rossetos Gournellis
Second Department of Psychiatry, Attikon University General Hospital,National and Kapodistrian University of Ath-
ens, Greece
Ioannis Michopoulos
Second Department of Psychiatry, Attikon University General Hospital,National and Kapodistrian University of Ath-
ens, Greece

Abstract
Background: Enhancing our understanding of cognitive factors, such as Early Maladaptive Schemas (EMS), in lung
cancer patients and exploring their relationships with anxiety, depression, and resilience could significantly improve
the quality of health services provided.
Aim: The aim of this study was to assess anxiety, depression, resilience and EMS in lung cancer patients undergoing
immunotherapy and compare them with individuals without cancer.
Methods: This case-control study was conducted in the Outpatient Department at Attikon University Hospital, Ath-
ens, Greece, from April 2022 to May 2023. A convenience sample consisting of 50 lung cancer patients and 50 controls
was used. Data collection included the Hospital Anxiety and Depression Scale (HADS-A and HADS-D), Connor-David-
son Resilience Scale (CD-RISC2), Young Schema Questionnaire-Short Form 3 (YSQ-S3), as well as demographic and
clinical information.
Results: The prevalence of anxiety and depression among lung cancer patients was 28% and 30%, respectively, com-
pared to 14% and 6% in the non-cancer sample, with a cutoff score of 8 on the HADS-A and HADS-D subscales. While
there was no statistically significant difference in anxiety prevalence between the two groups (p=0.087), there was
a significant difference in depression prevalence (p=0.002). Resilience levels showed no significant differences be-
tween the groups (p=0.449). Four EMS differentiated the groups: Emotional Deprivation, Vulnerability to Harm or
Illness, Enmeshment/Undeveloped Self, and Negativity/Pessimism. These schemas were used as dependent variables
in four stepwise multiple linear regression analysis models to determine if group (patient or control) was a significant
explanatory variable; the analyses indicated no differences between the patient and non-patient groups. Within the
patient group, women exhibited higher levels of Failure (p=0.001), Vulnerability to Harm or Illness (p=0.006), and
Enmeshment/Undeveloped Self (p=0.021). Employed patients showed elevated levels of Approval-Seeking/Recogni-
tion-Seeking compared to those who were unemployed (p=0.039). Patients with a psychiatric history demonstrated
significantly higher levels of Failure (p=0.004), Dependence/Incompetence (p<0.001), Vulnerability to Harm or Illness

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(p=0.023), Enmeshment/Undeveloped Self (p=0.012), Subjugation (p=0.004), and Insufficient Self-Control/Self-Dis-
cipline (p=0.022). Patients receiving psychiatric medication exhibited higher levels of Dependence/Incompetence
(p=0.001) and Subjugation (p<0.001). Smokers reported higher levels of anxiety (p=0.026) and depression (p=0.012),
as well as increased levels of Emotional Deprivation (p=0.036), Abandonment/Instability (p=0.030), Mistrust/Abuse
(p=0.006), Defectiveness/Shame (p=0.016), Self-Sacrifice (p=0.033), Insufficient Self-Control/Self-Discipline (p=0.009),
and Negativity/Pessimism (p=0.004). Most of the EMS were positively correlated with anxiety and depression and
negatively correlated with resilience.
Conclusions: Lung cancer patients had a significantly higher prevalence of depression compared to the non-patient
group. However, there were no significant differences in anxiety, resilience, or EMS between the two groups. Notably,
smokers within the patient group displayed higher levels of EMS than non-smokers. These findings underscore the
importance of psychological screening and interventions tailored to the specific needs of lung cancer patient

Keywords
lung cancer, anxiety, depression, resilience, early maladaptive schemas

PO6 Understanding the Interplay of Compassionate Care

and Work Dynamics in Healthcare
Vesna Antičević
University of Split, University Department of Health Studies, Croatia

Abstract
Introduction: Patients, their families and clinicians recognize compassion as an important standard of health care and
one of the key components of the experience of health care users. Despite the numerous advantages of compassion-
ate healthcare and the commitment of healthcare professionals, it is still missing or almost completely absent in many
healthcare systems.
Aims: This study aimed to verify the psychometric characteristics of the Compassion Scale and examine the contri-
bution of patient-centered compassionate care (including kindness, indifference, mindfulness and humanity) to the
generative commitment, work related locus of control, and the perception of psychological demands in nursing.
Methods: The study employed a cross-sectional design conducted in June 2023, involving 183 female nurses working
at Clinical Hospital Centre Split. Questionnaires used included Spector’s Work Locus of Control Scale, Psychological
Job Demands and Job Control Scale, Generative Commitment Scale, and Compassion Scale.
Results: Factor analysis of the Compassion Scale confirmed four latent factors (kindness, indifference, mindfulness
and humanity), together explaining approximately 50% of the variance in compassion. Generally, nurses evaluated
their own sense of compassion, control over working demands, and work commitment with high scores, perceiving
nursing as psychologically demanding profession and attributing their work success predominantly to internal fac-
tors. Regression analyses revealed significant correlations: Kindness positively correlated with internal locus of control
at work (β=0.20, p=0.009), greater commitment to work (β=0.43, p<0.001), and perception of greater psychological
demands at work (β=0.15, p=0.049). A more humane attitude towards patients was associated with giving less impor-
tance to external factors at work (β=-0.16, p=0.043), while focused awareness of patients’ needs was associated to a
greater sense of control over job demands (β=0.16, p=0.032).
Conclusion: The Compassion Scale was found to be suitable for use on Croatian population. Nurses assessed their
patient-centered compassion levels, commitment to their vocation, and a sense of control over work demands with
high scores. Professional success was attributed to their own commitments and abilities. Higher levels of kindness,
humanity, and focused awareness positively affected nurses' perception of professional demands.

Keywords
compassion, perception of psychological demands and job control, generative commitment, locus of control, nursing

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PO7 Predictors and outcomes of loneliness in first year engineering students

Vanja Putarek
Kutak za mene d.o.o., Croatia
Juraj Petrović
University of Zagreb Faculty of Electrical Engineering and Computing, Croatia

Abstract
Loneliness is a state experienced when people perceive the discrepancy between the desired quality or quantity of
interpersonal relationships and those that they currently have. Loneliness is positively related to mental health prob-
lems, such as depression and anxiety, and is especially widespread during adolescence and transition to college. Giv-
en the importance of loneliness for college adjustment, in this research we focused on the predictors and outcomes of
loneliness in first year engineering students. According to Beck’s cognitive theory (Beck, Rush, Shaw, & Emery, 1979),
dysfunctional beliefs make individuals vulnerable to mental health issues. Dysfunctional beliefs are rigid and distort-
ed thoughts that people hold about themselves, the world, and the future. Beck’s cognitive model assumes that these
beliefs shape an individual’s attention, perception, and interpretation of situations. They, therefore, have a key role
in forming and maintaining maladaptive behaviors. Given the importance of dysfunctional beliefs, in this research
we focused on examining whether dysfunctional beliefs predict loneliness and whether they predict depression and
distress via loneliness. In other words, the aim of our research was to explore mediation model in which dysfunctional
beliefs were defined as predictors of loneliness, and depression and distress as outcomes of loneliness. The aim of
the research was also to explore differences in loneliness depending on gender, whether students were raised in the
place of study or moved to the place of study, and usage of social networks. Research participants were 429 first year
engineering students. Data were collected using DAS-A, UCLA Loneliness Scale, DASS-21, Social Network Usage Scale,
and sociodemographic questionnaires. We firstly conducted confirmatory factor analysis and obtained two factors
(Perfectionism and Dependency) from DAS-A, one factor from UCLA Loneliness Scale, two factors from DASS-21 (De-
pression and Distress), and two factors from Social Network Usage Scale (Compulsivity and Ignorance of obligations).
Research results suggest that loneliness mediated between dysfunctional beliefs (i.e., Perfectionism subscale) and
outcomes. Higher perfectionism predicted higher loneliness which further predicted higher depression and distress.
The analysis revealed no gender differences in loneliness. Students who were raised in the place of study have lower
loneliness compared to students who moved to the place of study. Additionally, students who were more inclined
to use social networks reported higher loneliness. Our results show that loneliness has a significant role in students’
depression and distress. In accordance with Beck’s cognitive theory, this research supports the hypothesis that dys-
functional beliefs act as an important predictor of mental health problems. In line with research results, it seems
that students who move to the place of study, as well as students who use social networks more frequently are an
especially vulnerable population regarding loneliness. Results of the conducted research could be helpful for mental
health professionals working with students, signifying the need for considering students’ dysfunctional beliefs and
providing more attention to students who were not raised in their place of study.

Keywords
loneliness; dysfunctional beliefs; depression; distress; engineering students

PO8 Evaluating CBT in correctional settings - sex offender treatment

Branka Bagarić, Croatian Association for Behavioral and Cognitive Therapy / KBT, psychotherapy, education, and
software solutions, Croatia
Dragana Markanović, Croatian Association for Behavioural and Cognitive Therapies/ RESTRUCTA, psychotherapy,
education, and software solutions, Croatia
Mia Mudri, SOS Rijeka - centre for nonviolence and human rights, Croatia
Luka Mijalković, University Psychiatric Hospital Sveti Ivan, Croatia
Bernardica Franjić-Nađ, Juvenile Correctional Institution, Prison System and Probation Directorate, Ministry of Jus-
tice and Public Administration, Croatia
Smiljka Baranček, Training Center, Prison System and Probation Directorate, Ministry of Justice and Public Adminis-
tration, Croatia

Abstract
The primary aim of offender treatment is to reduce reoffending. Evaluating offender treatment is particularly chal-
lenging; randomised control trials are rarely used due to legal and ethical concerns and both self-report measures
with prisoners and reoffender rate data have considerable limitations. However, evaluating and improving sex offend-
er treatment is important for public safety and social reintegration of offenders.
Most offender treatments are CBT based, including PRIKIP – 6 months group program for sex offenders in Croatia.

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Data presented here, self-report data, are part of a larger evaluation project funded by the Ministry of justice and
public administration of Croatia. The aim of the project was to evaluate the PRIKIP program and its implementation,
as well as to suggest improvements in the existing evaluation procedure.
Data was available for a total of 155 male prisoners who participated in the PRIKIP program between 2013. and 2017.
Participants were sentenced to 1.5 to 14.5 years in prison for sex crimes and were serving their sentence in 4 different
prisons in Croatia. They filled a series of questionnaires prior and after participating in the program.
The results showed an improvement in several measures following the program, such as having higher motivation for
change, being more critical towards the committed felony, and having a more positive attitudes toward victims of sex
crimes. However, the main conclusion of this part of the evaluation project was that the evaluation design needs to
be improved and data gathering procedure systematised. This project presents a first step in this direction. Improving
the quality of PRIKIP evaluation will allow for more valid conclusions about this treatment to be made.

Keywords
CBT in correctional settings; sex offender treatment; forensic CBT; treatment evaluation

PO9 Does Emotion Regulation Group Therapy for Adolescents (ERGT-A) work
in routine outpatient care ?
Dimitar Krastev
PRIMA Child Psychiatry, Stockholm, Sweden
Hanna Sahlin
Karolinska Institutet, Sweden

Abstract
While deliberate self-harm (DSH) is prevalent and increasing among adolescents, evidence-based treatments suitable
for routine outpatient care are scarce. Emotion Regulation Group Therapy (ERGT) has proven effective in adults, and
its online adaptation för adolescents shows promise. Adjusted for adolescents, a 12-week Emotion Regulation Group
Therapy for Adolescents (ERGT- A) with special care to prevent social contagion, may offer benefits beyond reducing
DSH.
This study aimed to study the feasibility, acceptance and preliminary effects of ERGT- A as an adjunctive treatment
for adolescents with DSH in routine outpatient care. Particular focus was placed on patient safety, reducing the risk of
potential negative effects and gaining insights into data collection procedures, outcome measures, and preliminary
efficacy, in preparation for a potential randomized control trial.
The study was approved by Swedish Ethical Review Authority and 13 participants, and 13 caregivers has thus far been
included. A treatment manual has been adapted including: 1) shortening the treatment, 2) simplifying the language,
3) providing age-appropriate examples and 4) developing a parallel parent program (5 sessions) that mirrors the
adolescents’ sessions. ERGT-A is a skills-based treatment and teaches topics such as the increasing awareness of the
function of DSH, functionality of emotions, negative consequences of controlling emotions, non-avoidant emotion
regulation strategies, and impulse-control strategies. Besides following the content of ERGT-A the parent manual ad-
dressed specific parental topics such as: reducing self-harm contagion, validation and self-validation, assertive com-
munication and self-care.
Feasibility was assessed through eligibility rates, number and proportion of consenting participants attending at
least six of 12 sessions, data completeness and participant retention with the drop-out rate indicating ERGT-A tol-
erance. Attendance in over half of the ERGT-A sessions indicated feasibility. Potential negative effects were moni-
tored through patients’ weekly DSH records and safety analysis included calculating frequencies and rates of adverse
events, including increases in DSH. The preliminary effect of ERGT-A was assessed through self-report measures on
self-harm frequency, impulsive, destructive behaviors, emotion regulation and clinician rated functional impairment,
administrated pre- and post-treatment.
Recruitment proved straightforward, and participants were divided into two age cohorts: 13-14 and 15-17. A total of
13 adolescents and their parents completed all sessions in two routine outpatient Child & Adolescents Psychiatry Ser-
vices with attendance rates 90 % for children, 82 % for parents. Few adverse effects were reported. Preliminary results
regarding DSH frequency were promising. The study demonstrated successful recruitment and retention, acceptable
and feasible study procedures, acceptable intervention, with minor adaptations, indicating potential to help adoles-
cents with DSH. In depth interviews with the participants, exploring their experiences of the treatment, are ongoing
and a randomized controlled trial is in its planning stage.

Keywords
non-suicidal self-injury, deliberate self-harm, group therapy, adolescents, parent program

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PO10 The effect of inhibition on the spread of uncertainty and checking in

certain situations
Hodaya Adler, Bar Ilan University, Ramat Gan, Israel, Israel
Renana Eitan, Tel-Aviv Medical Center, Israel
Omer Linkovski, Bar Ilan University, Ramat Gan, Israel, Israel

Abstract
Difficulty tolerating uncertainty is a central deficit across psychopathologies, and a common response to it is check-
ing. Inducing inhibition improves resolution of uncertainty. However, it is unclear whether inducing inhibition im-
proves decision-making under conditions of uncertainty or whether it reduces checking behavior, which is a common
response to uncertainty. In this study we evaluated how inducing inhibition affects resolving uncertainty with and
without checking.
Healthy adults (N=34) completed three experiments combining an inhibition-induction task with a novel visu-
al-matching task, which dissociated resolving uncertainty from checking. In Experiment 1, the visual-matching task
included only “certainty” trials with unlimited checking. In Experiment 2, the task featured “certainty” and “uncertain-
ty” trials, without checking. In Experiment 3, the task featured “certainty” trials, without checking.
Our results showed that inhibition decreases checking even in certain situations and influenced decision-making in
a unique way. the results demonstrated that people tend to overestimate likelihood of uncertainty and wrongfully
identify uncertainty. Inducing inhibition attenuates this tendency and improves the number of correct rejections of
possible uncertainty. Given this pattern of results, we suggest that inducing inhibitory control improves the ability
to tolerate uncertainty when checking is improbable. The cognitive and clinical implications of our findings will be
discussed.

Keywords
Uncertainty; Intolerance of uncertainty; Stroop; Inhibition; Executive functions; Checking.

PO11 Superior Treatment Outcomes for Socially Anxious Patients with

Comorbid Depression by Integrating Cognitive Behavioral Therapy and
Psychodrama
Hanieh Abeditehrani
University of Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands
Corine Dijk
University of Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands
Arnoud Arntz
University of Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands

Abstract
Although cognitive behavioral group therapy (CBGT) is effective for social anxiety disorder (SAD), there are mixed
results on whether comorbid depression influences the effectiveness of CBGT for SAD. Experiential therapy such as
psychodrama (PD) provides emotional processing opportunities during anxiety-provoking reenactments. Integration
of CBGT and PD (labeled CBPT) might optimize outcomes for SAD patients with comorbid depression. We assessed
whether comorbid depression moderated treatment effects on social anxiety, both post-treatment and at six-month
follow-up. Patients with SAD (N=108) were randomly assigned to CBGT (n=36), PD (n=36), or CBPT (n=36). Depression
was assessed with the Beck Depression Inventory II (BDI-II) and diagnosed using the structured clinical interview for
DSM-IV (SCID-I). Moderation analysis showed there was an interaction between the level of depression and treatment
condition. Simple regressions showed that SAD patients with depression benefited more from CBPT than from PD or
CBGT in reducing social anxiety. Depression was related to better outcomes in decreasing fear of negative evaluation
for CBPT compared to PD, and this effect was sustained at follow-up. Additionally, higher BDI-II scores were associated
with increased dropout rates in PD compared to CBPT. Overall, the findings suggest that CBPT provides greater bene-
fits for treating SAD patients with comorbid depression.

Keywords
integrative therapies, cognitive behavioral therapy, psychodrama, comorbid depression

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PO12 Understanding Negative Interpretation Biases in Loneliness: Exploring

Associations with Depression and Social Anxiety
Carmen van den Bulck
University of Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands, Netherlands
Corine Dijk
University of Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands, Netherlands
Arnold van Emmerik
University of Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands, Netherlands
Marlies Maes
Utrecht University, Netherlands
Maaike Verhagen
Radboud University Nijmegen, The Netherlands, Netherlands
Jan Henk Kamphuis
University of Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands, Netherlands

Abstract
Introduction: In 2022, the prevalence of individuals who reported feeling lonely most or all of the time was 13%, high-
lighting loneliness as a major problem. Cognitive theories of loneliness propose that individuals who feel lonely tend
to negatively interpret ambiguity in social situations. This negative interpretation of social situations can reinforce
social withdrawal and contribute to the severity and persistence of loneliness. However, loneliness often co-occurs
with mental health conditions such as depression and social anxiety, that are also marked by negative interpretation
biases. Considering this overlap, it remains unclear whether negative interpretation biases of social situations in lone-
liness are explained by these co-occurring conditions rather than uniquely related to loneliness. This study examined
whether loneliness is associated with negative interpretation of ambiguous social situations, and if this relationship
remains after controlling for the effects of social anxiety and depression.
Method: Two hundred university students were recruited. Participants completed a survey that included the UCLA
Loneliness Scale (UCLA), the Social Interaction Anxiety Scale (SIAS), the Center for Epidemiologic Studies Depression
Scale (CES-D), and a questionnaire that assessed the likelihood of negative interpretations in social situations. The
study is approved by the ethics board of the Faculty of Social and Behavioural Sciences of the University of Amster-
dam.

Results: The data collection has been finished in May 2024. Preliminary hierarchical regression analyses demonstrated
that, without controlling for social anxiety and depression, loneliness was a significant predictor (β = -.41, p < .001)
and explained a significant proportion of the variance (16%) in negative interpretation biases in social situations.
However, when social anxiety and depression were taken into account, this effect did not remain. The combination
of loneliness, depression, and social anxiety explained a significant proportion of the variance (29%) in negative in-
terpretation biases in social situations, with social anxiety being the only significant predictor (β = -.42, p < .001). The
final results will be presented at the conference.
Discussion and conclusion: To our knowledge, this is the first study to examine negative interpretation biases focusing
on ambiguous social situations in loneliness. A better understanding of interpretation biases in loneliness can inform
the development of interventions, such as cognitive behavioral therapy or cognitive bias modification techniques.
This is necessary because existing loneliness interventions are only moderately effective, with elevated levels of lone-
liness remaining post-intervention. Our preliminary results indicated that the negative interpretation biases related
to loneliness might be better explained by social anxiety. Considering this overlap, further research is necessary to
examine whether loneliness is best treated with existing interventions for social anxiety.

Keywords
Loneliness, Social Anxiety, Depression, Interpretation bias

PO13 Working with thoughts, what do we know about them?

Daria Pereverzeva
Moscow State UNiversity, Russian Federation

Abstract
Why does psychotherapeutic work lead to rapid and lasting changes in some cases, but not in others? Within the
framework of CBT and the schema therapy approach, we appeal to the person’s thoughts. Therefore, one of the factors
on which the persistence of symptoms may depend is cognitive characteristics, including executive functions (Olley,

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2007; Manarte, 2021; Schmid & Hammar, 2021). A promisimg scientific paradigm that allows us to better understand
this relationship is to conduct studies on a group of individuals who are at high and very high risk of developing neu-
ropsychiatric diseases. This group consists, for example, of people who have a premutation of the FMR1 gene. Studies
have shown that up to 70% of individuals with an FMR1 premutation have an anxiety disorder, 40% have depression,
18-27% OCD (Wadell, 2013, Hagerman, 2018), 14-45% ADHD.
The study involved 15 women with a premutation of the FMR1 gene and 30 women without the genetic abnormality.
The cognitive assessment included a battery of tests measuring executive functions (working memory, flexibility and
inhibitory control). The results reveal a decrease in the flexibility of thought processes and a general increase in reac-
tion time in the experimental group compared to the central. In the report, we will consider the characteristics of the
clinical group and the pathogenetic mechanisms of the development of neuropsychiatric diseases, address the issues
of comorbidity of disorders, and discuss the possible role of the cognitive component in the dynamics of symptoms.

Keywords
executive functions, neuropsychiatric disorders

PO14 Online CBT Therapy for Agoraphobia: A Case Study

Selin Tutku Tabur
Hasan Kalyoncu University, PhD in Clinical Psychology, Turkey
Hakan Turkcapar
Social Sciences University of Ankara, Turkey

Abstract
Introduction: CBT is recognised as the gold standard in the treatment of panic disorder and agoraphobia (Tolin, 2010).
Studies have shown that online CBT targeting panic disorder or panic symptoms is used and effective in treatment
(Furukawa et.al., 2006). As a result of systematic reviews, it was concluded that there are few studies on online CBT
for panic disorder and agoraphobia (Berryhill et.al., 2019). Although there are studies on the effects of intensive CBT
programmes, more studies and case results are needed for online therapy where the normal protocol is given without
intensification. In this study, it was aimed to contribute to the literature on the effect of a non-intensive, standard CBT
protocol on agoraphobia online.
CASE: A 33-year-old male client with a diagnosis of agoraphobia and panic attacks according to the Diagnostic and
Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD) criteria received
8 sessions of CBT via Zoom. The presence and severity of panic disorder and agoraphobia symptoms were assessed
using self-report scales and clinician-rated scales. To test efficacy, self-report scales were given at the beginning and
end of the therapy process. Panic and Agoraphobia Scale (PAS), Agoraphobic Cognitions Questionnaire (ACQ) were
used. CBT provided via video call over the Internet was conducted remotely online without any face-to-face contact
with the therapist during the intervention. In addition, a follow-up interview was planned 3 months after the therapy
to investigate the effect of the treatment. The client's panic symptoms, agoraphobia symptoms and avoidance disap-
peared as a result of online therapy. The client did not meet the diagnostic criteria. The results are shown with before
and after scales. The client's PAS score was 0 after 8 interviews. ACQ responses; he rarely answered 4 questions and
never answered the others. These thoughts were asked to the client at the beginning and at the end of the therapy
process; the question ‘How much do you believe each of these thoughts when you experience panic symptoms?’
was answered 95% at the beginning and 0% at the end of the therapy. In the follow-up interview 3 months later, the
client stated that she did not experience any difficulty, she did not experience avoidance, and although she had these
thoughts, her belief in them was 0%.
Discussion: In recent years, many studies have shown that the application of CBT in an intensive time period (2-10
days) in the treatment of panic disorder and/or agoraphobia can provide significant reductions in symptoms (Stech
et.al., 2020). This study with a non-intensive program reveals that CBT can also help in this way. The effect of expo-
sure-based online CBT remains unclear (Stech et.al., 2020). This study supports that exposure studies can also be
effective for online CBT.
Conclusions: This study demonstrates that normal protocol CBT with online videoconferencing can be effective in the
treatment of agoraphobia. Difficulty in establishing and maintaining the therapeutic alliance and exposures targeted
in face-to-face therapy should not be a concern.

Keywords
agoraphobia, online therapy, cognitive behavioral therapy

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PO15 Mapping digital interventions for coping with different stressors: A

scoping review
Rita Sebastião
School of Psychology, ISPA-Instituto Universitário; APPsyCI – Applied Psychology Research Center Capabilities &
Inclusion, Portugal
Pedro Rodrigues Ribeiro
School of Psychology, ISPA-Instituto Universitário; APPsyCI – Applied Psychology Research Center Capabilities &
Inclusion, Portugal
Eduardo Sardinha
School of Psychology, ISPA-Instituto Universitário; APPsyCI – Applied Psychology Research Center Capabilities &
Inclusion, Portugal
Cátia Castro
School of Psychology, ISPA-Instituto Universitário; APPsyCI – Applied Psychology Research Center Capabilities &
Inclusion, Portugal
David Dias Neto
Associação Portuguesa de Terapias Comportamental, Cognitiva e Integrativa, Portugal

Abstract
Background: Stress, from different sources, can negatively affect mental health. Digital interventions to cope with
stress seem effective in protecting mental health. However, the characteristics of digital psychological interventions
for different stressful events are presented unclearly.
Objective: This scoping review aimed to map the literature about digital psychological interventions to cope with
different stressful events in the general population. The primary aim of this scoping review was to catalogue the com-
ponents of psychological interventions so that they might inform the development of a digital intervention to cope
with different stressful events. The secondary aims were to identify models, theories, or principles that have been
used to conceptualise and integrate into the interventions, as well as potential barriers and facilitators that have been
reported about the success of the intervention.
Inclusion criteria: This scoping review considered studies of digital psychological interventions to cope with stress,
that identify the source of stress and are intended for individuals from the general population. In all settings through
digital technologies.
Methods: This review was conducted following the JBI methodology for scoping reviews. The APA PsycINFO, MED-
LINE, Scopus, and Web of Science databases were searched for published articles. Literature published in English,
Portuguese, and Spanish was considered for inclusion. Independent reviewers screened the articles for relevance
against the inclusion criteria.
Results: Of the 5867 articles identified for this review, 131 were included. Twelve themes of components that have
been included within a psychological intervention were derived through thematic analysis of the scoped literature.
The themes were meaning and values, identification and awareness, social connection, relaxation, skills develop-
ment, empowering and compassionate verbalization, information and psychoeducation, behaviour change, inter-
vention monitoring and review, acceptance and defusion, thoughts change and emotional management. The most
frequently reported models, theories, or principles that were utilised to conceptualise and integrate into the interven-
tions were the Cognitive Behavioural Therapy (CBT) approach (n = 39, 29.8%), followed by mindfulness approaches
(n = 29, 22.1%), a mix between CBT and mindfulness approaches (n = 11, 8.4%) and Acceptance and Commitment
Therapy (n= 9, 6.9%). Regarding barriers and facilitators, 50 articles referred to that and it reflects individual factors,
distribution options, practical issues, support, design, content, and other factors.
Conclusions: The scoping review methodology does not attempt to assess the quality of evidence. Further research is
required to determine the relative importance of these different components, barriers, and facilitators of psychologi-
cal intervention from the perspective of the target user.

Keywords
stress; stressors; digital intervention; scoping review; cognitive behavioural therapy

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PO16 Early Detection of Gambling Disorder Risk Factors Among European

Adolescents: A Machine Learning Approach with a Gender and Cross-Cultural
Perspective
Gemma Mestre-Bach
Universidad Internacional de La Rioja, Spain
Giulia Testa
Universidad Internacional de La Rioja, Spain
Ernesto Tarragón
Universidad Internacional de La Rioja, Spain
Almudena Ruiz
Universidad Internacional de La Rioja, Spain
Oscar Garcia Garcia
Universidad Internacional de La Rioja, Spain
Vicente Soriano
Universidad Internacional de La Rioja, Spain

Abstract
Background: The increasing prevalence of gambling disorders (GD) among adolescents represents a significant public
health concern.
Aims: This study aims to harness advanced machine learning (ML) techniques to identify predictive patterns of GD
risk factors in a large and diverse sample of European adolescents. Utilizing the dataset from The European School
Survey Project on Alcohol and Other Drugs (ESPAD), encompassing a large sample of adolescents from 35 European
countries, we explored potential gender-related differences and cross-country variations in GD risk factors.
Methods: Our methodology integrated mixed techniques, including statistical analysis and ML, focusing on cluster
analysis to identify distinct groups of adolescents sharing similar behavioral patterns and risk factors. Gender differ-
ences and country-specific variations were also examined to tailor early detection strategies more effectively.
Results: The study revealed distinct predictive patterns of risk factors associated with GD, highlighting significant
gender differences and cross-country variations. Our findings suggest tailored interventions could be more effective
in addressing the specific needs of at-risk groups.
Conclusions: By identifying specific risk profiles among European adolescents, this research contributes to the devel-
opment of more targeted early intervention. This study emphasizes the need for gender-sensitive approaches and
acknowledges the importance of cultural differences in shaping gambling behaviors.
Recommendations for Cognitive Behavioral Therapy (CBT): Given the identified risk patterns, CBT interventions should
incorporate strategies that address the unique psychological and social dynamics associated with GD risk factors.
Tailoring CBT approaches to consider gender-specific needs and cultural contexts can enhance their effectiveness in
preventing GD among adolescents.

Keywords
gambling disorder; CBT; adolescents; risk factors

PO17 Parental Involvement in an Early Intervention for Anxiety-Prone

Toddlers and Preschoolers
Leonie Vreeke
Leiden University, Netherlands
Nina Komrij
Leiden University, Netherlands

Abstract
The high prevalence, negative outcomes, and ongoing nature of anxiety problems underscore the need for early and
effective interventions. Already during toddler age, some children show signs of excessive anxiety. One of these signs
is behavioral inhibition, in which a child exhibits withdrawn and shy behavior in unfamiliar or challenging situations
and with unfamiliar people (e.g., Clauss & Blackford, 2012; Paulus, Backes, Sander, Weber, & von Gontard, 2014). Re-
search has shown that behavioral inhibition can be reliably observed at an early age (e.g., Vreeke et al., 2012). There-
fore, this temperament may play a crucial role in identifying children at increased risk of anxiety problems, who may
benefit from early intervention. This intervention should focus in particular on the way parents deal with their anxious
children. Parents of anxious children often exhibit anxious behavior themselves and can model this behavior for their

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children (e.g., Bögels & Brechman-Toussaint, 2006). In addition, these parents tend to be overprotective of their anx-
ious children, which can interfere with the development of autonomy (Ginsburg et al., 2017). The lack of exposure
to challenging situations and thus the lack of learning opportunities for successful coping skills ultimately lead to
increased anxiety (Beato, Pereira, Barros, & Muris, 2015).
Rapee and colleagues (2005; 2010) developed an early intervention program for anxious preschoolers. This program,
called Cool Little Kids (CLK), is short-term and focuses on the anxious and over-controlling parenting behaviors of par-
ents and on reducing anxious behaviors in the children. The program focuses on groups of about six parent couples
and uses Cognitive Behavioral Therapy elements. Parents were psychoeducated about the nature of behavioral inhi-
bition and anxiety and taught techniques to reduce these behaviors in their children. The studies of the CLK program
in anxious Australian preschoolers have yielded positive results (Kennedy et al., 2009; Rapee et al., 2005; Rapee, Ken-
nedy, et al., 2010). In this study, the effectiveness of the Cool Little Kids program was investigated in a first sample in
the Netherlands. In a randomized controlled trial (RCT), parents of anxiety-sensitive children were randomly assigned
to either the CLK intervention condition or the control condition.
The results of this study show that early intervention through parental training can reduce anxiety problems in young
children and prevent further development of anxiety problems. Further implementation of this intervention program
in the Netherlands seems promising.

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

PO18 Improving Psychological Well-being: Introducing Rational Emotional

Behavioral Therapy in Romanian High Schools
Ana-Maria Jura
West University of Timisoara, Romania

Abstract
The current study focuses on implementing a group intervention based on Rational Emotional Behavioral Therapy in
two high schools in Romania. Rational Emotive Behavior Therapy (REBT) was pioneered by psychologist Albert Ellis
in the 1950s as a form of cognitive behavioral therapy. The primary objective of REBT therapy is to assist individuals
in comprehending and effectively handling irrational thoughts and negative emotions that could be contributing to
their psychological distress. REBT therapy is commonly used to address various psychological issues, including anx-
iety, depression, stress, anger, substance addiction, and more. This project focuses on 10th grade students from the
National College “Traian Lalescu” Reșita Romania and the Theoretical High School “Traian Vuia” Reșita, Romania. The
study aims to improve academic students’ mental health and reduce stress using Rational-Emotive and Behavioral
Therapy-based personal development programs. The research involved 90 tenth-graders from two western Roma-
nian high schools. The intervention, led by an educational management masters-degree psychologist, who substi-
tuted psychology classes in the treatment groups, while control groups attended regular psychology lectures. The
intervention in this study is conducted through four group sessions, each lasting 50 minutes. The first session intro-
duces the program, focusing on the foundations of REBT and improving self-esteem. The second session delves into
the ABCs of emotion, focusing on the difference between rational and irrational thinking. The third session focuses
on anxiety, academic expectations, and coping strategies in anxious situations. The fourth and final session focuses
on empowering change by mastering problem-solving and challenging irrational beliefs. This final session focuses
on exposure to in vivo home tasks and practicing using REBT concepts. The goal is to help students understand and
manage illogical thoughts and emotions that may be causing psychological suffering.
The study included a control group consisting of 10th grade students who were enrolled in psychology classes as part
of their school curriculum. The experimental group, on the other hand, comprised students who were scheduled to
take part in four group sessions that focused on the principles of Rational Emotional Behavioral Therapy.

Keywords
Rational Emotional Behavioral Therapy, REBT, students, intervention, control group

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PO19 What do healthcare professionals need from CBT? Investigating

LGBTQ affirmative attitudes and needs for better practice among Hungarian
healthcare workers
Gabriella Vizin
ELTE Eötvös Loránd University, Hungary
Tamara Szabó
ELTE Eötvös Loránd University, Hungary
Róbert Urbán
ELTE Eötvös Loránd University, Hungary

Abstract
Background: Attitudes related to LGBTQ (lesbian, gay, bisexual, transgender, queer) people were examined in several
areas in Hungary, however, a comprehensive examination of health professionals’ attitudes towards LGBTQ people
has not yet been carried out. LGBTQ people often do not seek health care and do not identify as LGBTQ people be-
cause of fear of judgment, stereotyping, and discrimination by health professionals. All of this is a particularly worry-
ing phenomenon, because various mental difficulties, risky behaviours, and certain types of somatic and psychoso-
matic diseases may appear in a higher proportion among them.
Methods: In a cross-sectional online survey, we asked healthcare professionals (medical doctors, nurses, other grad-
uate healthcare professionals and medical university students) to fill out our questionnaire (N=377). The participants
completed the Modern Homonegativity Scale and the Lesbian, Gay, Bisexual and Transgender Clinical Skills Develop-
ment Scale.
Results: The majority of Hungarian healthcare professionals have LGB patients, but not transgender patients. When
healthcare workers have LGBT patients, they have more positive attitudes toward LGBT people. Comparing the three
groups of healthcare workers (medical doctors, psychologists, other healthcare professionals), Hungarian psycholo-
gists have the lower negative attitudes and higher affirmative skills towards LGBT people.
Conclusions: There is an urgent need to provide the appropriate affirmative knowledge material (such as AFFIRM CBT
or LGBTQ Affirmative CBT) to Hungarian healthcare workers.

Keywords
LGBTQ affirmative practice, Hungarian healthcare workers, affirmative CBT

PO20 Overthinking, mind-wandering and maladaptive daydreaming:

investigating similarities and differences into two case studies
Katia Carbé
Les Toises - Psychiatry and Psychotherapy Center, Switzerland
Maxime Naudy
Les Toises - Psychiatry and Psychotherapy Center, Switzerland

Abstract
Maladaptive daydreaming is associated with excessive fantasy that is not recognized by any major medical or psy-
chological criteria, but it is considered as a dysfunctional coping strategy observed in several mental disorders (e.g.,
dissociative disorder, ADHD, Obsessive-Compulsive Spectrum Disorder, behavioral addiction, major depression and
anxiety disorder) (Somer et al., 2016; Somer, 2018). We investigate two patients presenting excessive daydreaming
(i.e., maladaptive daydreaming), which has caused them distress, and probably favored the risk of chronicity of their
clinical psychiatric disorders (i.e., anxiety and depression). In order to control their maladaptive daydreaming, we
have treated these patients by cognitive behavioral therapy (CBT), and we have investigated its efficacy by collecting
patients’ responses in the 16-item Maladaptive Daydreaming Scale (16-MDS; Somer et al., 2016), before and after
the treatment. As data have shown, they have responded favorably to several CBT attention-focused and grounding
techniques (e.g. mindfulness, body scan, five senses) (Wells, 1990, 2011; Fergus et al., 2014). We reviewed the available
literature regarding similar phenomena such as overthinking and mind-wandering (e.g., Christoff et al., 2016; Matsu-
moto & Mochizuki, 2018; Flaherty et al., 2022). However, the lack of extensive literature on the topic does not allow to
clearly disentangle these phenomena which are cognitively similar and different at the same time.

Keywords
maladaptive daydreaming, cognitive models, grounding techniques

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PO21 Trajectories of change in symptoms and interference among children

and young people receiving psychotherapy for anxiety problems: a
systematic review
Emily Whitaker
University of Oxford, United Kingdom
Chloe Chessell
University of Oxford, United Kingdom
Cathy Creswell
University of Oxford, United Kingdom

Abstract
Introduction:
Anxiety problems are among the most prevalent mental health difficulties in children and young people (Kessler et
al., 2005) and, left untreated, can lead to adverse outcomes in adulthood. Effective interventions are available, with
cognitive behavioural therapy (CBT) being the most widely used (James et al., 2020). However, there is heterogeneity
in both response during treatment and treatment outcomes. One way of ensuring CBT and other psychotherapies are
effective for as many children and young people as possible is to study trajectories of change during treatment. Iden-
tifying which particular groups of children and young people have a slower or poorer response during psychotherapy
can allow treatments to be adapted and personalised to better meet the needs of these groups.
This systematic review aimed to investigate this area by answering the following research questions: 1) What trajecto-
ries of change in symptoms and interference are observed among children and young people receiving psychothera-
py for anxiety problems? 2) What characteristics are associated with different classes of change trajectories?
Methods:
The review was prospectively registered on Prospero (CRD42024522248). Three electronic databases (PsycINFO, MED-
LINE and Embase) were searched for peer-reviewed articles and grey literature using search terms relating to: 1) Chil-
dren and young people; 2) Trajectory analysis; 3) Psychotherapy; 4) Anxiety. Hand searching was also conducted to
identify any relevant articles missed by the database searches.
Studies were included in the review if: 1) The participants were children and young people aged up to 18 years (inclusive)
receiving psychotherapy for problems with anxiety; 2) They used a longitudinal design that collects measures at three
or more timepoints; 3) The measures collected at these timepoints are standardised measures assessing participants’
anxiety levels (relating to symptoms or interference); 4) They used a trajectory analysis (for example, growth mixture
modelling (GMM) or latent class growth analysis (LCGA)) with the aim of identifying more than one trajectory class.
Titles and abstracts were screened against the inclusion criteria. The full text was read for any identified studies. Stud-
ies included in the final sample had relevant data extracted and had their quality assessed using the GRoLTS-Checklist
(Guidelines for Reporting on Latent Trajectory Studies; Van de Schoot et al., 2017).
Results:
Key information from the included studies will be presented, such as participant demographics, the type of psycho-
therapy received, analysis used, the different anxiety trajectories identified, and the characteristics that predict mem-
bership to different trajectories. The quality of the included studies will also be discussed.
Conclusions:
This is the first systematic review to explore trajectories of anxiety symptom and interference change among children
and young people receiving psychotherapy for anxiety problems. Identifying the different trajectories experienced
during psychotherapy is important for personalising treatment and improving outcomes.

Keywords
Anxiety; children and young people; psychotherapy

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PO22 A review of cognitive behavioral therapy (CBT) interventions targeting

problematic screen use in youths.
Louise Fugl Madelaire
Department of Child and Adolescent Psychiatry, Copenhagen University Hospital – Psychiatry Region Zealand, Den-
mark and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Den-
mark, Denmark
Juliane Dorthea Køhler Enevoldsen
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark, Den-
mark
Ole Jakob Storebø
Psychiatric Research Unit and Child and Adolescent Psychiatric Department, Region Zealand and Department of Psy-
chology, University of Southern Denmark and Research Director, Center for Evidence Based Psychiatry (CEBP), Den-
mark
Pia Jeppesen
Copenhagen University Hospital-Psychiatry, Denmark

Abstract
Background: The digital development of the past decades has resulted in remarkable changes in human behavior.
Although the digitalization has brought important tools and many opportunities in an interconnected world, it is con-
cerning that modern youths are spending a vast amount of their time on this passive, sedentary, and solitary activity
and are missing out on social, vigorous, and creative experiences. A mounting body of research indicates an associ-
ation between excessive screen time in youths and mental health problems. Despite the methodological challenges
in this research field, and the challenges with the evolving technology as a “moving target”, research findings indicate
that the impact of problematic screen use on youth mental health is substantial and suggests a need for intervention
in cases where problematic screen use affect youth mental health. Thus, we aimed to identify randomized controlled
trials (RCT) and other trials that evaluated cognitive behavioral therapeutic (CBT) programs targeting problematic
screen use in youths with the purpose of reducing anxiety, depression, behavioral and addictive problems in youths.
Methods: We performed a systematic literature search in Embase, Medline, PsychInfo and Cochrane Central using
all known terms that indicated problematic screen use including e.g. “internet addiction”, “problematic use of social
media” and “gaming disorder”. We included RCTs and non-RCTs testing a CBT intervention. Outcomes of interest were
change in screen time, addiction severity, and symptoms of depression, anxiety, and conduct problems.
Results: Thirteen studies (5 RCTs and 8 non-RCTs) totaling 1137 participants (age range 9-24 years) were identified.
The studies were published from 2010 to 2023. The intervention programs targeted solely Gaming Disorder (GD) (2
RCTs and 5 non-RCTs), or “social media addiction”, “internet use disorder”, “problematic gaming”, “internet addiction”
or “excessive smartphone use” (2 RCTs and 2 non-RCTs ), or a combination of these problems and disorders (1 RCT
and 1 non-RCT) in school-based or clinical samples of youths. The interventions were based on cognitive-behavioral
therapy methods and were delivered at schools or in a clinical context, group-based or individually with the youth
and/or the parents. Durations of the intervention programs ranged from 4 weeks to 6 months. Preliminary results of
the efficacy (between-groups differences in change of problematic screen use) and an evaluation of the quality of the
5 RCT studies will be presented on the congress.
Perspectives: The intervention manuals will be collected and potential promising common treatment elements will
be identified and integrated into the Danish Mind My Mind program[1], which is an evidence-based, transdiagnostic,
cognitive behavioral program for youths with emotional and behavioral problems.
References
[1] P. Jeppesen et al., ‘Effectiveness of Transdiagnostic Cognitive-Behavioral Psychotherapy Compared With Manage-
ment as Usual for Youth With Common Mental Health Problems: A Randomized Clinical Trial’, JAMA Psychiatry, vol. 78,
no. 3, Art. no. 3, Mar. 2021, doi: 10.1001/jamapsychiatry.2020.4045.

Keywords
Problematic screen use + emotional and behavioral problems + Transdiagnostic CBT

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PO23 Mental health literacy in Serbian adult population

Dragana Zanini
Faculty of Sport and Physical Education, Novi Sad, Serbia
Velinka Petrović
University of Belgrade, Faculty of Philosophy, Department of Psychology, Serbia
Ana Marković
Faculty of Philosophy, University of Novi Sad, Serbia
Nikola Đorđević
University of Nis, Faculty of Phylosophy, Serbia
Sanja Cvetanović
University of Nis, Faculty of Phylosophy, Serbia
Dragana Nedeljković
University of Belgrade, Faculty of Special Education and Rehabilitation, Serbia

Abstract
Background: The alarming results of cross-national analysis from 29 countries, published last year in Lancet Psychiatry,
stated that one of two people worldwide is at risk of facing with mental health disturbances during their lifetime (Mc-
Grath et al., 2023). The fact that majority of the affected people never receive treatment, especially in low- and middle
income countries, imposes great concern and call for public awareness about mental disorders. Hence, the first step
might be to ascertain mental health literacy (MHL) which indicates knowledge about ability to recognize, manage,
and prevent mental health issues and understanding the stigma associated with mental disorders (Jorm et al, 1997).
Higher MHL indicates higher probability to seek professional help when needed.
Aim: This research is aimed for establishing MHL in Serbian general population and score prediction based on so-
cio-demographic variables, resilience, coping strategies and help-seeking tendencies.
Methods: Overall, 209 participants of general population (F = 50,2%, mean age 38.44 ± 10.57, age range 19-68 y.) par-
ticipated in survey conducted online. The exclusion criteria from study were participants who have a degree or are in
the process of obtaining a degree in medicine and psychology. For measuring MHL, mental health literacy scale was
administrated (MHLS, O’Connor & Casey, 2015). The scale comprised 35 items, which consisted of ability to recognize
disorders, knowledge of where to seek information, knowledge of risk factors and causes, knowledge of self-treat-
ment, knowledge of professional help available and attitudes that promote recognition or appropriate help-seeking
behavior. Beside socio-demographic variables, as predictors were used short version of Connors-Davidson Resilience
Scale (CD-RISC10; Campbell-Sills & Stein, 2007), Mental health seeking attitudes scale (MHSAS; Hammer et al, 2018)
and Cognitive emotive regulation questionnaire – short version (CERQ-SF; Garnefski, Kraaij, & Spinhoven, 2001). Lin-
ear regression analysis was employed to analyze data.
Results: Mean score on MHLS was 96.72 ± 11.76, ranging from 65-127. Internal consistency was satisfying - Cronbach’s
α .79. The applied linear regression model was statistically significant (F = 8.77, p = .000). All predictors accounted for
26 % variance of MHLS score. Younger participants exhibits higher levels of mental health literacy (β = -.18, p = .02).
There are no gender, educational or relationship status differences explaining variance of MHLS. Those who have
more positive attitude toward help seeking when dealing with mental health problems have greater MHL (β = .16, p
= .02). Superordinate factors from CERQ-SF – adaptive strategies (acceptance, positive refocusing, refocusing on plan-
ning, positive reappraisal, putting into perspective) and less adaptive strategies (self- and other blame, rumination,
catastrophizing) also significantly predict MHLS score, albeit both in positive fashion – β = .25, p = .00 and β = .16, p
= .01, respectively.
Conclusion: According to the results, establishing mental health literacy is reasonable starting point in designing
intervention in order to prevent and alleviate mental health disorders and to increase care-seeking behaviors in Ser-
bian population. Due to cross-sectional design, biased online sampling, and small sample size, results could not be
generalized, and further researches are warranted.

Keywords
regression, resilience, coping strategies

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PO24 Development and validation of the Japanese version of the Auckland

Individualism and Collectivism Scale: Relationship between individualism/
collectivism and mental health
Shota Noda
Philipps University Marburg, Germany
Sho Okawa
Chiba University, Japan
Chantal Kasch
Philipps University Marburg, Germany
Christoph Vogelbacher
Philipps University Marburg, Germany
Cameron Lindsay
Philipps University Marburg, Germany
Motohiro Nishiuchi
Musashino University, Japan
Maaya Kobayashi
Musashino University, Japan
Stefan Hofmann
Philipps University Marburg, Germany

Abstract
Background: The association between cultural factors and mental health has been reported through cross-cultural
studies. Shulruf et al. (2007) developed the Auckland Individualism and Collectivism Scale (AICS) based on the com-
ponents of individualism/collectivism identified by Oyserman et al. (2002). In this study, we developed the Japanese
version of the AICS (J-AICS) and examined its reliability and validity. Previous studies have revealed the relationships
between individualism/collectivism and mental health (Germani et al., 2021; Nezlek & Humphrey, 2023). Therefore,
we also examined the association between each factor of the J-AICS (compete, unique, responsibility, advice, and
harmony) and variables related to mental health in the Japanese population.
Methods: We recruited 476 Japanese participants (mean age = 45.59, SD = 13.55, 235 males, 241 females) from the
general population. Participants completed a set of questionnaires consisting of the J-AICS, Horizontal and Vertical
Individualism and Collectivism (HVIC), Multidimensional Social Scale of Perceived Social Support (MSPSS), Self-deter-
mination and Responsibility factor in psychological independence (SDR), Multifaceted Cooperativeness Scale (MCS),
Patient Health Questionnare-9 items (PHQ-9), Generalized Anxiety Disorder-7 items (GAD-7), Short form of the UCLA
Loneliness Scale (ULS-3), and Satisfaction With Life Scale (SWLS). Other than the J-AICS, these questionnaires measure
vertical or horizontal individualism/collectivism, social support, self-determination and responsibility, cooperative-
ness, depression, anxiety, loneliness, and satisfaction with life.
Results: Confirmatory factor analysis showed that the correlated five-factor model showed an acceptable fit to the
data (CFI = 0.912, TLI = 0.901, RMSEA = 0.073, and SRMR = 0.086). The McDonald's ω coefficients were high for the com-
pete (ω = .86), unique (ω = .78), and advice factors (ω = .84) and low for the responsibility (ω = .63) and harmony
factors (ω = .64). Pearson's correlation coefficients between each factor of the J-AICS and HVIC, MSPSS, SDR, and MCS
were computed to examine the criterion-related validity of the J-AICS. Results revealed a high positive correlation
between the compete factor and vertical individualism, as well as a moderately positive correlation between the
unique factor and horizontal individualism. Furthermore, the responsibility factor exhibited weak to moderate posi-
tive correlations with the horizontal individualism and SDR, while the advice factor displayed weak to moderate pos-
itive correlations with the horizontal collectivism and MSPSS. Additionally, the harmony factor exhibited a moderate
positive correlation with the MCS. To examine the relationship between cultural factors and mental health, multiple
regression analysis was performed with each factor of the J-AICS as independent variable and the PHQ-9, GAD-7, ULS-
3, and SWLS as dependent variable. The results showed that the responsibility factor was significantly and negatively
associated with the PHQ-9, GAD-7, and ULS-3, but positively associated with the SWLS. In addition, the harmony fac-
tor was significantly and positively associated with the PHQ-9 and GAD-7, but negatively associated with the SWLS.
Conclusion: These findings demonstrate the J-AICS has sufficient validity; however, reliability was insufficient for
responsibility and harmony. Furthermore, the results showed that the responsibility was positively associated with
mental health and the harmony was negatively associated with mental health. Longitudinal studies are warranted in
the future.

Keywords
individualism; collectivism; cross-cultural difference; mental health

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PO25 Online cognitive behavioral therapy (CBT-PAC) for dealing with

parenting stress with autism spectrum tendencies:
One-year evaluation of a single arm study
Tomoko Kawasaki
Chiba University, Japan
Kayoko Taguchi
Chiba University, Japan
Hideki Nakamura
Jikei University, Japan
Kuniko Kanai
Chiba University, Japan
Saori Takenaka
Chiba University, Japan
Miyuki Furukawa
Chiba University, Japan
Mizuki Katono
Chiba University, Japan
Eiji Shimizu
Chiba University, Japan

Abstract
Introduction: Parents who raise children with autism spectrum disorder (ASD), compared with those without ASD, expe-
rience more difficulties in raising children and have higher parenting stress, which leads to development of depressive
symptoms. Cognitive-behavioral therapy (CBT) has been used in many countries to reduce parenting stress among par-
ents of children with ASD. On the other hand, there are no CBT programs in Japan to target stress reduction or promotion
of parenting resilience in parents raising children with ASD. In addition, although CBT has been reported to be effective
for depression and anxiety disorders as well as for long-term effects, few studies have examined the long-term effects of
CBT on parents of children with ASD. In our prior study, a significant increase in parenting resilience (PREQ total=+15.5
(SD=9.70); Cohen d=1.38, P<.0001) was observed in the post-test compared to the pre-test. In the present study, we
investigate whether this significant result is maintained in the study participants following a further one year.
Method: This single-arm phase-2 trial study aims to examine to the long-term effects of a video conference health
guidance CBT program on the parenting resilience of twenty-six parents with suspected autism spectrum children
aged 2 to under 7. Participants were assessed at pre-, 6-weeks-post-, and 10-weeks-post follow-up, with the addition
of a 1-year post-assessment examined in this report. The CBT-PAC program (CBT for Parents to Support Accepting Chil-
dren's Uniqueness) consists of a 6-week intervention (6 sessions of online health guidance based on CBT, 50 minutes
per session) and one follow-up session. The primary outcome is the amount of change in the Parenting Resilience Ele-
ment Questionnaire (PREQ) score from week 0 (baseline) to 1 year. Secondary outcomes include the Japanese version
of Parenting Stress Index (PSI), the General Health Questionnaire (GHQ-28), State-Trait Anxiety Inventory-JYZ (STAI),
and Eyberg Child Behavior Inventory (ECBI). For primary and secondary outcomes, paired t-test was used to compare
the scores before and 1-year after the program.
Results: A significant increase in parenting resilience (PREQ total=+15.8 (SD=11.74); Cohen d=1.50, P<.0001) was ob-
served in the 1-year post-assessment compared to the pre-test. In addition to the analysis results for the secondary
outcomes, significant increases were seen in all subscales of the PREQ score (knowledge of the child’s characteristics,
perceived social supports, and positive perception of parenting). Moreover, PSI score, GHQ-28 score, STAI-state, STAI-
trait score, and EBCL (problem) score were significantly decreased.
Conclusions: Compared to before the program began, parents after one year of program participation showed a sig-
nificant increase in resilience scores and improvement on the mental health scale.
Discussion: The decrease in the number of children's problem behaviors was significant, a factor that could be at-
tributed to the improvement in children's mental development over the one-year period and a decrease in behaviors
that irritated their parents. One study limitation was that a single-arm study. In the future, we will establish a control
group to test the effects of the intervention.

Keywords
Parent stress, Cognitive behavioral therapy, Child developmental, Resilience, Public health nurse

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PO26 Mindfulness and Psychological Distress: Mediator Roles of Deviance

from Negative Time Perspective and Delay of Gratification
Merve Ersahin
Private practice, Netherlands
Elif Peksevim
PERLA Psychology and Research, Turkey
Ayse Altan-Atalay
Kadir Has University, Turkey

Abstract
Mindfulness is a therapeutic technique that helps individuals to pay attention to the present moment in a nonjudg-
mental manner and change their relationship with inner events like thoughts and feelings. Trait mindfulness (dispo-
sitional mindfulness) refers to an innate personality characteristic that allows the individuals to remain fully focused
on the present moment without getting distracted easily. Individuals with more mindful attention awareness have
been documented to report lower levels of psychological distress. The aim of the current study is to examine the
relationship of mindful attention with anxiety and depression by focusing on the mediator roles of deviance from a
negative time perspective and capacity for delay of gratification, which are both resilience characteristics. Deviance
from a negative time perspective is a concept that was relatively recently introduced to the literature and it refers to
the individual’s capacity for inhibiting thoughts related to negative time frames such as the negative events that took
place in the past and the sense of loss of control over what the future may bring. Delay of gratification, on the other
hand, refers to the ability to postpone immediate gratification considering the favor of better long-term future con-
sequences. Higher levels of both deviance from negative time perspective and capacity for postponing pleasurable
activities and rewards were found to be associated with more pleasant mental health outcomes. We expect higher
levels of mindful attention to be associated with a greater capacity to remain focused on positive aspects of life. We
expect this tendency to enhance the individual’s capacity for delaying gratification, which is a significant predictor of
psychological distress. The participants were 279 (200 women) between ages 18 and 71 (M=31.51, SD= 12.61). All par-
ticipants filled out online questionnaires assessing the levels of mindful attention, time perspective, capacity for delay
of gratification, anxiety, and depression. Two separate serial mediation analyses were conducted with depression and
anxiety serving as the outcome variables, respectively. The results indicated that both deviance from a negative time
perspective and delay of gratification capacity were significant mediators in the relationship of mindful attention with
depression. However, the results for anxiety indicated a different pattern. Notably, neither deviance from a negative
time perspective nor delay of gratification were able to mediate the relationship between mindful attention and anx-
iety. The findings will be discussed under the light of recent literature.

Keywords
Mindful attention awareness, time perspective, delay of gratification, anxiety, depression

PO27 Thought speed and its effect on mood

Segev Feinstein
Bar Ilan University, Ramat Gan, Israel, Israel
Omer Linkovski
Bar Ilan University, Ramat Gan, Israel, Israel

Abstract
Introduction
Thoughts are a central target in clinical interventions. Clinical research traditionally focused on thoughts’ content
(e.g., Beck, 1979). In recent years, there is a growing body of research regarding a different aspect of thought and its
psychological effects– thoughts’ speed (Yang et al., 2018).
Previous research has manipulated thought speed through tasks involving reading statements at different speeds, find-
ing that faster reading leads to higher positive affect in both non-clinical and depressed populations (Yang et al., 2014;
Pronin & Wegner, 2006). While Pronin and Wegner (2006) attribute the mood boost to thought speed itself, an alternative
explanation is that reading functioned as an activating intervention, akin to behavioral activation approaches (Kanter et
al., 2010). These effects may be also moderated by situational and personal factors (Pronin & Jacobs, 2008). The current
study aims to investigate the role of thought speed in influencing mood and specifically to test whether faster thinking

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increases positive affect. We wish to do so through a more ecological, less energy-consuming manipulation of hearing
self-recºrdings of statements rather than reading them aloud. We will also assess whether personal motor rhythm, the
level of repetitive negative thinking (RNT), and a thought speed manipulation affect mood. By examining these factors,
we hope to gain a more nuanced understanding of the mechanisms underlying the thought speed-mood relationship.
Method
Participants will be 120 students. The design is a 2X2 - positive/negative statements x fast/slow listening speed. The
procedure involves two sessions. At Time 1, participants answer questionnaires regarding RNT, mood and thought
speed, measure personal rhythm, and then record themselves reading statements. At Time 2, after repeating baseline
measures, they listen to their own recordings at the assigned speed condition, then complete measures again.
Aims
Participants are expected to show a difference in the effect of thought speed on mood as a function of the valence
of statements. In addition, the interaction between RNT and personal rhythm is expected to determine the effects of
the thought speed manipulation. Participants with high RNT will benefit (but those with Low RNT will suffer) from a
change in speed towards the mean: slow participants in the fast condition and fast ones in the neutral will show more
positive affect and lower RNT distress.
Our results may provide a better insight into thought speed’s role across disorders, especially those including re-
petitive negative thoughts. Such understanding could facilitate accurate diagnosis and tailored treatments. Clarify-
ing the thought speed-mood connection enables developing simple, cost-effective interventions targeting thought
speed modification. It also allows enhancing existing therapies (e.g. guided imagery or meditation) by accounting for
thought speed components within them.

Keywords
Thought speed, Mood ,Repetitive negative thinking (RNT), Transdiagnostic processes, Cognitive behavioral therapy,
Thought manipulation

PO28 Frameworks for cultural adaptations of CBT: Finding a way forward

Ivana Mrgan
Centre for Personal Development Apsiha, Croatia
Nataša Jokić-Begić
University of Zagreb, Faculty of Humanities and Social Sciences, Croatia

Abstract
Bearing in mind increasing rates of globalization and growing diversity of global communities, there is a clear need for
cultural adaptations of psychological treatments and, by extension Cognitive behavioral therapy (CBT). Indeed, most
of the evidence-based treatments reflect Western values, concepts, and explanatory models of illness. These might be
quite different in diverse populations given that culture tends to shape the perception of health, as well as the rules,
assumptions and beliefs associated to health, including acceptable treatment options and level of community in-
volvement. Moreover, these may also interact with a broad range of risk and protective factors usually not accounted
for in a traditional CBT conceptualization.
Interestingly, there is a growing body of evidence suggesting the effectiveness of culturally adapted treatments, con-
tributing to an emerging field offering numerous implications for future research. That said, this process is complicat-
ed by the apparent absence of consensus on what cultural competence is. Some of the frameworks for cultural adap-
tation focus on the therapist’s characteristics while others pertain to the therapy process itself. This research focused
specifically on the characteristics of treatment. In general, cultural adaptation frameworks include efforts aimed at
systematic modifications of service delivery, elements of therapeutic process or treatment components. Most of the
empirical findings are promising but rarely include optimal study designs, active control, or detailed descriptions of
the adaptations.
For this reason, one of the aims of this systematic review was to describe the process, relevant elements and frame-
works used in the cultural adaptation of CBT. Specifically, our goal was to sum up the findings on the effectiveness of
culturally adapted CBT in comparison to its classic form in an outpatient setting. The study was conducted in accor-
dance with PRISMA-P guidelines and included randomized controlled trials published in English. The screening pro-
cess included two electronic bibliographic databases - psychINFO and PubMed, primary study registers, the Cochrane
Library CENTRAL and Gov.Trial database, and selected grey literature sources - www.opengrey.eu and DART. Web of
Science was also included in the screening.
Despite the lack of detailed descriptions concerning the steps taken in the process or the frameworks used, all in-
cluded studies emphasized the relevance of explanation or myth of illness, and mentioned accommodations made
to the content and process of the treatment. Included studies inserted narrative reviews and elements of qualitative

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research that preceded the accommodations of CBT protocols. Moreover, they included descriptions of both surface
modifications (e.g., location, language, use of appropriate metaphors, family engagement, socialization to treatment)
and deep modifications (e.g., adding culturally relevant modules linked with identity and spirituality, adaptation of
therapy processes, or focusing on emotional constriction).
To conclude, a systematic approach including detailed documenting and resources used, is of outmost importance
for future randomized controlled studies. Ideally, they would include information on the process, content and out-
comes of the cultural adaptation of CBT interventions to facilitate validation and replication of said models. Both the
body of research and clinical practice highlight the need for culturally adapted treatments to offer effective care in
the changing world.

Keywords
Cognitive behavioral therapy, CBT, cultural adaptations, adaptation framework, cultural modifications, randomized
controlled trials

PO29 Transdiagnotic Risk Factors and Sexual Satisfaction:

A Serial Mediation Model
Ali Rıza Gürbüz
Koc University, Turkey
Gökçe Elif Yılmaz
Koc University, Turkey
Naz King
Koc University, Turkey
Tuğçe Zeynep Artunay
Anglia Ruskin University, Turkey
Selin Öykü Gergeri
Koc University, Turkey
Ayse Altan-Atalay
Kadir Has University, Turkey

Abstract
Transdiagnostic risk factors are factors connected with the development or maintenance of multiple mental disorders.
Sexual satisfaction, which refers to one’s evaluation of sexual relationships or activities that could have both positive
and negative aspects, is an essential component of sexual health and sexual well-being; however, the relationship
between transdiagnostic risk factors and sexual satisfaction is understudied. This situation prevents clinicians and
researchers from gaining a holistic understanding of the complexity of sexual experience. The current study aims to
investigate how certain transdiagnostic risk factors, such as perfectionism and repetitive negative thinking (RNT),
interact with sexuality-related risk factors, such as sexual self-consciousness in the prediction of sexual satisfaction.
In our model, we expected self-critical perfectionism to be associated with sexual satisfaction and we expect this
relationship to be serially mediated by repetitive negative thinking and sexual self-consciousness, respectively, while
controlling for age and gender. The data were collected from 356 sexually active participants (293 women, 82.3%)
between ages 18 and 54 (Mage = 27.9, SD = 7.10) from Turkey. The data were gathered through self-report measures
assessing perfectionism, RNT, sexual self-consciousness, and sexual satisfaction. Overall, the results show that our
transdiagnostic model is statistically significant. Consequently, the link between self-critical perfectionism and sexual
satisfaction is mediated by RNT and sexual self-consciousness. In other words, self-critical perfectionism is associated
with more experiencing of negative thoughts in an uncontrollable and repetitive manner, which in turn leads to a
feeling of self-consciousness in situations that involve sexual intimacy. Elevations in sexual self-consciousness in turn
is associated with reduced levels of overall sexual satisfaction. These findings advance our understanding of sexual
satisfaction and sexual well-being by providing insight into both clinical and research settings. In the clinical setting,
the findings contribute to develop tailored interventions for improving sexual satisfaction by addressing self-criti-
cal perfectionism and the mediating role of RNT and sexual self-consciousness. From the research perspective, the
finding expands the theoretical framework into the transdiagnostic approach for developing more comprehensive
models for sexual satisfaction. Furthermore, the findings hold promise for improving the prevention and treatment
interventions that target sexual dysfunctions as they identify the contribution and underlying mechanism of transdi-
agnostic risk factors.

Keywords
sexual satisfaction, sexual self-consciousness, repetitive negative thinking, self-critical perfectionism, transdiagnostic
approach

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PO30 Cognitive Behavioral Therapy-Based Midwifery Care for Perinatal

Depression and Anxiety in High-Risk Preterm Pregnancies: A Prospective
Case Series
Chie Tanii
Osaka University, Japan
Eiji Shimizu
Chiba University, Japan
Tomoko Kawasaki
Chiba University, Japan

Abstract
Background: Pregnant women at high risk for obstetric complications may experience worsening depression and
anxiety due to the management and outcomes of their pregnancies. These conditions can significantly impact chil-
dren’s development and childcare. In recent years, cognitive behavioral therapy (CBT) has proven effective in treating
perinatal depression and anxiety. However, few midwife-led, CBT-based intervention trials have been conducted to
prevent depression and anxiety in high-risk pregnant women.
Aims: This study aimed to evaluate the feasibility and effectiveness of a CBT-based midwifery care program for the
prevention of perinatal depression and anxiety in high-risk pregnant women in Japanese clinical settings.
Methods: A single arm, prospective, open-label case series design was used (clinical trial registration no.
UMIN000054078). Three patients with obstetric complications admitted to the center were included in the study.
The midwifery care program comprised six individual 30- minute sessions addressing perinatal-specific anxiety and
depression during pregnancy and the first month postpartum. The program is based on standard midwifery care
models, such as antenatal education, birth planning, and birth review, and incorporates CBT elements such as psycho-
education, cognitive restructuring, and behavioral activation. It focuses on anxiety regarding preterm birth and aims
to promote positive acceptance of one’s own birthing experiences that lead to preterm birth. Patients were assessed
at baseline, prepartum, and postpartum until the end of the intervention at one month postpartum. The primary
outcome was the State-Trait Anxiety Inventory (STAI), and the secondary outcomes were the Generalized Anxiety
Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Edinburgh Postnatal Depression Scale (EPDS), Japanese
version of the Mood and Anxiety Symptom Questionnaire, and the EuroQol 5-Dimensions 5-Level. Pre- and post-in-
tervention findings were compared between individuals. Results: Three pregnant women met the inclusion criteria
and were enrolled. They were admitted at 28–33 weeks of gestation for the treatment of hypertensive disorders of
pregnancy, fetal growth restriction, and threatened premature labor. The presence of depressive and anxiety symp-
toms after hospital admission was assessed using the PHQ-9, EPDS, and GAD-7, respectively. None of these assess-
ments met the clinical criteria. All participants completed all sessions at one month postpartum. The STAI scores for
both state and trait anxiety decreased from baseline to the end of the program, and they accepted the intervention
well. Conclusion: These results provide preliminary support for the feasibility of CBT-based interventions delivered by
midwives. We plan to conduct a randomized controlled trial to assess the effectiveness of this intervention.

Keywords
anxiety; cognitive behavioral therapy; depression; high-risk pregnancy; pregnant women

PO31 The association between childhood adversities and cluster C

personality disorders: A meta-analysis
Stefania Crisan
Evidence-Based Psychological Assessment and Interventions Doctoral School, Babeş-Bolyai University, Cluj-Napoca,
Romania, Romania
Maria Stoia
Evidence-Based Psychological Assessment and Interventions Doctoral School, Babeş-Bolyai University, Cluj-Napoca,
Romania, Romania
Elena Predescu
Iuliu Haţieganu University of Medicine and Pharmacology, Cluj-Napoca, Romania
Andrei Miu
Cognitive Neuroscience Laboratory, Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
Aurora Szentagotai-Tatar
Department of Clinical Psychology and Psychotherapy; The International Institute for the Advanced Studies of Psy-
chotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania

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Abstract
Introduction. Studies suggest that adverse childhood experiences (ACEs) may contribute to the onset and develop-
ment of cluster C personality disorders. However, the association between ACEs and these disorders remains unclear
in terms consistency across studies and effect magnitude, as well as generalizability within cluster C. The current
meta-analysis aimed to examine the associations between ACEs and cluster C personality disorders based on the
available literature. Methods. Systematic searches were conducted in Pubmed, Scopus, Web of Science and PsychInfo
databases. Forty eight eligible studies were included in the analyses, and pooled effect sizes were estimated both
at the level of cluster C, and at the level of each corresponding disorder. Moderation and meta-regression analyses
were also conducted. Results. ACEs were consistently associated with overall cluster C, as well as each of the corre-
sponding disorders in this cluster. Sources of heterogeneity included type of instrument used to assess childhood
adversities (interviews < questionnaires), and type of instrument used to assess the personality disorders (clinical
interviews > questionnaires, as well as their combination with interview). Questionnaires used to assess ACEs and clin-
ical interviews used to assess cluster C increased the investigated associations. The associations between ACEs and
all investigated personality disorders decreased with age. Conclusions. ACEs are consistently associated with cluster
C personality disorders. Future work could clarify whether this association is causal, using longitudinal designs which
are currently scarce and considering the potential sources of effect variability identified in the present study.

Keywords
cluster C; personality disorders; childhood adversities; psychopathology

PO32 Emotion regulation difficulties in the relationship between childhood

adversity and cluster C personality disorders
Stefania Crisan
Evidence-Based Psychological Assessment and Interventions Doctoral School, Babeş-Bolyai University, Cluj-Napoca,
Romania, Romania
Andrei Miu
Cognitive Neuroscience Laboratory, Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
Aurora Szentagotai-Tatar
Department of Clinical Psychology and Psychotherapy; The International Institute for the Advanced Studies of Psy-
chotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania

Abstract
Introduction. Childhood adversity and cluster C personality disorders are associated, but the mechanisms that explain
these associations are unclear. Emotion regulation could be a potential factor at play in these associations. So far,
available studies in the case of cluster C focus on strategy implementation and no studies have investigated emotion
regulation using ecological measures. This research focuses on the association between childhood adversity, emo-
tion regulation goals and strategies, and cluster C symptomatology, across two studies. Methods. Study 1 employs a
cross-sectional design, using data from a sample of 141 participants that present cluster C symptomatology. Study 2
employs a daily diary design that assesses childhood maltreatment, emotion regulation goals and strategies, cluster C
symptoms and negative emotions. Results. In Study 1, findings suggest associations between facets of childhood ad-
versity, emotion regulation, personality dysfunction and cluster C symptoms. The role of childhood maltreatment in
the association between emotion regulation and cluster C was investigated. In Study 2, findings suggest associations
between negative emotions, emotion regulation facets, and cluster C. We investigated the role of emotion regulation
and childhood maltreatment in the association between negative emotions and cluster C symptoms. Conclusion. The
results of this study point to significant associations between variables, taking both habitual and specific emotion
regulation measures into account. The identified emotion regulation difficulties could have important implications
for the improvement of assessment, prevention and intervention efforts for cluster C symptoms.

Keywords
cluster C personality disorders; childhood adversity; emotion regulation strategies; emotion regulation goals; nega-
tive emotions

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PO33 Virtual reality exposure therapy for specific phobia in children: A pilot
study exploring fear of heights
Andreas Blicher
Copenhagen Business School, Denmark
Monika Walczak
University of Copenhagen, Denmark
Sonja Breinholst
University of Copenhagen, Denmark
Signe Vangkilde
University of Copenhagen, Denmark

Abstract
Cognitive behavioral therapy (CBT) with exposure as an active treatment component is a first-line, evidence-based
intervention for anxiety disorders. Virtual reality (VR) presents potential advantages for psychologists treating anxi-
ety disorders in children with the prospect of optimizing exposure-based treatments. This pilot study assessed the
acceptability and feasibility of VR exposure therapy for children with specific phobias, focusing on acrophobia (fear of
heights). We examined the system’s usability and the likelihood of its adoption by children and clinicians. Participants
included six children aged 9 to 15 and three clinicians. The children were exposed to a computerized VR environment
- the Richie’s Plank Experience. Data were gathered through interviews with both children and clinicians focusing on
user experience. Results indicated that all children experienced heightened anxiety during the VR simulation, as ex-
pected in an exposure situation, but willingly used the VR headset, engaged with the environment, and tolerated the
exposure well. Clinicians reported a favorable view of integrating VR exposure into therapeutic protocols for anxiety
disorders. Further research is necessary to validate the effectiveness and explore the broader applicability of VR expo-
sure therapy for treating specific phobias in children.

Keywords
Virtual reality; cognitive behavioral therapy; specific phobia; children; anxiety

PO34 Investigating the associations between metacognitive beliefs, cognitive

avoidance, and anxiety symptomatology in clinically anxious children
Monika Walczak
Czech Republic
Sonja Breinholst
University of Copenhagen, Denmark

Abstract
Metacognitive therapy (MCT) demonstrates promising results for emotional disorders in adults. Some studies report
superior effects of MCT when compared with traditional cognitive behavioral therapy. The metacognitive model pos-
tulates that different domains of metacognition and cognitive attentional syndrome are central in causing and main-
taining psychological problems, including anxiety disorders. Understanding the mechanisms involved in etiology and
maintenance of childhood anxiety could potentially lead to increased treatment outcomes. Tests of the metacogni-
tive model in child populations are relatively scarce, however, a growing body of research supports the application
of MCT in treatment of anxious children. The aim of the current study is to empirically investigate the links between
metacognitions and cognitive avoidance as a constituent of the cognitive attentional syndrome (CAS) and anxiety
symptomatology in 248 school-aged children with anxiety disorders. The associations between anxiety symptom-
atology and five domains of metacognition, including positive metacognitive beliefs, negative metacognitive beliefs,
cognitive confidence, cognitive self-consciousness, and the need for controlling one’s thoughts, as well as five cogni-
tive strategies of avoidance comprising thought suppression, thought substitution, avoidance of threatening stimuli,
transformation of images into thoughts, and distraction, were investigated in a cross-sectional design. The results of
hierarchical regression analyses indicate that metacognitive beliefs accounted for a large proportion of variance in
anxiety symptomatology, beyond age, gender, and cognitive avoidance. Further analyses investigating the specif-
ic domains of metacognition and cognitive avoidance strategies showed that negative metacognitive beliefs were
the strongest predictor of anxiety symptoms, while negative metacognitive beliefs, need for control and cognitive
self-consciousness emerged as significant metacognitive predictors of cognitive avoidance. Positive metacognitive
beliefs did not emerge as significant predictors of anxiety symptomatology or cognitive avoidance in this sample of

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clinically anxious children. The results provide preliminary evidence for the associations between specific metacogni-
tions, cognitive avoidance strategies and anxiety levels in children with anxiety disorders. Clinical implications of the
results will be presented.

Keywords
Metacognitions, Cognitive avoidance, anxiety disorders, metacognitive model of anxiety in children

PO35 Enhancing Engagement in Public Speaking Exposures through an

Imaginal Supportive Other
Avishai Ella
The Hebrew University of Jerusalem, Israel
Hadar Arnon
The Hebrew University of Jerusalem, Israel
Hila Sorka
The Hebrew University of Jerusalem, Israel
Jonathan D. Huppert
The Hebrew University of Jerusalem, Israel

Abstract
Introduction: Various cognitive-behavioral therapies (CBT) utilize in-vivo and imaginal exposure techniques to alle-
viate anxiety symptoms. Although exposure-based interventions prove effective in reducing anxiety and improving
well-being, they often evoke negative reactions, leading to avoidance behaviors, reduced adherence, and higher
dropout rates. Supportive others, like therapists or loved ones, can aid during exposure, yet their assistance is not
always readily available. This pilot study explores a novel technique, “imaginal supportive other,” where individuals
vividly imagine a supportive figure to boost their motivation and willingness to engage in anxiety-producing virtual
public speaking tasks. This study assesses whether this approach enhances engagement in public speaking expo-
sures.
Methods: A randomized controlled design is used to evaluate the impact of imagined supportive figures on public
speaking exposures in individuals with significant public speaking anxiety. The study will randomly assign 20 adults,
10 participants in each condition: 1) an experimental group, who uses the imagined support of a significant other, or
2) a control group, which does exposure as usual. All participants will deliver four speeches to varying sized virtual
audiences. The experimental group is guided through a visualization exercise before speaking tasks, imagining a sup-
portive figure offering encouragement, while the control group starts the tasks directly. Anxiety levels are measured
using the Subjective Units of Distress Scale (SUDS). Participants’ willingness to engage in increasingly challenging
tasks and their baseline and post-treatment anxiety levels will be assessed through standardized questionnaires.
Participants: Students aged 18 or older with high public speaking anxiety and fluency in English are eligible for the
study. Exclusion criteria include severe mental health conditions, and other comorbidities that could affect the ability
to complete the study.
Procedure: After informed consent and screening for eligibility, participants will receive psychoeducation on public
speaking anxiety and the rationale behind exposure therapy. They will rate their SUDS, when considering various
audience sizes and speaking topics. Topics range from personal, such as “How do you celebrate your birthday?” to
collective, such as “How do you celebrate a major holiday?” Participants in the experimental group will undergo a
guided visualization to imagine a supportive figure offering encouragement, while those in the control group pro-
ceed directly to their first speech task. All participants complete graded exposure tasks, progressing at their discretion
through larger audience sizes.
Measures: The Public Speaking Anxiety Scale (PSAS) assesses baseline anxiety levels, while SUDS scores provide a
quantitative measure of anxiety during exposure tasks. The primary outcomes are participants’ willingness to engage
in more anxiety-provoking audiences and the reduction of anxiety from baseline to the final speech task.
Conclusion: The study investigates the effectiveness of imagined supportive others in enhancing exposure to public
speaking anxiety. If successful, this approach could offer a cost-effective, self-administered tool for motivating indi-
viduals to confront their fears. Further research should explore the applicability of this technique to other anxiety-pro-
voking situations, potentially providing a novel intervention strategy in clinical practice.

Keywords
Social Anxiety, interpersonal emotion regulation, Imagination, Exposure, Engagement

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PO36 The effects of bilateral stimulation on the installation

of positive cognitions
Laura Mertens
Ghent University, Belgium

Abstract
Introduction: The protocol for Eye Movements Desensitization and Reprocessing (EMDR) of Shapiro (1995), forms the
basis for one of the most widely used treatments for PTSD. The protocol consists of eight phases, among which an
‘assessment phase’, ‘desensitization phase’ which is followed by the ‘installation phase’. During the assessment phase
a target memory is identified, along with its sensory and affective components. Furthermore the patient is invited to
express a negative cognition that they have about themselves regarding this situation. A positive alternative cogni-
tion is also formulated to be used during the installation phase.
In the desensitization phase a traumatic memory is retrieved, while applying bilateral stimulation (BLS), decreasing
the negative emotions associated with it. In the installation phase that follows, the patient is asked to activate the
negative memory and focus on the positive cognition, while BLS is administrated. During this phase, the memory is
brought into awareness together with the more adaptive self-appraisal statement (Leeds, 2009). The associative bond
is strengthened by linking this positive cognition to the target memory (Shapiro, 2001). BLS is therefore used in both
the desensitization phase as well as for the installation of positive cognitions.
In clinical practice BLS is still used during the installation phase, being part of standard EMDR protocols (Hase, 2021;
Shapiro, 2001).However, empirical support for this practice seems to be lacking. In this context, some studies even
suggest that the use of BLS during the installation of positive cognitions may need to be reconsidered.
Method: In this experiment a negative memory will be identified as well as a negative and alternative positive cogni-
tion. The experiment will, however, only include the installation phase and not the desensitization phase, as the focus
lays on the role of BLS during the installation of positive cognition. Only participants without self-reported elevated
scores of depression, anxiety, stress or trauma-related symptoms can participate. We aim to recruit a minimum of 60
participants (20 participants for each condition) and a maximum of 150 participants.
Results: Based on the Working Memory Hypothesis, we expect: H1: No beneficial effects of horizontal visual stimula-
tion (BLS) compared to vertical visual stimulation on rated credibility of the positive cognition (i.e., no difference be-
tween both groups); H2: visual stimulation (horizontal/vertical) may hinder the installation of the positive cognition
(limiting increases in credibility compared to the control group). We are currently collecting data. (Preliminary) results
will be available for EABCT 2024.
Conclusion: This study evaluates the need for BLS during an important phase of the EMDR protocol, the installation
phase. As such, this study will have immediate implications for treatment of PTSD.

Keywords
Trauma, EMDR, bilateral stimulation

PO37 PTSD symptomatology following events not meeting DSM-5 PTSD

criterion A in a French spoken General Population during pandemic:
Nosological issues between PTSD and Adjustment disorder.
Pierre Orban
Nantes University, Belgium
Pierre Philippot
UCLouvain, Belgiu
Abdel. H. Boudoukha
Nantes University, France

Abstract
Introduction
Exposure to traumatic events is particularly high in the general population and can lead in a small proportion to
PTSD. The nosological criteria underpinning the definition of a traumatic event should then be rigorously screened
as it plays an important role in the prevalence of PTSD. That definition has also changed over time and recent studies
indicate that although not exposed to an event meeting the current criterion A, people can report DSM-5 B, D, E and
F criteria for PTSD (which we call PTSD-Like). Kilpatrick et al (2009) considered that the prevalence of PTSD-Like was so
low that the question was not relevant. However, to clarify this issue, we conducted a cross sectional study in a French
speaking general population sample.

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Method
594 participants (10% male, 87 % female) recruited online filled a set of questionnaires with the PCL-5 for clearly
identified events that were either included or excluded from Criterion A, experienced for more than one month, and
for which a psychological distress was reported. We differentiated 4 groups of participants according to two criteria:
the participant has at least one significant PCL-5 for an event in criterion A (PTSD) and secondly, the participant has
at least one significant PCL-5 for an event excluded from criterion A (PTSD-Like). We compared the frequency and the
intensity of symptoms for the groups PTSD, PTSD-Like, PTSD+PTSD-Like, and no PTSD symptomatology.
Results
The results showed that PTSD-like symptomatologies are more common than previously thought, unlike earlier find-
ings by Kilpatrick et al. (2009). Notably, 58.6% of positive PCL-5 for events excluded from Criterion A were due to
events not considered by Kilpatrick et al., such as moral harassment and sudden abandonment. Additionally, PTSD
and PTSD-Like were found to be identical in symptom intensity and dispersion, challenging the notion of PTSD-like
symptomatologies being a weaker form of PTSD and questioning their classification within adjustment disorders.
The study also identified individuals with mixed PTSD and PTSD-like symptomatologies, suggesting potential un-
derdiagnosis of multiple PTSD forms. These mixed profiles accounted for 11.4% of the sample, while 31.6% reported
PTSD-like symptoms without associated PTSD.
Conclusion
This research highlights the need for further studies to evaluate the prevalence and nature of PTSD-like symptoms. It
suggests that PTSD-like symptomatology is a significant symptomatic category within the population that warrants
further exploration in the context of adjustment disorders, including risk factors, maintenance, and therapeutic ap-
proaches.

Keywords
PTSD, Adjustment disorder, PTSD-Like

PO38 The relation between parentification and mental health: the role of self-
esteem and self compassion
Ana Kurtović
Faculty of Humanities and Social Sciences, Department of Psychology, Croatia
Ana Babić Čikeš
Faculty of Humanities and Social Sciences, Department of Psychology, Croatia
Valentina Galinec
Primary school Djuro Ester Koprivnica, Croatia

Abstract
Parentification occurs when children assume the responsibilities of an adult within the family, which are develop-
mentally inappropriate and often include sacrifice on the part of the child in order to satisfy the parents’ needs. Long
term parentification can, therefore, be considered as a form of neglect and have profound consequences on children’s
wellbeing. The aim of this study was to examine the relation between parentification and mental health problems,
and examine possible mechanisms for this relation. We assumed that parentification would affect mental health
problems through self-esteem and self-compassion. A total of 235 university students completed Filial Responsibility
Scale-Adult version (Jurkovic & Thirkield, 1999), Self-Liking/Self-Competence Scale-Revised (Tafarodi & Swann, 2001),
Self-Compassion Scale (Neff, 2003) and Depression Anxiety Stress Scale (Lovibond & Lovibond, 1995). The results have
shown that parentification predicted mental health problems, while self-esteem and self-compassion also contrib-
uted to mental health problems once the effect of parentification was controlled. Further analyses (Hayes Process)
demonstrated that both self-esteem and self-compassion mediated the effect parentification on mental health prob-
lems, although the direct effect of parentification remained significant. Our results are consistent with other studies
demonstrating negative effects of parentification on mental health. They also offer insight into possible mechanisms,
which can prove useful as a target of therapeutic interventions with adult clients when changes in parenting style are
not possible or meaningful.

Keywords
Parentification, self-esteem, self-compassion, mental health

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PO39 Cognitive behavioral therapy for obesity management in patients with

chronic kidney disease
Katja Kurnik Mesarič
Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia, Slovenia
Jernej Pajek
Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia, Slovenia
Špela Bogataj
Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia, Slovenia
Bernarda Logar Zakrajšek
Management, Division of Surgery, University Medical Centre Ljubljana, Slovenia, Slovenia
Jana Kodrič
Unit of Child Psychiatry, University Children’s Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia, Slo-
venia

Abstract
Obesity is a major public health problem, that can lead to the onset and progression of chronic non-communicable dis-
eases. Among these diseases, chronic kidney disease is particularly affected by obesity, that can impact the progression
of the disease. Early diagnosis combined with appropriate treatment and lifestyle changes can limit the progression of
the disease. The inclusion of clinical psychological and psychotherapeutic interventions in the management of over-
weight and obese patients enhance lifestyle changes and increase motivation for weight loss. Cognitive behavioural
therapy and behavioural therapies are widely used and effective in the weight loss process in healthy populations.
The impact and effectiveness of weight loss interventions in patients with chronic kidney disease are limited in terms
of clinical effectiveness, and further research is needed with different approaches to weight loss in patients with
chronic kidney disease.
The aim of our study is to help patients with chronic kidney disease to achieve appropriate weight management. The
study intervention is based on the cognitive behavioral therapy model. A team of clinical psychologists, psychologist,
medical doctors, kinesiologist and dietitian collaborated to develop an individualised intervention cognitive behav-
ioral therapy intervention with nutritional and exercise counseling. 38 adult patients with chronic kidney disease
(stages 2 – 4) were randomly assigned to two groups: the intervention group with a 16-week cognitive behavioral
therapy program, diet and exercise counseling, or the control group with diet and exercise counseling.
The study protocol and the preliminary results of the ongoing study will be presented.

Keywords
cognitive behavioral therapy, obesity, chronic kidey disease, obesity management

PO40: Going online - Examining the preliminary effectiveness of a video-

based group CBT on depression and therapeutic change factors
Jana Schneider
MEU - Study Center of DIPLOMA, University of Applied Sciences, Magdeburg, Germany, Germany
Michael Spaeth
MEU - Study Center of DIPLOMA, University of Applied Sciences, Magdeburg, Germany, Germany
Thomas Berger
Universität Bern, Switzerland

Abstract
Background: Depression remains a major public health concern globally, with approximately half of all cases remain-
ing untreated due to factors like misdiagnosis, societal stigma, and logistical challenges including long waiting times
or extensive commuting therapy sessions. Given the rising demand for psychoptherapy, there is a critical need for
therapeutic approaches that tackle these issues. Video-based therapies, applicable for both individual and group
settings, have emerged as a promising solution. However, video-based group therapies have not been as extensively
researched compared to individual therapies. Therefore, we are currently conducting a two-arm randomized con-
trolled trial to evaluate the effectiveness and therapeutic process of video-based (VB) versus traditional face-to-face
(F2F) group cognitive behavioral therapy (CBT) for depression.
Methods: To date, the trial includes 17 adults (aged 19 – 63 years) from Magdeburg and Hannover, Germany, diag-
nosed with depression ranging from mild to severe. Participants have been randomly assigned to either F2F (n = 10)

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or VB (n = 7) group, with both groups receiving 12 sessions of CBT. Sessions for the VB group are conducted via the
certified platform Consularia Live. Primary outcomes are assessed by the Beck Depression Inventory II Revised and the
Scale for Assessing Therapeutic Processes in Group Therapy at the start, during, and after the therapy. Linear mixed-ef-
fects models were fitted to compare treatment effects over time and between groups on the primary outcomes.
Results: Preliminary analysis revealed no significant effect of the treatment modality (F2F vs. VB) on depression scores,
β = -1.243, p = .823. Neither group therapy modality – F2F nor VB - significantly reduced depressive symptoms. How-
ever, a noticeable trend toward symptom reduction was observed, β = -7.300, p = .056. No significant interaction
effect between treatment modality and therapy effectiveness was found, β = -1.986, p = .723.
A significant effect of time on group therapeutic change factors was found, β = 0.976, p = .012, suggesting improve-
ments over time, regardless of the group modality, β = -7.760, p = .162. Depression scores had no significant impact
on the therapeutic change factors, β = -0.005, p = 0.597. No significant interaction effect was found between treat-
ment modality and time, β = -0.134, p = 0.813
Discussion: We provide first evidence that group therapeutic change factors, regardless of therapy modality (F2F and
VB), improve throughout the therapeutic process. Currently, a trend toward reduction in depressive symptoms was
observed in both groups which will be further investigated in larger samples. Nevertheless, the consistent improve-
ment in group therapeutic change factors over time suggests that both modalities are capable of facilitating thera-
peutic progress. This underscores the potential of video-based interventions to serve as effective alternatives when
traditional therapy is not accessible. These findings highlight the critical need to further refine and enhance digital
therapy platforms and they encourage psychotherapists to embrace online group therapy as a means to meet the
increasing demand for accessible mental health services effectively.

Keywords
cognitive-behavioural therapy (CBT), group therapy, video-based therapy, depression, therapeutic change factors,
RCT

PO41: Mediators of the association between adult attachment and

dispositional, interpersonal and relationship mindfulness
Marco Pereira
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Fac-
ulty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal

Abstract
Background: Theoretical associations between attachment, mindfulness, interpersonal and close relationships, and
emotion regulation suggest that adult attachment may be linked to mindfulness via self-regulatory abilities. The ob-
jective of this study was to assess the direct effect of attachment on dispositional, interpersonal and relationship
mindfulness, as well as indirect effects through emotion regulation.
Method: The sample consisted of 458 individuals (72.5% female; 65.6% in a romantic relationship) with a mean age of
39.75 years (SD = 13.81; range: 18-76), recruited from the community. Participants completed self-reported measures
assessing adult attachment (Experiences in Close Relationships – Relationship Structures), dispositional mindfulness
(Mindful Attention Awareness Scale), interpersonal mindfulness (Interpersonal Mindfulness Scale), relationship mind-
fulness (Relationship Mindfulness Measure), and emotion regulation (Difficulties in Emotion Regulation Scale – Short-
form).
Results: There was a significant direct effect of attachment-related avoidance on dispositional mindfulness (-1.80, 95%
CI [-2.80, -0.79]), interpersonal mindfulness (-2.54, 95% CI [-3.50, -1.58]), and relationship mindfulness (-1.76, 95% CI
[-2.24, -1.28]). The direct effect of attachment-related anxiety on dispositional (-0.34, 95% CI [-0.98, 0.30]), interper-
sonal (-0.12, 95% CI [-0.74, 0.49]) and relationship (0.02, 95% CI [-0.31, 0.35]) was not significant. Attachment-related
anxiety was indirectly associated with dispositional, interpersonal and relationship mindfulness via emotion regula-
tion. Attachment-related avoidance was indirectly associated through emotion regulation only with dispositional and
interpersonal mindfulness.
Conclusions: Our results showed that different forms of mindfulness, mainly dispositional and interpersonal mind-
fulness, were linked to attachment insecurity dimensions (i.e., higher anxiety and/or avoidance) through increased
difficulties in emotion regulation. Attachment dimension-specific differences were also observed: for anxiety-related
attachment, difficulties in emotion regulation exerted a stronger mediating effect. In the context of insecure attach-
ment, enhancing emotion regulation skills may increase a person’s capacity for mindful awareness in individual and
interpersonal contexts.

Keywords
attachment, mindfulness, interpersonal mindfulness, emotion regulation

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PO42 Work Engagement and Flow Experiences: Online versus Face to Face
psychotherapy for RE&CBT therapists
Teodora Petković
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Anđela Stojanović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Ana Petić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Maja Stojanović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Jovana Bojović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia

Abstract
Introduction
The all-encompassing impact of the digital sphere, especially the Internet, deeply molds almost every aspect of
our lives. Within the domain of psychotherapy, the Internet’s sway is swiftly expanding. Since the outbreak of the
COVID-19 pandemic, we have witnessed the growing popularity of online forms of counseling, and there is ongoing
debate about whether this form is more beneficial than live sessions, both for patients and therapists. This paper aims
to examine whether online psychotherapy sessions are as beneficial for therapists as face-to-face sessions. The focus
was on therapists’ sense of work engagement and work-related flow experiences during work.
Method
The methodology was quantitative research with participants anonymously completing online questionnaires after
providing informed consent. The sample consisted of 83 RE&CBT therapists or therapists in training, the majority of
whom were women (88%). Among the participants, 59% conducted their therapy mostly or entirely in-person, while
the remaining 41% conducted theirs mostly or entirely online. Participants completed the short version Utrecht Work
Engagement Scale and the Work-related Flow Inventory, along with open-ended questions regarding the barriers and
benefits of online therapy.
Results
The independent samples t-test indicated no statistically significant difference between participants working in-per-
son and those working online, neither in work engagement (t(81)= -1.098, p>0.05) nor in work-related flow (t(81)=
.031, p>0.05). When examining the subscales of the Work Engagement Scale, the independent samples t-test indi-
cated no significant difference between participants working online and in-person in terms of vigor (t(81)= -1.112;
p>.005), dedication (t(81)= -1.074; p>.005), and absorption (t(81)= -.860; p>.005). Participants achieved high scores on
the Work Engagement Scale regardless of the mode of work (M(online)=47.91; M(in-person)=49.92), as well as on the
Work-Related Flow Inventory (M(online)=68.59; M(in-person)=68.51). Based on the qualitative analysis of open-ended
responses, therapists perceive the primary advantages of online therapy as time-saving benefits, as well as increased
accessibility for those unable to attend in-person sessions due to distance or physical limitations. However, they also
identify technical issues, such as internet connectivity problems, and the challenge of incomplete nonverbal commu-
nication, as significant drawbacks.
Discussion
The findings of this study suggest that RE&CBT therapists achieve similar levels of work engagement and flow regard-
less of the mode of work. Specifically, therapists working online experience comparable levels of energy during work,
a sense of importance, enthusiasm, and challenge, as well as being concentrated and happily occupied with their
work. Additionally, the experience of flow, characterized by total immersion in an activity accompanied by intense
enjoyment, did not significantly differ between these two groups of therapists. These findings imply that online psy-
chotherapy may provide equally fulfilling experiences for therapists as traditional in-person sessions, thereby open-
ing new avenues for therapy delivery in the contemporary digital age. However, it is important to note the limitation
of this study, namely the small sample size, which may affect the generalizability of the findings. Further research with
larger and more diverse samples is warranted to validate these results.

Keywords
work engagement, work-flow, online therapy, in-person therapy, RE&CBT

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PO43: Cognitive Behavioral Therapy in the Treatment of Adolescent Anorexia

Nervosa: An In-Depth Case Analysis
Hazal Baş
Kocaeli University School of Medicine, Department of Child and Adolescent Psychiatry, Turkey
Gokce Yagmur Efendi
Kocaeli University School of Medicine, Department of Child and Adolescent Psychiatry, Turkey

Abstract
Anorexia nervosa (AN), a debilitating eating disorder characterized by severe food restriction, intense fear of weight
gain, and distorted body image, poses significant challenges in its treatment and management. Over the years, the
focus of interventions for anorexia nervosa has shifted from primarily medical approaches to encompass comprehen-
sive psychotherapeutic strategies that consider both developmental and biological factors. Among these psycho-
therapeutic approaches, Cognitive Behavioral Therapy (CBT) has emerged as a prominent and effective intervention
for various eating disorders, including anorexia nervosa. Cognitive Behavioral Therapy, specifically tailored to address
eating disorders, has shown promise in treating adolescents with anorexia nervosa, demonstrating positive outcomes
and predictors of change in real-world clinical settings. In this case report, we present the case of a teenager with AN
who underwent CBT and additional psychopharmacological treatment.
A 17-year-old female patient presented to our clinic with complaints of persistent sadness, anhedonia, and fear of
weight gain beginning approximately in December 2022. The patient's parents also reported that the patient had
been eating very little, refusing to eat, feeling unhappy, and having crying attacks. As a result of the psychiatric eval-
uation at our clinic, the patient was diagnosed with anorexia nervosa. Medical treatment with fluoxetine 20 mg was
prescribed, and CBT was planned.
The interviews with the patient initially aimed to establish a therapeutic relationship, followed by providing informa-
tion about the physiology of the digestive system. The meaning of the term "anorexia" and its characteristics were
studied, and the potential consequences and risks related to the disorder were deliberated as a part of psychoedu-
cation. In the initial meetings, we discussed with our patient, who was unable to maintain a regular eating diary, the
challenges of doing so and the potential benefits of an eating list. The patient's daily calorie goal was discussed, and
any dysfunctional beliefs related to this goal were addressed. Together with the patient, the disease was formulated,
and efforts were made to raise the patient’s awareness of the vicious cycles that show the continuation of eating
problems. The negative consequences of excessive weight loss were discussed together (Increased body hair, fatigue,
osteoporosis, etc.), and tables regarding these were drawn and discussed with the patient. An attempt was made to
concretize the disorder and related cognitions utilizing metaphors. Daily activation tasks were given, and the patient's
participation was ensured.
During the interviews with the family, a detailed evaluation was made targeting the parents' difficulties and their
knowledge about eating/weight, and comprehensive psychoeducation about the disease was given. In family ses-
sions, inappropriate communication attitudes and the acceptance of emotions were also addressed.
A therapeutic relationship was established, and the patient started participating in social activities and was able to
maintain a regular eating diary. The frequency of daily mirror checks and weighing was reduced. The goal of not drop-
ping below the current weight was achieved, and there was a decrease in depressive symptoms.
This case report aims to illustrate the effectiveness of structured CBT and psychopharmacologicaltreatment in an
adolescent with AN.

Keywords
Anorexia nervosa, cognitive-behavioral therapy, adolescent

PO44: Navigating Changes: A Mixed-Methods Exploration of Therapists’

Experiences with Video Based Therapy in Post-COVID-19 Outpatient Settings
Julia Rosenbaum
MEU - Die Multiversität Studienzentrum der DIPLOMA Hochschule, 39112 Magdeburg, Germany, Germany
Michael Spaeth
MEU - Die Multiversität Studienzentrum der DIPLOMA Hochschule, 39112 Magdeburg, Germany, Germany
Thomas Berger
Universität Bern, Switzerland

Abstract
The COVID-19 pandemic significantly accelerated the adoption of video-based therapy (VBT) due to the necessity
for remote consultations. Initially eligible for compensation in Germany from October 2019, VBT became essential

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for maintaining psychotherapeutic services during the lockdown periods. This study aims to identify the key factors
influencing the adoption and continued use of VBT by German psychological psychotherapists in the post-pandemic
era. A mixed-methods design was employed to comprehensively analyze the factors impacting the adoption and
utilization of VBT.
A longitudinal quantitative survey was conducted with N = 299 licensed psychotherapists from the federal states gov-
erned by the East German Chamber of Psychotherapists (excluding Berlin). Conducted from March to May 2024, the
survey employed a questionnaire adapted from Domröse et al. (2021), previously used in the same research project to
examine attitudes toward and usage of VBT during the COVID-19 pandemic. The initial study revealed significant po-
larization among psychotherapists regarding the future use of VBT: 21.4% were undecided, 26.3% rejected its contin-
ued use, and 57% expressed willingness to continue employing VBT post-pandemic. These prior results highlighted
the role of media affinity, underscored the need for training, and identified a discrepancy between empirical evidence
supporting VBT’s efficacy and therapists' perceptions of therapeutic relationships within VBT.
The current study aims to longitudinally analyze the usage of VBT during and in the first year following the COVID-19
pandemic, focusing on factors influencing its acceptance and sustained use. The study seeks to identify determinants
and moderator variables affecting VBT acceptance and usage, and to understand therapists' perceptions of VBT's im-
pact on their work. A mixed-methods design was used, integrating independently collected and analyzed quantita-
tive and qualitative data. From June to September 2024, problem-centered interviews (Witzel, 2000) were conducted
with both users and non-users of VBT to gather qualitative data. These interviews explored the causes, effects, and
backgrounds of VBT, beginning with a narrative-generating question and followed by group-specific questions on
VBT experiences or attitudes and intentions.
Data analysis has commenced, with the presentation of longitudinal quantitative results and initial qualitative find-
ings scheduled for September. The analysis will initially focus on descriptive statistics to characterize the sample's
technological affinity and VBT usage post-contact restrictions. ANOVAs will examine differences in technology ac-
ceptance, usage, and VBT satisfaction. Exploratory factor analyses will identify key predictors and barriers. Chi-square
tests will compare usage behavior across survey waves. Correlations and regressions will explore the relationships
between perceived barriers, predictors, and attitudes towards VBT, with multiple regression analysis predicting the
intention to use VBT based on the Unified Theory of Acceptance and Use of Technology model. Problem-centered
interviews will be recorded, transcribed, and analyzed using content analysis in MAXQDA.
Ultimately, the study seeks to develop a model illustrating how psychotherapists integrate VBT into outpatient prac-
tice and contrasts it to its use during the pandemic. The findings will provide an overview of VBT's practical appli-
cations, highlight approaches for its targeted future use, as well as the actual limitations of VBT, address therapists'
concerns and explore potential barriers to its broader adoption.

Keywords
video-based therapy, longitudinal study, mixed-methods design, technology acceptance

PO45 Do negative emotions mediate the association of negative appraisals

and responses to involuntary musical imagery? Testing an OCD-analogue
cognitive model of distressing earworms
Josepha Wassermann
MSB Medical School Berlin, Germany
Karina Wahl
Universität Basel, Switzerland
Benedikt Reuter
MSB Medical School Berlin, Germany

Abstract
Background: Most people experience earworms or involuntary musical imagery (INMI) on a regular basis, but little
attention has been paid to INMI that is experienced as distressing. Phenomenologically, distressing INMI shares some
characteristics with obsessive thoughts or images. Both are intrusive and repetitive, interrupt ongoing thoughts and
are often experienced as uncontrollable.
Research Question: In order to better understand the development of distressing INMI, we tested predictions from
the cognitive model of obsessive-compulsive disorder. Specifically, we examined the assumption of a relationship be-
tween negative appraisals and responses to INMI, which is mediated by negative emotions. We expected a positive re-
lationship between negative appraisals and responses and hypothesized that this is mediated by negative emotions.
Method: Individuals with OCD (n = 79) and students without OCD (n = 298) completed the Characteristics of Ear-

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worms Questionnaire (CEAR). The main hypothesis was tested using a mediation analysis with the following CEAR
subscales: negative appraisals as predictor, negative emotions as mediator, and reactions as outcome. Group (with vs.
without OCD) was included as covariate.
Result: Analysis did not reveal a significant mediation effect. The direct effect of negative appraisals on responses to
INMI remained significant, when negative emotions were included as a mediator.
Conclusion: While the hypothesized mediation was not confirmed, the results support the notion of a relationship
between negative appraisals and unhelpful reactions to INMI. These findings are consistent with the prominent role
of appraisals in the cognitive model of OCD, but challenge the assumption that their influence on dysfunctional re-
actions is mediated by negative emotions. If replicated, results may provide an initial starting point for the effective
treatment of distressing INMI.

Keywords
involuntary musical imagery, negative appraisals, cognitive model of OCD, questionnaire

PO46: The Unified Protocol for adults in online group format: A single case
study of a panic disorder and agoraphobia comorbid
with depressive disorder
Liliana Pedro
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC),
Faculty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Catarina Francisco
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC),
Faculty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Marco Pereira
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC),
Faculty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Ana Fonseca
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC),
Faculty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Maria Cristina Canavarro
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC),
Faculty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal

Abstract
Group Transdiagnostic cognitive-behavioral treatments (CBT) have been developed to treat different patients with
various mental disorders simultaneously. Although group-based interventions have been traditionally applied in
face-to-face formats, when applied in online formats they can improve mental health access, particularly for patients
with geographic and physical mobility limitations. Among the transdiagnostic approaches, the Unified Protocol (UP)
has emerged as a flexible and effective intervention for treating comorbid conditions, such as anxiety and mood
disorders. There is solid evidence of the effectiveness of the UP in both face-to-face individual and group formats
worldwide, with more recent attention being directed toward its online implementation. The objective of this pre-
sentation was to present a case study that illustrates the application of a 12-week UP intervention, in an online group
format, in a 49-year-old Portuguese woman with a primary diagnosis of panic disorder with agoraphobia, comorbid
with major depressive disorder. At the end of the intervention, we observed a significant decrease in the severity and
impairment of anxiety (as assessed by the Generalized Anxiety Disorder-7 [GAD-7] and the Overall Anxiety Severity
and Impairment Scale [OASIS]) and depressive symptoms (as assessed by the Patient Health Questionnaire-9 [PHQ-9]
and the Overall Depression Severity and Impairment Scale [ODSIS]), as well as improvements in emotional regulation
difficulties (as assessed by Difficulties in Emotion Regulation Scale-Short Form [DERS-SF]). Likewise, improvements
were observed across all transdiagnostic dimensions (e.g., neurotic temperament, depressed mood, somatic anxiety,
avoidance) assessed by the Multidimensional Emotional Disorder Inventory (MEDI). The patient expressed high satis-
faction (i.e., 3 out of 3) with the intervention program (overall), with its components in particular, as well as the online
delivery format. These findings are consistent with prior research, particularly those that support the effectiveness of
the UP in face-to-face groups addressing comorbid disorders. However, it is essential to highlight the need for addi-
tional research to examine the generalizability of the findings of this case study, particularly regarding the effective-
ness of the UP delivered in an online group format.

Keywords
Unified Protocol; Transdiagnostic treatment; Group Intervention; Online Intervention; Comorbidity; Anxiety; Depression

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PO47 Investigating modes of support and self-/therapist tailored content in

ICBT for depressive symptoms - A factorial trial
Anton Käll
Linköping University, Sweden

Abstract
Aim: While ICBT is an effective option for treating mental health problems in a regular care setting, the question
remains about how best to provide support and content for patients in a way that promotes both clinical benefits
and cost-effectiveness. The aim of the current study was to investigate the impact of two factors relevant for im-
plementation of such interventions: First, whether a multiprofessional on-demand solution of support can produce
comparable efficacy to regular support from a therapist. Second, whether there is a difference in efficacy between
therapist-tailored and self-tailored content of the treatment (with a previous trial favouring self-tailored content).
Methods: A total of 248 participants were recruited and randomized to one condition of each factor. Questionnaires
assessing symptoms of depression and other common psychiatric disorder were administered at pre- and posttreat-
ment along with a measure of quality of life. Data were analysed using mixed-effects models.
Results: Data from the whole sample indicated large within-group reductions across all symptom measures and a
large increase in quality of life during the treatment phase. Comparisons of the different factor levels did not indicate
any significant differences between the factors, neither for the self-/therapist-tailored comparison nor the two modes
of support. Gains were maintained two years after the conclusion of the treatment.
Conclusions: A team-based, on-demand support approach produced results comparable to regular therapist support.
This novel mode of providing support may prove useful for integration into clinical practice and the multiprofessional
nature of most healthcare systems. Who chooses the content of the intervention does not seem to matter for treat-
ment efficacy.

Keywords
Factorial Trial; Depression; ICBT; Tailored treatment;

PO48 VR-SOAP: A Modular CBT Treatment in Virtual Reality for Social

Functioning in Young Adults with Psychosis
Ivo Alexander Meins
Dept of clinical and developmental neuropsychology University of Groningen, Groningen, The Netherlands, Nether-
lands
Wim Veling
University Medical Center Groningen, University of Groningen, Groningen, The Netherlands, Netherlands
Gerdina Hendrika Maria Pijnenborg
Dept of psychotic disorders GGZ-Drenthe, Assen, The Netherlands, Netherlands
Elisabeth Christine Dorothée van der Stouwe
University Medical Center Groningen, University of Groningen, Groningen, The Netherlands, Netherlands
Dauw Catharina Muijsson
University Medical Center Groningen, University of Groningen, Groningen, The Netherlands, Netherlands
Saskia Anne Nijman
Early Detection & Intervention Team (EDIT) Rotterdam Rijnmond, PsyQ, Rotterdam, The Netherlands, Netherlands

Abstract
Background
Young people (18-40) with a psychotic disorder have the same social goals as their healthy peers, but their social net-
works are smaller, they participate less often in leisure activities, and they are less successful in work and education.
Causes of these problems are multifaceted but culminate in difficulties with interacting in daily life social situations.
Current treatments have only moderate effects on social functioning and often target a single specific domain. We
developed and piloted a modular VR treatment for social functioning and participation (VR-SOAP). Presently, we are
conducting a clinical trial to investigate effectiveness.
Methods
Using an iterative scrum method with software engineers, clinicians, researchers, and individuals with lived experi-
ence of psychosis, we developed a modular CBT protocol and software prototype. A modular CBT treatment compris-
es multiple self-contained modules that can connect to other modules but also function independently. A modular

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approach to CBT could be beneficial as it allows for a more inclusive approach, potentially increases patient engage-
ment, and addresses the multifaceted nature of e.g., social interaction difficulties.
Subsequently, three therapists and five patients with a psychotic disorder aged 18-40 piloted VR-SOAP. Patients and
therapists were interviewed to assess the acceptability of the intervention along the seven domains of the Theoretical
Framework of Acceptability. Feasibility was assessed by means of interviews and session forms.
Results
The final protocol of VR-SOAP consisted of the following modules and targets: 1. Motivation and Pleasure (negative
symptoms); 2. Understanding Others (social cognition); 3. Safety and Trust (paranoid ideations and social anxiety);
4. Self-Image (Self-esteem and self-stigma) 5. Communication (communication and interaction skills). Patients and
therapists chose two out of the first four modules and always completed the Communication module.
Both participants and therapists found the therapy acceptable. They found the intervention simple to comprehend,
beneficial, and aligned with their values. Participants expressed increased confidence in their social interactions and
reported improvements in skills such as initiating conversations and maintaining a positive outlook.
No dropouts occurred during the pilot phase.
Discussion
The pilot phase of VR-SOAP demonstrated high acceptability across all dimensions of the acceptability framework.
The intervention was well tolerated and perceived as effective. In the ongoing randomized controlled trial, VR-SOAP
will be compared to an active control condition, VRelax, which targets daily reactivity and stress recovery. Participants
can state their preference for either condition, and those without a preference will be randomized (i.e. patient pref-
erence trial)
If VR-SOAP proves effective, it could offer much-needed support for young adults with a psychotic disorder to engage
in social activities and participate in society. Additionally, the modular nature of the treatment, targeting various
transdiagnostic factors, may provide insights for new treatments to improve social functioning across a range of
symptoms and disorders, including mood disorders, autism spectrum disorders, and anxiety disorders.

Keywords
Modular CBT, Psychosis, Social functioning, Virtual Reality, Pilot, Clinical Trial

PO49 Efficacy of Cognitive Behavioral Therapy Supported by the Therapeutic

Chatbot (Fido): Therapy Acceptability and Effects on Depression, Anxiety, and
Social Anxiety in a Randomized Controlled Trial
Robert Szymański
SWPS University of Social Sciences and Humanities, Poland
Stanisław Karkosz
Laboratory of Affective Neuroscience, Institute of Psychology, SWPS University, Poznań, Poland, Poland
Katarzyna Sanna
Center for Research on Personality Development, Institute of Psychology, SWPS University, Poznań, Poland, Poland
Jarosław Michałowski
Laboratory of Affective Neuroscience, Institute of Psychology, SWPS University, Poznań, Poland, Poland

Abstract
Introduction:
Traditional psychotherapy for common mental health conditions like depression and anxiety can be resource-inten-
sive (burdening both therapists and the public health system) and may utilize outdated and unengaging therapeu-
tic resources (such as paper-and-pen worksheets). Leveraging the promising evidence from recent meta-analyses of
agent-guided cognitive-behavioral therapies (AG-CBT), an ongoing clinical trial investigates the efficacy of Fido, the
first Polish-language chatbot specifically designed to complement traditional psychotherapy. While prior research
suggests that the previous iteration of Fido may be beneficial for improving mental health in subclinical populations,
this RCT investigates Fido’s efficacy in reducing the severity of depression, anxiety, and social anxiety symptoms in a
clinical sample of adult participants. We also study Fido’s acceptability as a conversational agent in a therapy setting.
Method:
We are conducting a 3-arm, open-label RCT with 5 time points: before the intervention, after the intervention, and at
one-, three- and six-month follow-ups. Participants complete screening surveys and undergo clinical interviews. We
enroll individuals aged 18-40 meeting the criteria for depression, generalized anxiety, social anxiety, or adjustment
disorder (with depression or anxiety symptoms). They are randomized in a 1:1:1 allocation ratio into 3 arms: experi-
mental, active control, and waitlist control. Participants in the experimental arm receive a set of exercises via a web-
based chatbot with the addition of five online therapy sessions of approximately 15 minutes with a human therapist.
The active control arm is given five traditional 50-minute online sessions (with a human therapist) and also includes

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homework assignments (matching the chatbot exercises). Each intervention follows the same set of standard CBT
topics, including general psychoeducation, the ABC model, cognitive distortions identification, Socratic questioning,
as well as gratitude practice. Symptom severity is assessed at each time point using self-report instruments for mea-
suring depression (PHQ-9, CESD-R), generalized anxiety and worry (GAD-7, PSWQ), social anxiety (LSAS, SAD-D based
on DSM-V), life satisfaction (SWLS), generalized self-efficacy (GSES) and loneliness (R-UCLA). We also utilize the The-
oretical Framework of Acceptability (TFA) items and the Negative Effects Questionnaire (NEQ) as well as the Working
Alliance Inventory-Short Revised (WAI-SR) to extend patient-reported outcomes.
Results and discussion:
Primary data collection and analyses will be completed by August 2024 (Ntarget = 75). We will compare changes in de-
pressive, generalized anxiety, and social anxiety symptoms after the therapy (or waiting period) and at a one-month
follow-up. Special attention will be given to participants’ perceived therapy acceptability, potential adverse effects of
each intervention, and therapeutic alliance and bond formed with the chatbot (in the experimental arm) and with
their therapist (in the active control arm). Qualitative patient feedback regarding the strengths and weaknesses of
each intervention will be summarized. We will discuss the benefits and risks of Fido use as a supplementary AG-CBT
solution alongside traditional clinical interventions.

Keywords
agent-guided CBT, chatbot, depression, anxiety, social anxiety, RCT, mHealth

PO50 Perception of Students’ Exam Anxiety From the Point of View of

Elementary and High School Teachers
Sava Cicmil
JZU Dom zdravlja Nikšić, Montenegro
Boris Ćorić
Specijalna psihijatrijska bolnica Dobrota, Kotor, Montenegro
Jovana Nikolovski
Edukativni centar Kognipraxis, Serbia
Mila Ignjatović
SARLAH DOO, Serbia

Abstract
This research aims to find out how elementary and high school teachers perceive exam anxiety in their students who
have it. We are interested in what symptoms lecturers notice exam anxiety by, then, their opinion on the factors that
cause exam anxiety. Furthermore, our field of interest is what the lecturers do when they notice that a student has
exam anxiety, with the aim of alleviating its symptoms, but also, what behaviors of the lecturers themselves contrib-
ute to intensifying the symptoms of exam anxiety. Finally, our goal is to investigate what are the lecturers’ recom-
mendations when it comes to reducing symptoms, or preventing exam anxiety. This research included 20 lecturers,
10 of whom teach in elementary school, and 10 teach in high school. All respondents work in schools in Nikšić, Mon-
tenegro. This is a qualitative research and semi-structured interview was used to obtain data. The data analysis was
done through thematic analysis, and the results indicate that lecturers notice exam anxiety by psychophysiological
symptoms, such as stiffness, tremor, facial redness etc. Regarding the causal factors of exam anxiety, the respondents
believe that those are student’s nature, student’s personality traits such as perfectionism, the ambitions of parents
who redirect them to their children, student’s ambition, prejudices about lecturers, fear of teachers, the impact of
corona virus, fear of subjects, etc. Lecturers use various techniques to reduce exam anxiety in their students, such as
encouragement, help and humor, but they often tend to criticize students when they show nescience, and that can
negatively affect the students, in the sense of exam anxiety. In order to reduce the symptoms of exam anxiety, or to
prevent this phenomenon, lecturers believe that students should consult with professionals (psychologists, peda-
gogues), talk to their parents, lecturers and peers. Also, they believe that certain changes should be introduced in
the educational system of Montenegro, such as cancelling the grades on some of the trimesters and reduction of the
amount of study material. This research shows that lecturers in Nikšić, Montenegro, know well and recognize exam
anxiety as a phenomenon and try to alleviate its symptoms when they notice them in their students, but they them-
selves tend to negatively influence their students with some of their behaviors, when it comes to exam anxiety, and
that it is possible that because of this, they gave some socially desirable answers on interviews. Such data enable fur-
ther research to be carried out, which would examine, for example, lecturers’ awareness of their own ways of behavior
that negatively affect their students. Also, students’ perception of the existence and effectiveness of interventions
used by lecturers to help them with their exam anxiety could be examined.

Keywords
exam, anxiety, factors, lecturers, perception

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PO52 Intervention mapping of E:REMEDI

Elīna Ieva Smule
Rigas Stradins Universit, Latvia
Christian Martin Gerhard Stierle
Fresenius University of Applied Sciences, Hambur, Alte Rabenstraße. 1, 20148 Hamburh, Germany
Ilona Krone
Lect. (acting) Dr. psych., Academic Staff, Department of Health Psychology and Paedagogy Lead Researcher (Acting),
Institute of Public Health, Latvia

Abstract
Background: Digital interventions, such as websites, have been proposed to address society's demand for psychologi-
cal health support in the digital space. However, many existing applications lack professional input and may not cater
to specific demographics, possibly due to poorly described intervention development processes. This study aims to
accurately describe the intervention mapping for the E:REMEDI website, tailored for Latvian-speaking young adults.
The intervention focuses on enhancing emotion regulation skills to improve psychological well-being.
Objective: This study details the development of E:REMEDI, an evidence-based self-help program aimed at improving
emotion regulation skills. Using the Intervention Mapping (IM) method, the program incorporates psychoeducation,
compassion-focused techniques, and interactive tasks. E:REMEDI is delivered via computers, with potential future
delivery via mobile devices.
Methods: The study employed four steps of Intervention Mapping: 1. Needs assessment: Based on this assessment, a
logic model was developed; 2. Identification of intervention objectives: Determinants and objectives of the interven-
tion were identified; 3. Theory-based methods and practical strategies: The theoretical framework of change was used
to inform the design, additional content, and functionality of the interactive E:REMEDI intervention; 4. Development
of the intervention.
Conclusions:The theoretical framework was used to inform the design, additional content, and functionality of
E:REMEDI. Thirteen emotion regulation-affecting behaviours were identified, leading to improved outcomes such
as increased psychological health, enhanced emotion regulation skills, and greater participation in psychological
health-related activities for individuals with low emotion regulation skills. Based on these findings, the E:REMEDI
intervention was developed.
Results: The program consists of a 7-week course with 11 sessions. Each session lasts up to 20 minutes. Homework
is assigned between sessions, which the user must complete for six consecutive days to access the next session. The
session schedule is based on the Adaptive Coping with Emotions Model (Berking & Whitley, 2014) and includes: Psy-
choeducational components; 1 to 2 interactive tasks from compassion therapy; Feedback; Homework.

Keywords
digital (psychological) intervention; intervention mapping; digital health; website; technology; psychological health;
emotion regulation; emotion regulation skills; the Adaptive Coping with Emotions Model (ACE Model); Compas-
sion-Focused Therapy (CFT)

PO53 The relationship between burnout and depression: Can self-compassion

be an antidote for depression in CBT therapists and trainees?
Višnja Tatić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Aleksa Pantić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia

Abstract
A study conducted by Australian psychologists has shown that self-compassion moderates the relationship be-
tween burnout and depression, suggesting a protective potential against developing depression (McCade, Frewen,
& Fassnacht, 2021). The primary aim of the current research was to explore the relationship between burnout and
depression among CBT therapists and trainees in Serbia, Croatia, and Bosnia and Herzegovina. Additionally, this re-
search investigated the role of self-compassion in this relationship to determine if the findings from the aforemen-
tioned study could be replicated among CBT psychotherapists and trainees in our region. Three hypotheses were
proposed: there will be a significant negative association between self-compassion and burnout, as well as between

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self-compassion and depression, and that self-compassion will moderate the relationship between burnout and de-
pression. The sample consisted of 120 CBT psychotherapists and trainees under supervision from Serbia (75.8%), Cro-
atia (16.7%), and Bosnia and Herzegovina (7.5%). The following instruments were used: The Self-Compassion Scale
– Short Form SCS-SF (Raes, Pommier, Neff, & Van Gucht, 2011), Copenhagen Burnout Inventory CBI (Kristensen, Borritz,
Villadsen, & Christensen, 2005), Depression Anxiety Stress Scales - depression subscale of 7 items (DASS-21; Lovibond
& Lovibond, 1995). All correlations were statistically significant (p < .01). A negative association was found between
self compassion and burnout (r = −.297**) supporting the hypothesis that higher levels of self compassion are asso-
ciated with lower levels of burnout. Similarly, a negative association was found between self compassion and depres-
sion (r = -.373**), supporting the hypothesis that higher levels of self-compassion are associated with lower levels of
depressive symptoms. Also, a positive association was found between burnout and depression (r = .522**). Hierar-
chical linear regression was performed to test the moderating effects of self-compassion on the association between
burnout and depression. A multiple regression was undertaken to determine whether self-compassion moderated
the relationship between overall burnout and depressive symptoms. The effect of burnout on depression was positive
and significant [b = 0.25, 95% CI (0.175, 0.324), t = 6.656, p=.000]. When burnout was entered as the only predictor,
the regression model explained 26.7% of variance in depression scores. However, the interaction between burnout
and self-compassion wasn’t found to be statistically significant [b = 0.001, 95% CI (−0.008, 0.011), t = 0.264, p = .792],
opposed to the hypothesis that self-compassion moderates the effect of burnout on depression, meaning that it can’t
be considered a protective factor against depression in people experiencing high levels of burnout. Nevertheless,
self-compassion was once again confirmed as an important factor of wellbeing, since significant negative correlations
were reported with both depression and burnout. Further research may consider exploring reasons why burnout
happens and how it could be prevented in the first place, as in this study self-compassion couldn’t be considered a
protective factor against developing depressive symptoms in individuals suffering from burnout. Further replications
should also be conducted, as it is possible that different results would be obtained with other samples.

Keywords
depression, burnout, self-compassion

PO54 Investigating a mindfulness intervention for eating disorder symptoms

and body dissatisfaction: negative affect and interoceptive awareness as
mediators
Maria-Camelia Lica
Babeș-Bolyai University, Department of Clinical Psychology and Psychotherapy, Romania
Lia-Ecaterina Oltean
Babeș-Bolyai University, Department of Clinical Psychology and Psychotherapy, Romania

Abstract
Background: Body dissatisfaction and symptoms of eating disorders are relatively common, and yield significant in-
dividual and societal costs. First line treatments like CBT show good results for some individuals, more than others,
suggesting the need for additional research. Mindfulness interventions seem promising as they might target certain
mechanisms, leading to symptom and body dissatisfaction reduction. Studies so far focused mostly on mindfulness
psychotherapy interventions, but less is known about self-administered online interventions and their mechanisms
of change.
Objective: In this randomised controlled study, we aimed to (1) investigate the effectiveness of an online mindfulness
intervention in reducing body dissatisfaction and eating disorder symptoms, and to (2) test the mediating role of
negative affect and interoceptive awareness for the effectiveness of the intervention, at post-test and at 1 month
follow-up.
Methods and preliminary results: Eligible participants (N = 100, aged 18-52, with self-reported eating disorders symp-
toms) were recruited via online ads on social media platforms in Romania and randomly assigned to two groups:
mindfulness and an active placebo. Thirty participants completed the intervention and 24 responded at follow-up.
Preliminary results on participants recruited thus far showed that eating disorder symptoms decreased. The mean
score for the intervention group (M = 2.238, SE = .330), was lower than the placebo group at post-test (M = 2.932, SE
= .317), F (1, 29) = 1.299, p > .05. Scores remain lower for the intervention group at follow-up (M = 2.055, SE = .363),
compared to active placebo (M = 2.609, SE = .349), F (1, 23) = 1.217, p > .05. Both groups showed reduced body dis-
satisfaction, with lower follow-up scores for the intervention group (M = 47.500, SE = 5.087) compared to the placebo
(M = 53.538, SE = 4.887), F (1, 23) = 1.464, p > .05. Interoceptive awareness had an effect on eating disorder symptoms,
but results were not statistically significant at post-test (b = -1.993, p = 0.056, 95% CI [-.513, .171]) or at follow-up (b

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= -3.170, p = 0.004, 95% CI [-3.921, 2.487]). The direct group effect was not significant. Results were similar for body
dissatisfaction.
Discussion: Our preliminary results suggest that an online mindfulness intervention might have an effect on decreas-
ing eating disorder symptoms and body dissatisfaction. Eating disorder symptoms were lowered at post-test and
might be maintained at follow-up. Body dissatisfaction seems to decrease as well. The effect could be mediated by
interoceptive awareness. Considering our small sample size, some results were not statistically significant. Because
of this, the power of the study is lowered, so results should be interpreted with caution. Despite study limits, results
of this study are important. The mindfulness intervention is simple and easy to administer, even online. It also shows
results in lowering key eating disorder symptoms and body dissatisfaction.
This research was supported by the Student Research Fellowship at STAR-UBB Institute, Babeș-Bolyai University.

Keywords
eating disorders, body dissatisfaction, online intervention, mindfulness intervention, online intervention, interocep-
tive awareness, negative affect

PO55 Relationship among emotional regulation strategies, mindfulness and

creativity focusing on both self-reported creativity and creative behaviors
Tijana Marković
University of Belgrade, Faculty of Philosophy, Serbia
Marija Nenadović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Isidora Pejčinović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Natalija Krasojević
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia

Abstract
Introduction: This study investigates the relationship among emotional regulation strategies (ERS), mindfulness, and
creativity, focusing on self-reported creativity and creative behaviors. Expressive creative activities in therapy are pos-
itively associated with mental health, suggesting that creativity’s therapeutic effect might be linked to emotional
suppression. Research on the third wave of CBT, based on mindfulness, emphasizes the positive relationship between
full awareness and cognitive reappraisal, improving therapeutic outcomes. Including multidimensional measures of
these constructs in research could enhance therapeutic practices by supporting interventions that improve mental
health both within and outside the therapeutic context.
Method: This study used a sample of 235 participants, aged 18 to 59 (age: M = 32,69, SD = 9,40; 73,2% female, 26,8%
male), recruited online. We employed the Emotion Regulation Questionnaire (ERQ), the Five Facet Mindfulness Ques-
tionnaire-Short Form (FFMQ-SF), and Questionnaire of self-assessment of creativity and the Questionnaire of self-as-
sessment of creative behavior (Ljubotina et al. 2015).
Results: Significant positive but relatively low correlations were found between the ERS of reappraisal and emotional
suppression with self-assessments of creativity (r= .140, p< .05; r= .240, p< .01). Low to moderate correlations were
found between dimensions of mindfulness, Describing and Observing with self-assessed creativity (r= .182, p< .001;
r= .387, p< .01), as well as between Describing (r= .273, p< .01), Observing (r= .528, p< .01), Nonjudging (r= -.262, p<
.01), Nonreactivity (r= .309, p< .01) and emotional suppression. No significant associations were found with ERS or
overall mindfulness regarding creative behavior.
Stepwise multiple regression analysis identified four mindfulness dimensions as key predictors of the emotional sup-
pression: Describing (t= 5.574, p< .01), Observing (t= 9.994, p< .01), Nonreactivity (t= 6.469, p< .01), and Nonjudging
(t= -8.524, p< .01). In terms of the reappraisal strategy, Nonreactivity emerged as a significant predictor (t= 4.974, p<
.01). Conversely, for self-assessment of creativity, emotional suppression and overall mindfulness were significant pre-
dictors (t= 3.139, p< .01 and t= 2.669, p< .01). However, emotional suppression lost its predictive power when mind-
fulness dimensions were included in the predictive model with Describing and Observing becoming key predictors
of creativity (t= 2.187, p< .05; t= 6.599, p< .01).
Discussion: The unexpected positive correlations between emotional suppression and self-assessed creativity might
suggest that classification of ERS into adaptive and maladaptive is overly simplistic and that contextual factors need
to be considered. The absence of correlation between creative behavior, mindfulness and ERS, should be reconsid-
ered using a different, more elaborate questionnaire. Our results support Baas et al. Differential Hypothesis (2014),
suggesting that only the ability to consistently observe and attend to stimuli predicts creativity.

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Conclusion: These findings have practical implications for therapeutic interventions, emphasizing the importance
of targeting specific dimensions of mindfulness and adaptive ERS to enhance creativity and emotional well-being.
Integrating creativity-enhancing techniques and open-monitoring type of meditation practice into clinical practice
may offer novel avenues for promoting psychological health. Further research is warranted to clarify the underlying
mechanisms and refine therapeutic approaches aimed at harnessing the potential of mindfulness and ERS in foster-
ing creativity and overall well-being.

Keywords
mindfulness, emotional regulation strategies, reappraisal, emotional suppression, creativity, CBT third wave

PO56 The role and utility of attachment styles

and emerging technology in CBT
Srđan Bogojević
N/A, Serbia
Božidar Antić
Contact Service d.o.o., Serbia
Slađana Ljubojević
Phuket d.o.o., Serbia
Jovana Krstić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)
Jasenko Pucar
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)

Abstract
Recent studies have shown the importance of attachment style tendencies in the treatment outcome as well utility
in enriching the therapeutic alliance. As there is limited research on how attachment styles are used or can be used
in the CBT framework, this study served as an exploratory device for uncovering this question considering various
factors. Additionally, we live in an ever-changing environment and it seems that the use of AI technology is on the
rise. As such we explored how this tool could be used by both clients and practitioners. Participants were recruited
into two groups, the first consisted of 153 members of various internet groups, while the other of 39 CBT/REBT prac-
titioners. We examined how both groups scored on several questionnaires and analyzed their answers on open-end-
ed questions regarding attachment style and AI use. Preliminary results show that both groups’ attachment style is
significantly associated with emotional intelligence, where more anxious or avoidant individuals score consistently
lower on various dimensions of Emotional intelligence. Categorizing participants into four distinct styles gave a more
nuanced overview of these and other associations. The first group had a more even distribution of attachment styles
with 31% being secure, 19% anxious, 27% avoidant, and 23% fearful avoidant. Practitioners as expected fell largely
into the securely attached group with 80%, followed by 12% anxious and 8% avoidant. Some attachment styles seem
to be more prone to specific coping strategies than others, most notably fearful avoidant participants had a great-
er tendency towards denial, behavioral disengagement and substance abuse which was associated with lower life
satisfaction and greater distress. An interesting find is that practitioners under supervision seem to be less anxiously
attached than certified therapists. Practitioners with higher attachment anxiety had significantly lower scores across
all EI facets, while the same did not apply in case of the avoidance dimension. Practitioners seem to not focus on at-
tachment styles as much as they would like to and have not explored AI use in their practice. On the other hand 8% of
the first group seem to be using AI during emotional distress in some capacity. When asked what could be improved
on in therapy, former and current CBT clients cited the therapeutic alliance and therapeutic style. The implications can
be quite broad, therapists can identify their clients’ attachment traits and focus on coping strategies that are more
beneficial for them. When dealing with attachment styles CBT practitioners seem less likely to explore educating cli-
ents, teaching social skills, and using the working alliance as a safe space where clients can explore their attachment
style tendencies in the form of irrational beliefs and maladaptive behavior towards the therapist. The growing need
for AI in the context of emotional distress, as noted here and in other studies is also something practitioners can be
made aware of and be more willing to explore in practice. Some potential uses so far are emotional support in the
form of validation, psychoeducation and general help regarding homework.

Keywords
CBT, REBT, attachment styles, emotional intelligence, coping strategies, chat-GPT

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PO57 The Power of Perception: Unpacking the Role of Negative Thinking in

High School Students’ Test Anxiety
Ercan Akın
Hacettepe University, Department of Guidance and Psychological Counseling, Turkey
Türkan Doğan
Hacettepe University, Department of Guidance and Psychological Counseling, Turkey
Eyüp Sabır Biçer
Hacettepe University, Department of Guidance and Psychological Counseling, Turkey
Nilüfer Koçtürk
Hacettepe University, Department of Guidance and Psychological Counseling, Turkey
Duygu Betül Özkanca
Bahçeşehir University, Department of Guidance and Psychological Counseling, Turkey
Elif Özüm Kuş,
Halic University, Department of Clinical Psychology, Turkey
Cemile Dur Öztürk
Hacettepe University, Department of Guidance and Psychological Counseling, Turkey

Abstract
Introduction: Test anxiety is a term with emotional and cognitive components. Negative cognitions are an important
factor in test anxiety. Although there are studies supporting the relationship between negative cognitions and test
anxiety in the literature, some of the cognitive components may be shaped by the influence of culture. Therefore, the
aim of this study is to determine the factors that contribute to the formation and maintenance of negative cognitions
about taking an exam among adolescents using a qualitative approach.
Method: The study used the Consensus Qualitative Research (CQR) method. In this study, purposive sampling was
used; firstly, the Test Anxiety Inventory (TAI) was applied to the students who applied, and fifteen students who scored
above the average were randomly invited to the study. Fifteen students participating in the study were administered
an inventory including semi-structured interview questions prepared using cognitive and behavioral therapy litera-
ture and expert opinions.
Results: Students’ negative cognitions about the exam were categorized into four areas: self-oriented, other-oriented,
future-oriented, and test-oriented. The self-orientated domain had three themes: self-criticism, lack of confidence,
and high self-expectations. The other-oriented domain contained two themes: blaming others and concern about
the social consequences of failing. The future-orientated domain had two themes: reading the future and intolerance
to uncertainty. Three themes of the test-oriented domain were identified: distraction during the exam, inefficient
test-taking strategies, and negative study skills evaluation. According to the study’s findings, it was revealed that
students had negative cognitions that can be expressed as thoughts about themselves, others, the future, and the
exam itself.
Discussion and Conclusion: In this study, it was aimed to examine adolescents’ test-related negative cognitions based
on a qualitative research method. The study results reveal that students have negative cognitions, which are thoughts
about themselves, others, the future, and the test itself, and that these negative cognitions may impact students’ test
anxiety levels, self-confidence, academic performance, and well-being. Mental health professionals and educators can
contribute to improving students’ academic performance and well-being by addressing these negative cognitions.

Keywords
Test anxiety, negative cognitions, adolescent, dysfunctional thinking

PO58 Exploring health anxiety in long COVID survivors: a qualitative analysis

Matea Šoštarić
University of Zagreb, Faculty of Humanities and Social Sciences, Croatia
Nataša Jokić-Begić
University of Zagreb, Faculty of Humanities and Social Sciences, Croatia
Tanja Jurin
University of Zagreb, Faculty of Humanities and Social Sciences, Croatia
Anita Lauri Korajlija
University of Zagreb, Faculty of Humanities and Social Sciences, Croatia

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Abstract
Health anxiety, encompassing a spectrum from mild concern to excessive worry about having or developing a dis-
ease, has drawn heightened attention in the wake of the COVID-19 pandemic. The pandemic has not only heightened
the risk of developing health anxiety but also triggered underlying health anxiety in many individuals. Long COVID,
often termed post-COVID syndrome, significantly impacts individuals who endure persistent symptoms following
acute COVID-19. Research suggests that up to 80% of severe COVID-19 patients experience prolonged physical and
psychological symptoms. In light of the evolving landscape of post-COVID health complications, there remains a no-
ticeable gap in research concerning health anxiety among long COVID survivors.
Our study aimed to investigate the phenomenon of health anxiety among adult survivors of severe COVID-19 during
the post-acute period (within one year of hospital discharge). This research forms part of a broader project spanning
Bulgaria, Slovakia, Croatia, and Romania, employing a biopsychosocial public health perspective. We conducted in-
depth, semi-structured interviews with 30 adult survivors (15 women and 15 men, aged 21-78), analyzing the data
thematically.
Our findings reveal that individuals who have survived serious COVID-19 identified several triggers for health anxi-
ety. These triggers include physical symptoms, medical appointments, exposure to illness-related stimuli, changes in
health status, and physical exertion or activity. These triggers activated their core beliefs and thoughts about health,
which were often negative. Participants reported various reassurance-seeking behaviors, bodily symptom preoccu-
pations, avoidance behaviors, and security behaviors. Some participants indicated pre-existing health anxiety, while
others experienced heightened health anxiety after hospitalization. Those displaying higher health anxiety symp-
toms tended to be more preoccupied with bodily sensations and exhibited maladaptive coping behaviors.
The findings underscore the necessity for tailored interventions to address health anxiety and its consequences in
the context of post-COVID syndrome. Healthcare providers should consider these insights when developing support
strategies for individuals experiencing health anxiety following severe COVID-19.

Keywords
health anxiety, long COVID, qualitative analysis

PO59 Cognitive model of perceptual anomalies: The role of source

monitoring, top-down influence and inhibitory control processes in
hallucinations in schizophrenia and hallucinatory-like experiences
in the general population
Adrianna Aleksandrowicz
Institute of Psychology, Polish Academy of Sciences, Poland
Joachim Kowalski
Institute of Psychology, Polish Academy of Sciences, Poland
Steffen Moritz
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
Izabela Stefaniak
Faculty of Medicine, Lazarski University, Poland
Łukasz Gawęda
Institute of Psychology, Polish Academy of Sciences, Poland

Abstract
Background: Cognitive models emphasize that top-down processes, source monitoring, and inhibitory control con-
tribute to mechanisms of perceptual anomalies such as auditory hallucinations (AHs) and hallucinatory-like experi-
ences (HLEs). The prevalence of perceptual abnormalities is not restricted to the clinical population and represents
a continuum ranging from illusions to distressing hallucinations. Still, there is little evidence to confirm that these
processes explain mechanisms of perceptual anomalies on the entire continuum of different perceptual phenomena.
The study aims to investigate a gradual pattern in the number of errors made on tasks assessing top-down process-
es, source monitoring, and inhibitory control. Patients diagnosed with schizophrenia spectrum disorders who are
currently experiencing hallucinations are expected to make the most errors, followed by non-hallucinating patients,
individuals with frequent HLEs, and finally, healthy controls, who are expected to make the fewest errors. Moreover,
the study aims to examine the relationship between perceptual anomalies, cognitive processes, self-disturbances,
and social functioning on the entire continuum of perceptual phenomena.
Methods: Eighty-nine patients with schizophrenia spectrum disorders (SSD) were divided into two groups based on
AHs presence - 46 with AHs and 43 - non-hallucinating, 43 matched healthy controls, and a sample selected from

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the general population of 40 participants with high HLEs and 43 with low HLEs performed three experimental tasks
assessing top-down processes (False Perception Task - FPT), source monitoring (Action Memory Task - AMT), inhib-
itory control (Go/No-Go Task). Patients were assessed with the Positive and Negative Syndrome Scale (PANSS), and
all groups were screened using the Mini International Neuropsychiatric Interview (MINI) for the presence of mental
disorders. Exclusion criteria were: age 18-45 years, neurological disorders, alcohol dependence in the past 12 months,
hearing and intellectual impairments. Additionally, for the non-clinical groups, the presence of the current mental
disorders was the exclusion criterion. All patients were stable during the assessment and had no major changes in
pharmacological treatment two weeks before the study. Group differences were calculated with Kruskal-Wallis ANO-
VA. Correlational analyses were performed with Spearman’s rho correlations with the Holm correction for multiple
comparisons. Then, a hierarchical regression model was created to search for possible predictors of self-reported
perceptual anomalies in the entire sample.
Results: Both clinical groups committed significantly more false perceptions in the FPT and committed more source
monitoring errors than HC. However, there were no significant differences between clinical groups (SSD with AH vs
SSD without current AH) and non-clinical groups (high HLEs vs low HLEs). No significant group differences were found
for false alarms in the Go/No-Go Task. However, there was a significant relationship between self-reported perceptual
and all the cognitive processes, as well as self-disturbances and social functioning. Regression analysis showed that
all three tasks significantly predicted self-reported perceptual anomalies in the entire sample.
Discussion: Although this study shows some discontinuities in cognitive mechanisms of perceptual anomalies in clin-
ical and non-clinical populations, the investigated processes are connected with self-reported perceptual anomalies.
Addressing the impact of cognitive processes on perception could be an important aspect of future studies investi-
gating interventions directed at perceptual anomalies.

Keywords
perceptual anomalies, hallucination continuum, source monitoring, top-down processes, inhibitory control

PO61 Coping with economic strains: Reliability and validity of the European
Portuguese version of the Dyadic Coping Inventory for Financial Stress
Marco Pereira
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC),
Faculty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Mariana Gonçalves
University of Coimbra, Faculty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Susana Pina
University of Coimbra, Faculty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Afonso Gomes
University of Coimbra, Faculty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Ana Sofia Roque
University of Coimbra, Faculty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Stephanie Alves
Lusófona University, HEI Lab: Digital Human Environment Interaction Labs, Lisbon, Portugal, Portugal
Alexandra Martins
Cantanhede Health Center, Coimbra Local Health Unit (ULS Coimbra); University of Coimbra, Center for Research in
Neuropsychology and Cognitive-Behavioral Intervention (CINEICC), Coimbra, Portugal, Portugal
Ana Vedes
Clinical Psychologist in Private Practice, Zurich, Switzerland, Switzerland

Abstract
Background: Couples fighting over money is common within families and there is ample evidence suggesting that
financial stress can negatively affect a couple’s relationship. The Dyadic Coping Inventory for Financial Stress (DCIFS)
is a 23-item self-report measure that was recently developed to assess the way couples cope with financial stress. The
aim of this study was to present the psychometric properties of reliability and validity of the European Portuguese
version of the DCIFS.
Method: The sample consisted of 215 individuals (77.2% female) with a mean age of 39.58 years (SD = 12.25; range:
19-79), recruited from the community. All participants were in a romantic relationship, on average for approximately
15.56 years (SD = 12.45). In addition to the DCIFS, participants completed self-reported measures assessing dyadic

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adjustment (Revised Dyadic Adjustment Scale), communication (ENRICH), psychological distress (Depression Anxiety
Stress Scales), relationship mindfulness (Relationship Mindfulness Measure), and work-family conflict (Work-Family
Conflict and Family-Work Conflict scales).
Results: The Confirmatory Factor Analysis (CFA), at item-level, indicated that the 11-factor model yielded an accept-
able fit to the data (CFI = .952; RMSEA = .066; 90% CI for RMSEA = [.056; .077]; SRMR = .056). Intercorrelations between
DCIFS subscales were all in the expected direction and consistent with the original validation study. Acceptable val-
ues of internal consistency were found for nearly all subscales, with Cronbach’s alphas ranging between .72 (Negative
DC by the partner) and .96 (Joint Problem-focused DC). Stress communication by oneself (Cronbach’s alpha = .55),
Stress communication by the partner (Cronbach’s alpha = .63) and Negative DC by oneself (Cronbach’s alpha = .62)
were below the .70 threshold. Correlations with self-reported measures assessing dyadic adjustment, dyadic com-
munication, relationship mindfulness, psychological distress, and work-family conflict supported the convergent and
discriminant validity of the 11 subscales of the DCIFS.
Discussion: These preliminary results generally attest the reliability and validity of the European Portuguese version
of the DCIFS and establish its applicability in research and clinical settings, particularly among couples and families
struggling with financial issues.

Keywords
dyadic coping; financial stress; reliability; validity.

PO62 Neurodevelopmental traits and Chronic pain

Rieko Takanashi
Japan
Mirai Miyoshi
Chiba University, Japan
Kayoko Taguchi
Chiba University, Japan
Tokiko Yoshida
Chiba University, Japan
Eiji Shimizu
Chiba University, Japan

Abstract
Introduction: The high prevalence of chronic pain is one of the major problems in developed countries, and a consid-
erable number of cases remain incurable partly due to psychological and social problems. In recent years, a high rate
of patients with pain problems have been diagnosed with attention deficit hyperactivity disorder (ADHD) and autism
spectrum disorder (ASD). Therefore, it is important for practitioners who approach chronic pain to consider those neu-
rodevelopmental traits. In this study, we investigated the frequency of people with chronic pain who have a probable
neurodevelopmental disorder and found neurodevelopmental characteristics related to chronic pain. The aim of this
study is to obtain empirical data for the development of cognitive behavioral therapy for chronic pain patients with a
neurodevelopmental disorder.
Methods: A cross-sectional case-control study through an anonymous online survey was conducted from August 31st
to September 20th, 2022. Individuals with somatic pains as their main concerns for more than 6 months and a score
of 23 or higher on the Somatic Symptom Disorder – B Criteria Scale (SSD-12) were included in the probable chronic
pain group, and individuals with no somatic symptoms who scored 0 on the SSD-12 and were age and sex-matched
to the chronic pain group were included in the healthy control group. Individuals diagnosed with cancer, alcohol or
substance use disorder, incarceration, cardiovascular disease, or cerebrovascular disease were excluded. We used the
Adult ADHD Self-Report Scale-V1.1 (ASRS-V1.1) as a measure for ADHD and the Autism Spectrum Quotient (AQ) for
ASD. We compared the two groups regarding neurodevelopmental traits using the Mann-Whitney U test and exam-
ined the association of neurodevelopmental characteristics and chronic pain using logistic regression analysis (SPSS,
version 29.0).
Results: Among the 34,060 individuals aged 18-85 who participated in this study, 1,583 (4.6%) were considered to
have probable SSD and 851 (2.5%) to have chronic pain. After excluding individuals with the conditions mentioned
above and with invalid responses to questionnaires, we included 523 individuals in the chronic pain group (mean
age 52.3±13.4) and 542 in the control group. In the chronic pain group, 115 (22%) rated higher than the cutoff point
on ASRS-V1.1 and 83 individuals (16%) rated higher than the cutoff point on AQ, while only 5 (1%) and 14 (3%) in the
control group rated higher than the cutoff point on each scale, respectively. Individuals in the chronic pain group had
significantly higher scores on all subscales of ASRS-V1.1 and AQ. Significant associations between chronic pain and

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inattention (ASRS-V1.1), attention switching, and attention to details were observed (OR, 0.79; 95% CI, 0.75-0.83, OR,
0.86; 95% CI, 0.77-0.96, OR, 0.9; 95% CI, 0.83-0.97, respectively). A significant association between chronic pain and
attention switching disappeared in the model with personality traits included as independent variables exploratory.
Conclusion: This study illustrated a high frequency of the probable comorbidity of neurodevelopmental disorder and
chronic pain. Inattention, attention switching, and attention to details were related to chronic pain. Specific protocols
for chronic pain with neurodevelopmental disorder which focuses on attention would be helpful for those patients.

Keywords
Neurodevelopmental traits, Chronic pain, Cognitive Behavioral Therapy

PO63 Psychotherapists’ Misconceptions About CBT

Olga Bradić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Marija Mirkailo
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Marija Milenković
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Anđelka Jonić Đorđević
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia

Abstract
Cognitive Behavioural Therapy (CBT) is a widely respected and evidence-based approach to mental health treatment.
Despite its proven effectiveness, several misconceptions persist about what CBT entails and who can benefit from it.
Dispelling these myths is crucial to ensure that individuals can make informed decisions about seeking therapy and
fully take advantage of its benefits.
According to (Tovilovic,2021) there are nine common myths surrounding CBT: CBT Requires High Intelligence; It Ig-
nores Emotions; It Focuses Only on Positive Thoughts; CBT is a Quick Fix; CBT is Only Focused on Symptom Relief; CBT
is Not Interested in The Client’s Past; CBT Neglects The Role of Client-therapist Relation as a Factor of Change; CBT
Doesn’t Perceive Social and Environmental Factors as Important; CBT is Just Common Sense. The goal of this study
was to explore how psychotherapists in Serbia perceive these myths. Our expectations were that not CBT oriented
psychotherapists would show a higher level of belief in above mentioned myths about CBT.
By using a descriptive type of research we have collected data from therapists and trainees of CBT and other psycho-
therapeutic modalities (Transactional Analysis (26,7%), CBT (20%), Systemic Family Therapy (13,3%), Psychodynamic
Therapy, Integrative Therapy, Constructivist Therapy, Psychodrama Therapy, Gestalt Therapy, and others) from Ser-
bia. They have all been contacted through a collective mailing list throughout March and April of 2024. The sample
consisted of 120 people (98 female and 22 male) with a range of therapeutic experience from 0 to 49 years, the most
represented were those with 10. Based on the CBT myths mentioned by Tovilovic, 2021., we have created a question-
naire with 9 items (α=0,78) representing each myth with a Likert-type scale (1 = strongly disagree, 5 = strongly agree).
The findings of the study indicate that CBT psychotherapists are the least ones prone to believing in myths, which
was somewhat expected. Psychotherapists from other modalities: Psychodynamic; Systemic and Psychodrama were
the ones who showed the highest rate of belief in these misconceptions. Based on the results, It cannot be predicted
if psychotherapists would have a positive or a negative score (believing/not believing) based on their years of experi-
ence and their psychotherapeutic modality of choice. The only significant difference in attitudes towards these myths,
based on the psychotherapeutic modality, was shown in case of the myth: CBT is Not Interested in The Client’s Past.
Psychodynamic, psychodrama and systemic psychotherapists (exactly in this order) were the ones who showed the
highest belief in this myth.
The findings highlight the need to promote CBT and enhance awareness about the misconceptions and myths that
have developed around it. Increased education and accurate information are crucial to ensure that both therapists
and the general public understand the true nature and benefits of CBT. By addressing these myths, we can help ther-
apists provide more accurate guidance to their clients, ultimately improving the quality and effectiveness of mental
health treatment. Raising awareness and correcting these misconceptions will enable individuals to make more in-
formed decisions about their therapeutic options and maximise the benefits of CBT.

Keywords
Misconceptions, Myths, Psychotherapists, CBT

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PO64 Screen Time And Mental Health Among Serbian-Speaking Children and
Adolescents: Parents’ Perspective
Željka Buturović
SRABCT, Serbia
Darja Bjelić-Jovanović
SRABCT, Serbia
Brankica Severović
Panorama Fachklinik für Psychosomatik, Psychotherapie und Naturheilverfahren im Allgäu, Serbia
Sanja Leštarević
nstitute of Mental Health, Belgrade, Serbia, Serbia
Ivana Vračkić
SRABCT, Serbia
Marina Sokolov
SRABCT, Serbia
Jelena Stevovski-Radović
VIZIM Health Center, Serbia

Abstract
Introduction: The use of digital media, especially social media, among teens, has become a recognized public health
issue. Some studies have found associations between smartphone and social media use and depressive as well as in-
ternalizing symptoms (Silva Santos et al, 2023) while hourly screen time was found to increase depressive symptoms
in adolescent populations through interferences with problem-focused coping (Hokby et al, 2023). There is a growing
need for data from the developing world to better understand generalizability of these findings. Here we build on the
findings of Višnjić et al (2018) who discovered a relationship between stress levels and nighttime smartphone location
among Serbian and Italian students and Ružić-Baf et al (2022) who have found, in a sample of Croatian students, that
late time smartphone use was related to sleep disturbance and morning fatigue.
Aim: To investigate a relationship between smart phone use and mental health among Serbian-speaking children and
adolescents.
Method: We have been surveyeing Serbian-speaking adults using a snowball method. Respondents are asked to fill
out an online questionnaire consisting of demographic questions, their digital habits as well as digital habits of their
children, their sleep habits, parent’s personality, anxiety and depression symptoms of children (parent’s version of the
47-item RCADS-P scale), as well as addiction indicators (modified Bergen Facebook Addiction Scale-BFAS).
Results: Our preliminary results, based on a sample of 191 parents, point out to the significant correlation between
parents’ and childrens’ screen times. We found no significant differences in total anxiety between groups of children
having less than four (<4 hours m=13.85, SE=1.31; >4 hrs m = 14.50, SE=1.74), and more than four hours of screen
time. However, we found a statistically significant difference in major depression, with children who had more than
4 hours of screen time scoring significantly higher. Modified BFAS scores showed the same pattern and also reached
statistical significance. We did not find gender-related significant differences in either screen time or total anxiety
(females m=14.71, SE=1.45; males m = 3.46, SE=0.54) or major depression (females m=3.19, SE=0.46; males m = 13.26,
SE=1.61).
Conclusion: Our preliminary results suggest a positive relationship between screen time and depression among Ser-
bian-speaking children and adolescents.
References:
Hökby S., Westerlund J., Alvarsson J.,Carli V. and Hadlaczky G. (2023) Longitudinal Effects of Screen Time on Depressive
Symptoms among Swedish Adolescents: The Moderating and Mediating Role of Coping Engagement Behavior. Int. J.
Environ. Res. Public Health 2023, 20(4), 3771;
Ružić-Baf M. , Kadum S., Dumančić M. (2022). Influence of Smartphones on Students’ Life in the Republic of Croatia.
Croatian Journal of Education Vol.25; No.3, pages: 795-833
Santos RMS, Mendes C., Bressani GYS, Ventura Sd A, Nogueira YJdAl, Miranda DM, Romano-Silva M.A. (2023) The asso-
ciations between screen time and mental health in adolescents: a systematic review. BMC Psychology 11(1)
Višnjić A., Veličković V.,Sokolović D.,Stanković M., Mijatović K.,Stojanović M., Milošević Z.and Radulović O. (2018) Rela-
tionship between the Manner of Mobile Phone Use and Depression, Anxiety, and Stress in University Students. Int. J.
Environ. Res. Public Health 2018, 15(4), 697;

Keywords
depression, anxiety, screen time, online, social media, adolescent, child, parent

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PO65 Standpoints of final-years REBT trainees towards CBT interventions

Aleksandra Vojvodić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Daria Milutinović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Milenka Milošević
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Jovana Tasić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Aleksandra Tanasković
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Dunja Mraović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Lara Pejić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Jelena Zec
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia

Abstract
Introduction
This study aims to explore the perspectives of final-years Rational Emotive Behaviour Therapy (REBT) trainees on
various Cognitive Behavioural Therapy (CBT) interventions. As they approach the end of their formal education, their
insights are invaluable for understanding the practical application and perceived efficacy of different CBT techniques.
Methods
We conducted a qualitative study with 10 final-year REBT trainees who work with clients under supervision. Data
collection was carried out through online interviews. The interviews focused on trainees’ perceived effectiveness,
frequency, preferences, and the importance of the therapeutic relationship compared to specific interventions.
Preliminary Results
Preliminary findings indicate that trainees prefer cognitive interventions. In contrast, behavioural interventions are
less commonly used. The reasons for these preferences are multiple, involving personal confidence and observed
outcomes.
Trainees consistently appreciate cognitive interventions for their structured approach and direct impact on clients’
thought processes. These interventions help clients identify and challenge irrational beliefs, which are seen as em-
powering and effective in promoting rational thinking. However, some trainees find these techniques can sometimes
appear too “robotic,” particularly when they are still under supervision. There is also a concern that clients who are
highly emotionally aroused may resist cognitive interventions due to the difficulty of challenging deeply held beliefs.
Emotional-imaginative interventions are valued for their ability to facilitate emotional change by allowing clients to
re-experience and reframe their issues from different perspectives. The effectiveness of these interventions largely
depends on the client’s ability to visualise and remain focused during sessions. However, some clients have difficulty
engaging in imaginative exercises.
Behavioural interventions are praised for their applicability in real-life situations and their gradual exposure tech-
niques, which help clients confront and overcome problems. Trainees find these interventions particularly effective
in facilitating tangible changes in behaviour. Additionally, trainees often feel that designing appropriate behavioural
tasks requires a level of creativity that may be daunting for those with less experience.
Mindfulness interventions are generally well-received by trainees who have observed significant benefits in clients’
increased awareness and ability to manage bodily sensations and thoughts. However, mindfulness is not universally
effective. Therefore, the suitability of mindfulness interventions varies significantly among different clients. Some of
the issues that were revealed during our research were: ability of the trainees to adapt the voice to the technique;
some clients struggle to remain present or find these exercises irrelevant.
Discussion
The data suggests a significant emphasis on cognitive techniques among trainees, reflecting perhaps both their train-
ing focus and the immediate cognitive restructuring benefits they observe in clients. The less frequent use of be-
havioural interventions may stem from either a lack of confidence in applying these techniques or perceived barriers
in client engagement and compliance.
Conclusion
This study contributes to the field by providing a better understanding of the practical applications and preferences
of REBT trainees towards CBT interventions. The findings highlight the need for broad training in various techniques
to ensure effective therapy. This abstract serves as a preliminary overview of an ongoing study, with final results and
analyses to be presented upon completion.

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Keywords
Trainees, Cognitive Interventions, Behavioural Interventions, Emotional-Imaginative Interventions, Mindfulness Inter-
ventions

PO66 COGNITIVE BEHAVIORAL THERAPY OF YOUNG ADULT WITH

HYPERKINETIC DISORDER – A CASE REPORT
Amina Gačanin
Public institution “Health Center of Sarajevo Canton”, Bosnia and Herzegovina
Dzejna Ćapin
Private psychological practice, Bosnia and Herzegovina

Abstract
INTRODUCTION: Attention Deficit Hyperactivity Disorder (ADHD) is neurodevelopmental disorder characterized by
inattention and hyperactive impulsive behaviour, which is more frequent and more intense than in a typical person
of the same developmental level. There is a traditional understanding that most children outgrow ADHD, but recent
systemic reviews have estimated prevalence of persistent ADHD in 2.58% of adults and of symptomatic ADHD in
6.76% of adults.
CASE PRESENTATION: This is a case report which presents case of 23-year-old female who was referred to the assess-
ment by a multidisciplinary team (psychiatrist, psychologist, neurologist, EEG). The client was diagnosed with hyper-
kinetic disorder and associate anxiety/depressive disorder and has been included in cognitive behavioural therapy
(CBT). CBT interventions addressed executive function deficit and motivation deficit, as well as the depression and
anxiety disorders. As a supportive measure, mindfulness training was also included in treatment regimen. After the
first cycle of treatment regimen, reevaluated T.O.V.A., BG-II, WB-II verbal scales, Wb-sp. MMPI, PIE, WZT, interview an-
swers, and behaviour ratings have considerably improved. Considering improvements, medication was reduced and
continuation of cognitive-behavioural therapy was prescribed.
CONCLUSION: The presented therapeutic work with a young adult client indicates the effectiveness of the CBT ap-
proach in working with adults with difficulties caused by hyperkinetic disorder circle.

Keywords
Hyperkinetic disorder; Attention Deficit Hyperactivity Disorder (ADHD); Adults; Cognitive-behavioural therapy

PO68 Intolerance of uncertainty, worry and sleep quality in adolescents

Ana Babić Čikeš
Faculty of Humanities and Social Sciences Osijek, Department of Psychology, Croatia
Ana Perić
Dječji vrtić More Rijeka, Croatia
Ana Kurtović
Faculty of Humanities and Social Sciences, Department of Psychology, Croatia
Ivana Marčinko
Faculty of Humanities and Social Sciences, Department of Psychology, Croatia

Abstract
Intolerance of uncertainty (IU) is defined as “a predisposition to react negatively to an uncertain event or situation,
independent of its probability of occurrence and of its associated consequences” (Ladouceur et al., 2000, pp. 934). It
is reciprocally related to worry and anxiety in adult population, as well as in young people. A few studies also showed
that UI is related to sleep quality, but nature of that relationship is not completely clarified. This is especially relevant
for high school student’s samples. In this research we wanted to examine if IU contributes to sleep quality in high
school students and if worry has a mediator role in relationship of IU and sleep quality. High school students of one
high school in Croatia (N = 206) between the ages of 14 and 19 took part in the research during regular classes in
school. Participants filled out the questionnaires on their mobile phones and computers during class in the presence
of the researcher. The constructs were assessed using The Penn State Worry Questionnaire for Children, The Intol-
erance of Uncertainty Scale-Short Form and The Pittsburgh Sleep Quality Index. The results showed that all three
constructs are significantly interrelated, with moderate correlation between IU and worry and weak correlations of IU

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and worry with sleep quality. Hierarchical regression analyses with age, gender, IU and worry as predictors entered in
three steps showed that no model contributes significantly to sleep quality, but IU showed to be significant predic-
tor of sleep quality in the second step of analyses. This research showed that IU could have a significant role in high
school student’s sleep quality, although variables included in this research haven’t explained significant proportion of
sleep quality variance. Further research should include participants from different high schools, as well as other mea-
sures, like objective measure of sleep quality. Also, longitudinal methods of research of this topic are recommended.

Keywords
Intolerance of uncertainty, worry, sleep quality, high school students

PO69 What do adolescents think of an App designed to reduce cognitive risk

factors for eating disorders?: a mixed-methods study
Laura Carratalá-Ricart
University of Valencia, Spain
Marta Corberán Vallet
University of Valencia, Spain
María Roncero Sanchis
University of Valencia, Spain
Belén Pascual-Vera
National University of Distance Education, Spain
Gemma García-Soriano
University of Valencia, Spain

Abstract
Background. In recent years, there has been a growing scientific interest in the potential of eHealth to reduce risk
factors for eating disorders, and outcome research suggests that they may offer a promising approach. However,
there is a need for studies to identify methods to improve adherence and attrition, as high dropout rates have been
reported. Nevertheless, despite the number of eHealth interventions available, there is currently a lack of usability, ac-
ceptability, and feasibility studies. Furthermore, the perspectives of end users have rarely been reported. It is therefore
important to assess these variables to ensure that eHealth interventions are effective and meet the needs of users.
Objective. This study aimed to examine the usability and acceptability of GGED-AD, the first mobile app-based inter-
vention designed to reduce cognitive risk factors for eating disorders in adolescents.
Method. 42 adolescents (61.9% female) with a mean age of 13.98 years (SD = 0.51) participated in the study. The sam-
ple was obtained from a randomized controlled trial, and the target group included participants who had completed
the use of GGED-AD as a part of the experimental group. We conducted a study based on a convergent mixed-meth-
ods approach, and participants completed open-ended questions as part of a semistructured interview, and self-re-
port measures (i.e., System Usability Scale, SUS, and the Usefulness, Satisfaction, and Ease of Use Questionnaire, USE).
Descriptive statistics and coding template analysis with a pre-established set of themes were used to analyze the
interviews and questionnaires.
Results. The average SUS score was 73.33 (SD = 11.60), and the mean score on the USE was 4.18 on a 7-point scale.
Thus, indicating that the app has satisfactory usability and acceptability. The qualitative data was organized according
to the pre-established themes into: usability, visual design, user engagement, content, therapeutic persuasiveness,
therapeutic alliance, and usefulness. The analyses of the initial three themes indicated that the app is straightforward
to use, attractive, and engaging for users. However, about the “content” of the intervention, participants highlighted
some issues regarding feedback provided by the app. Regarding the categories “therapeutic persuasiveness” and
“therapeutic alliance”, data showed that the app encourages users to engage in positive behaviors and fosters an
alliance with them. Additionally, users found the app to be highly useful.
Discussion. The findings of this study indicate that GGED-AD has satisfactory usability and acceptability. Moreover,
the integration of qualitative and quantitative data allowed for better data mining and better insights into the ex-
periences of adolescents, who highlighted the usability and visual design of the app, as well as the need to review
how feedback is provided. Furthermore, the study also provides valuable information on how to best design eHealth
interventions to increase their likelihood of adoption in the ‘real world’.
Acknowledgements. Grant PID2021-124409OB-I00 funded by MCIN/AEI/10.13039/501100011033/ and by the ERDF
- A way of making Europe.

Keywords
Usability, acceptability, eHealth, eating disorders, mixed methods, GGED-AD, risk factors, app-based interventions.

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PO70 An app to challenge obsessional beliefs in adolescents: pre-post

intervention efficacy and a one-and six-month follow-up study.
Yuliya Saman
University of Valencia, Spain
Laura Carratalá-Ricart
University of Valencia, Spain
Belén Pascual-Vera
National University of Distance Education, Spain
Ángel Carrasco Tornero
Hospital Universitario y Politécnico La Fe, Spain
Gemma García-Soriano
University of Valencia, Spain

Abstract
Introduction. Adolescence is a high-risk period for the development of psychological disorders such as obses-
sive-compulsive disorder (OCD). Cognitive explanatory models posit that dysfunctional beliefs have an essential role
in the etiology and maintenance of obsessive-compulsive disorder. In this sense, it could be of interest to address
OCD-related dysfunctional beliefs in adolescents to improve their mental health through a widely accessible and
tailored intervention such as the app GGOC-AD. It is an adaptation for the adolescent population of GGOC, an app
specifically developed to challenge OCD-related beliefs.
Aim. This study aims to examine the efficacy of the use of the app GGOC-AD on OCD-related beliefs and symptoms.
Additionally, we sought to assess if the changes produced after de use of the app (i.e., post-treatment) are maintained
at one- and six-month follow-ups.
Method. A parallel two-armed randomized controlled trial was conducted. A group of 67 students (M= 15 years; SD=
0.60; 68.7 % women) were recruited from a public school in the Valencian Community (Spain) and were randomly al-
located to either the experimental (usage of GGOC-AD) or the control (usage of GGN-AD; an app with neutral content)
group. Participants were required to use their respective app for 14 days and complete a set of questionnaires before
(T1; pre-treatment) and after the app usage (T2; post-treatment). Additionally, they completed assessments at one
month (T3) and six months follow-up (T4). Data on obsessive-compulsive symptomatology (OCI-R-CV), and OCD-re-
lated dysfunctional beliefs (OBQ-CV) was collected. A 2 (group: experimental vs. control) x 2 (time: T1 vs. T2) mixed
model repeated measures analysis (ANOVA) was conducted to assess the pre-post intervention effect and paired
t-tests were performed to analyze the maintenance of the results (T2 vs. T3; T2 vs. T4).
Results. The ANOVA revealed a significant interaction effect for OCI-R-CV (F1,65 = 10.41; p = .002; ƞ 2P = .14) and OBQ-
CV (F1,65 = 13.61; p < .001; ƞ 2P = .17). Paired t-tests for the experimental group showed no significant changes in
OCI-R-CV between T2 and T3 (t29 = 0.57; p = .285) or between T2 and T4 (t29 = -1.26; p = .11). Likewise, there were no
significant changes in OBQ-CV between T2 and T3 (t29 = 0.42; p = .341), nor T2 and T4 (t29 = -0.05; p = .481).
Discussion. After the intervention with GGOC-AD, OCD-related beliefs and symptoms decreased significantly, and this
improvement was maintained even six months after having finished the intervention. Thus, this app is a promising
tool for enhancing the mental well-being of the adolescent population by reducing risk factors such as obsessional
beliefs. Future studies should aim to study its effectiveness on clinical adolescent samples.
Acknowledgements. Grant PID2021-124409OB-I00 funded by MCIN/AEI/10.13039/501100011033/ and by the ERDF
- A way of making Europe.

Keywords
Obsessive-ompulsive disorder, Maladaptive beliefs, mHealth application, Adolescence, Randomized controlled trial,
follow-up

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PO71 The mediating role of self-compassion in the relationship between

perfectionism and rumination
Anamarija Bolvanac
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Katarina Ristić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Tijana Lajić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Marija Davidoski
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Miljana Stojanović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia

Abstract
Introduction
Self-compassion, perfectionism and rumination, which belong to individual cognitive category, are important factors
related to depression and anxiety among students. According to the diathesis-stress model for students with high
perfectionism, external and internal sources of anxiety and stress during studies can be even more distressing, as the
exceedingly high expectations for themselves and others are unlikely to be met. Perfectionism is considered to ex-
plain increasing levels of negative repetitive thinking, such as worry and rumination. In the recent studies, rumination
has been studied extensively as a transdiagnostic variable in depression and anxiety. The aim of this study is to exam-
ine the perfectionism-rumination relationship and mediating role of self-compassion within university students, as
a potential target for future interventions, aimed at reducing perfectionism-driven rumination, as well as depression
and anxiety symptoms consequently.
Method
The methodology was based on quantitative analysis of students’ responses to the online questionnaire. The ques-
tionnaire consisted of Frost Multidimensional Perfectionism Scale (FMPS), Ruminative Response Scale (RRS) and
Self-Compassion Scale (SCS). The study was performed with a total of 180 university students in Serbia, with the mean
age of 22.5 years and the majority being women (82.8%). The data was statistically analyzed using Pearson correlation
method in SPSS and mediation analysis in PROCESS macros for SPSS.
Results
The correlation analysis of the main variables in the research show that there is a statistically significant positive cor-
relation between Perfectionism and Rumination (r=0.540, p<0.01.), as well as a negative correlation between Self-com-
passion on the one hand and Perfectionism (r=-0.503, p<0.01.) and Rumination (r=-0.471, p<0.01.), on the other. Thus,
it has been shown that people with more expressed perfectionism are more prone to a ruminative reaction style, and
that people with more compassion towards themselves are less prone to rumination and have less intensive perfec-
tionist tendencies. The data, furthermore, confirm that self-compassion partially mediates the relationship between
perfectionism and the ruminative reaction style. It has been shown that people who are prone to perfectionism are
less prone to rumination, the more self-compassion is expressed. The study also examines the relationship of Concern
over mistakes as maladaptive perfectionism in relation to rumination, self-compassion and its subscales.
Discussion
The findings of our study show that perfectionists tend to have low self-compassion, as well as that perfectionism
and self-compassion are positively and negatively associated with ruminative response style, respectively. What is
more, perfectionism positively correlates with rumination via low self-compassion. In other words, the latter acts as
a partial mediator in that relationship, suggesting it may have a protective role in preventing ruminative response
style in highly perfectionist students. However, it is important to note that larger and more diverse sample would
better support the generalization of the study findings. The findings underline self-compassion’s relevance in perfec-
tionism-driven rumination prevention and management, supporting its use as an intervention target in depression
and anxiety treatment. Future studies should also focus on investigating the efficacy of those interventions in CBT
practice.

Keywords
self-compassion, perfectionism, rumination

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PO73 Exploratory study on dissociative experiences in a community sample:

Exploration of the factor structure of dissociation.
Déborah Dawant
Psychological Science Research Institute, UCLouvain., Belgium
Celine Douilliez
Psychological Science Research Institute & Specialised Psychological Consultation, UCLouvain, Belgium
Pierre Philippot
Psychological Science Research Institute & Specialised Psychological Consultation, UCLouvain, Belgium

Abstract
Dissociation is a complex and multifaceted construct that remains poorly understood and assessed, particularly in
French-speaking populations. While 26 validated assessment scales exist in English, only three self-assessment scales
are available in French (Cernis et al., 2021). The most widely used scale in French-speaking population is the DES (Dis-
sociative Experience Scale: Bernstein & Putnam, 1986). Several validation studies of the French versions of the DES
have been proposed (Darves-Bornoz et al., 1999; Larøi et al., 2013), demonstrating good psychometric properties and
satisfactory internal consistency, according to the authors. However, despite these findings, several criticisms can be
levelled at the DES, in both French or English version. These include a failure to consider recent conceptions of disso-
ciation (Cernis et al., 2021), a lack of stability in the factor structure observed across studies (Kennedy et al., 2004) and
unsatisfactory test-retest reliability, partly linked to the response format (expressed in %) but also to the very content
of the items, which is easily open to interpretation (Trujillo et al., 2022). These criticisms are in part due to the lack of
conceptual clarity surrounding dissociation. There is no consensus on its definition or on theoretical models explain-
ing its development and maintenance. Despite numerous attempts to define, assess and conceptualize dissociative
experiences, reconciling heterogeneous theoretical standpoints in the field remains a challenge.
The preliminary results of a data-driven study exploring the factorial structure of a set of 166 items, which aims to
capture dissociation, will be presented. These items were inspired by existing scales, translated in French, and refined
to assess dissociative experiences in an exhaustive way. The study sought to answer the following questions. Is disso-
ciation a multidimensional construct, encompassing various distinct yet interrelated dimensions, each representing
specific symptom sets but collectively viewed as a unified concept? If dissociation is indeed a multidimensional con-
struct, what are the factors representing those different symptoms dimensions? The aim of the study was to identi-
fy the underlying factors of dissociation, through a diverse set of items representing dissociative experiences from
various theoretical frameworks, thereby providing a clearer understanding of this complex construct. Preliminary re-
sults from an exploratory factor analysis on 570 French-speaking participants from a community sample recruited via
social networks, will be presented. Factorial structure will be discussed in the light of current models of dissociation.

Keywords
dissociation, dissociative experiences, assessment, exploratory factor analysis

PO74 Development of UP-Prevent: Results from two focus group with mental
health professionals with training in applying the Unified Protocol
Catarina Francisco
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC),
Faculty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Inês Maçãs de Carvalho
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC),
Coimbra, Portugal, Portugal
Laura Martínez-García
Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain, Spain
Marco Pereira
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC),
Faculty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Ana Fonseca
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC),
Faculty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Maria Cristina Canavarro

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University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC),
Faculty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal

Abstract
Introduction/Aim: Emotional disorders (EDs), particularly anxiety and mood disorders, are highly prevalent world-
wide. Likewise, the proportion of individuals with subclinical symptoms of anxiety and/or depression (i.e., those who
report significant clinical symptoms, but do not fulfill the criteria for having a disorder) is higher and a current con-
cern. The subclinical symptomatology also negatively impacts individuals’ lives, affecting their functioning, quality
of life and increasing the risk of having a diagnosis of ED in the future. Thus, it is of utmost importance to intervene
preventively with this population to avoid the exacerbation of the symptoms and, consequently, the onset of an ED
diagnosis. The Unified Protocol (UP) is a CBT-based transdiagnostic treatment that intervenes in EDs and that presents
several advantages (e.g., applied different application formats). The UP has proven effective in different formats (e.g.,
group, online) and for different populations (e.g., eating disorders, borderline personality disorder). Recently, brief
versions of the UP have been developed, and the available results reinforced its potential as a preventive intervention.
Accordingly, the aim of this study was to present the results obtained from two focus group sessions with Portuguese
mental health professionals with training in applying the UP, held to understand which content and characteristics a
brief and preventive version of the UP (UP-Prevent) should encompass.
Methods: Two focus group sessions were carried out with 9 mental health professionals (all psychologists) with train-
ing and experience in applying the UP. A discussion guide was developed by the researchers beforehand and included
topics such as challenges, barriers, and facilitators of applying a brief version of the UP, advantages and disadvantages
of applying the UP, receptiveness of the population with subclinical symptoms to receive a preventive intervention, as
well as structure (e.g., number of sessions, duration, etc.) and content (e.g., nuclear modules, modules to be reduced
or eliminated) of the UP-Prevent. Qualitative analyses (thematic analysis) were conducted with the assistance of MAX-
QDA software, by two independent researchers.
Results: The results of the thematic analysis suggested three themes and nine subthemes. The first theme was con-
cerned with the Challenges of implementing a preventive version, which presented two subthemes: External challeng-
es to the intervention and Internal challenges to the intervention. The second theme was Facilitators of implementing
a preventive version, which included four subthemes: Recruitment, Implementing the intervention, Population char-
acteristics, UP characteristics. The third theme was related to the Adaptations for the UP-Prevent, composed of three
subthemes: Structure, Content and Evaluation.
Conclusions: These results suggest important principles that will be crucial to develop a brief preventive intervention
based on the UP, which may be particularly useful for the population with subclinical symptoms of anxiety and/or
depression and ultimately may prevent the development of Emotional Disorders.

Keywords
Focus group; Unified Protocol; Subclinical symptoms; preventive intervention

PO75 How can I evaluate the effectiveness of my therapeutic intervention?

Bénédicte Thonon
UCLouvain, Belgium
Audrey Krings
University of Liège, Belgium

Abstract
his poster aims to raise awareness among clinicians about evaluating their therapeutic interventions, in the spirit of
evidence-based practice (EBP). EBP is now prescribed in the medical sectors, particularly in medicine and psychology.
Following this practice, an evaluation of the effects of the therapeutic intervention is essential. However, this eval-
uation cannot be limited to clinical impressions, which are influenced by various biases potentially responsible for
errors in judgment. Assessment using pre- and post-intervention tools is a more objective method often considered
by therapists. However, this does not allow for the intra-individual variability of the targeted measures. An alternative
to this limitation is the use of repeated measurements as prescribed by multiple baseline protocols (Krasny-Pacini &
Evans, 2018). In addition, the inclusion of transfer and control measures in this protocol makes it possible to verify the
specificity of the effects of the proposed intervention. To illustrate these key points, a clinical case is presented.
Krasny-Pacini, A., & Evans, J. (2018). Single-case experimental designs to assess intervention effectiveness in rehabil-
itation: A practical guide. Annals of Physical and Rehabilitation Medicine, 61(3), 164–179. https://doi.org/10.1016/j.
rehab.2017.12.002

Keywords
EBP, assessment, case study, multiple baseline design

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PO76 Promoting self-efficacy in a brief virtual reality-based exposure (VRE)

for acrophobia
Kayleigh Piovesan
Department of Behavioral and Clinical Neuroscience, Ruhr-University, Bochum, Germany
Armin Zlomuzica
Department of Behavioral and Clinical Neuroscience, Ruhr-University, Bochum, Germany

Abstract
Exposure therapy for phobic fear and anxiety disorders is highly efficient. However, some patients show only a partial
remission of symptoms or do not profit from exposure. Evidence from our lab indicates that self-efficacy enhance-
ment (SEE) in combination with VRE administered after the exposure session can be a promising add-on treatment
to further decrease fear and avoidance in height phobia. The present study builds on these previous findings and
examined whether SEE during versus after a brief VRE is more beneficial to promote VRE effects in height-fearful
participants. Height-fearful participants received a brief VRE in combination with a SEE which was operationalized by
retrieval of specific mastery experiences. SEE was administered either during the VRE session or after the VRE session.
Effects of different conditions of VRE and SEE administration were assessed on various treatment outcome measures.
The latter included treatment-induced changes in i.) subjective height-related fear and avoidance, ii.) behavioural
approach towards a real height-scenario and iii.) psychophysiological indices of fear. Immediate (24 hours after VRE)
as well as long-term assessments (3 months after VRE) of therapy outcome were performed. We present preliminary
study findings on differences in treatment outcome between the respective conditions containing SEE in combina-
tion with VRE.

Keywords
fear of heights; self-efficacy; virtual reality; exposure; mastery experience

PO77 Comparative efficacy of different cognitive-behavioral therapy

protocols for procrastination: a randomized controlled trial
Weronika Maria Browarczyk
Institute of Psychology, SWPS University, Warsaw, Poland; Laboratory of Affective Neuroscience, Institute of Psycholo-
gy, SWPS University, Poznań, Poland
Joachim Kowalski
Experimental Psychopathology Lab, Institute of Psychology of Polish Academy of Sciences, Warsaw, Poland
Magdalena Pietruch
Laboratory of Brain Imaging, Nencki Institute of Experimental Biology, Polish Academy of Science, Warsaw, Poland,
Poland
Jarosław Michałowski
Laboratory of Affective Neuroscience, Institute of Psychology, SWPS University, Poznań, Poland, Poland
Marek Wypych
Laboratory of Brain Imaging, Nencki Institute of Experimental Biology Polish Academy of Science, Warsaw, Poland,
Poland

Abstract
Procrastination is a behavior characterized by the voluntary delay of intended tasks or actions despite knowing that
this postponement may lead to negative consequences. CBT has been widely recognized as an effective intervention
for reducing procrastination and mitigating associated mental health issues such as depression and anxiety. How-
ever, it is crucial to investigate whether different CBT protocols vary in their efficacy, which necessitates rigorously
designed and suitably powered studies.
The current study aimed to compare the efficacy of two CBT protocols for procrastination against active and waitlist
control groups. The 5-week-long programs were delivered online in a group setting and conducted by pairs of ther-
apists. All three active protocols included identical psychoeducation and cognitive interventions, with variations in
behavioral techniques. The behavioral module in the first protocol focused on realistic planning and timely begin-
ning (RPT), while the second protocol employed working time restriction (WTR). The active control group used the
Pomodoro technique (PT). It was hypothesized that RPT and WTR protocols would be more efficacious in reducing
procrastination levels than the control conditions (PT, waitlist). Furthermore, it was expected that RPT and WTR proto-
cols would demonstrate greater efficacy in reducing depression and anxiety compared to the control conditions. The
study included 222 high-procrastinating students (nRPT = 50, nWTR = 58, nPT = 56, nwaitlist = 58), who were assessed
four times: before, during, immediately after the intervention, and six months post-intervention.

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The intention-to-treat analysis using linear mixed models demonstrated significant intervention effects on procrasti-
nation (Aitken Procrastination Inventory) reduction from baseline to post-treatment, with large between-group effect
sizes for active protocols compared to the waitlist control group (Cohen's d: RPT = -1.34; WTR = -1.41; PT = -1.53). The
same analysis for secondary outcomes revealed that the active protocols were more effective than the waitlist in re-
ducing depression (Patient Health Questionnaire-9, Cohen's d: RPT = -0.57; WTR = -0.73; PT = -0.86). Additionally, WTR
and PT significantly reduced anxiety (General Anxiety Disorder-7, Cohen's d: WTR = -0.58; PT = -0.61) compared to the
waitlist, which showed increased scores for depression and anxiety. There were no significant differences in the reduc-
tion of procrastination, depression, or anxiety between active conditions (RPT, WTR, PT). The follow-up measurements
showed no significant differences in procrastination, depression, and anxiety scores from post-test to six months later
in all three active conditions.
To our knowledge, this is the first study directly comparing the efficacy of different CBT protocols targeting procras-
tination. All three active conditions (RPT, WTR, PT), as compared to the waitlist, showed high and similar efficacy in
the reduction of procrastination. Importantly, the six-month follow-up demonstrated the stability of these effects, in-
dicating long-term benefits. The interventions also showed partial efficacy in reducing depression and anxiety, high-
lighting their potential for improving overall well-being. The lack of differences between the protocols that varied
in behavioral modules may indicate the comparable efficacy of the assessed psychotherapy components. However,
further studies are needed to verify how specific cognitive, behavioral, and psychoeducational elements contribute
to the effectiveness of CBT treatment for procrastination.

Keywords
procrastination, psychotherapy efficacy, randomized controlled trial

PO78 RE&CBT for Children and Adolescents Who Stutter

Mirjana Marković
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Lara Dobrković
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia

Abstract
Introduction
This study is based on previous findings [1] that shows a higher rate of spontaneous recovery from stuttering in
younger children (ranging from 40 to 80%), whereas spontaneous recovery in children older than six years is less
likely. In this work, we postulated that psychotherapy aimed at assisting children in recognizing their thoughts and
emotions as well as teaching them about the connection between cognition and emotions (re&cbt) could significant-
ly influence their speech and result in their recovery, either temporary or permanent.
Objectives
The main objective of the study was to examine efficiency of re&cbt with stuttering children over the age of six. The
psychotherapeutic process included re&cbt sessions with each child, as well as parental journaling and required psy-
choeducation for parents.
Method and Procedure
The type of research design is pre-test /post-test without a control group.
Six stammering children and adolescents, and six mothers, participated in the study. The entire process lasted for a
period of 9 months. The age range of participating children was from six to thirteen. There were three methods used
to evaluate the efficacy of re&cbt. In order to assess any changes in the severity of stuttering following re&cbt treat-
ment, firstly the parents kept a notebook documenting the daily frequency of stuttering in their children in shared
situations. Secondly, the speech therapist assessed the degree of stuttering of the children both before and after the
completed re&cbt treatment using the Riley test (Stuttering Severity Instrument Riley). Thirdly, the psychotherapist
reviewed all of the recordings of the sessions and reflected on changes in acceptance and anxiety level related to
stammering. Acceptance of stuttering was measured as a binary variable that was obtained by assessing cognition
using three assessment methods: Standardized self-report survey: The Child and Adolescent Scale of Irrationality
(Bernand., M. E & Cronan, F. 1999.); Inference chaining; and The sentence completion technique. The data processing
method was descriptive.
Results
After one month which included 4 CE&REBT sessions all participants’ percentage of stuttering syllables dropped by
more than half. Also, intensity of the stuttering dropped for all participants during same period: one month, i.e. 4
RE&CBT sessions. According to the speech therapist’s assessment, the first participant’s stuttering completely dis-
appeared after nine sessions, or two months following active re&cbt implementation. Between the third and sixth
month of the study, three participants were no longer stuttering; two children continued to stammer nine months
later, albeit in fewer circumstances and with more syllable repetitions than blocks. This outcome is associated with ac-

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cepting stuttering and lowering anxiety related to stuttering, allowing the use of re&cbt as well as relaxation breath-
ing techniques, according to an examination of audio recordings. Positive improvements in the degree or intensity of
stuttering were reported by every individual.
Conclusion
RE&CBT has been shown to be an effective psychotherapy strategy for treatment of stuttering in children and ado-
lescents.
Reference
[1] A. Laiho, A. Klippi, „Long- and short-term results of children’s and adolescents’ therapy courses for stuttering“ Int J
Lang Commun Disord. 2007 May-Jun;42(3):367-82

Keywords
re&cbt, children, adolescents, stuttering

PO79 The impact of group cognitive behavioral therapy for parents of

children with autism and behavioral insomnia
Ajda Demšar
Center for Hearing and Speech Maribor, Slovenia
Karin Bakračevič
University of Maribor, Slovenia

Abstract
Autism spectrum disorder (ASD) is a developmental neurological disorder that often co-occurs with other conditions.
The prevalence of sleep disorders in children with ASD ranges from 40 to 80%. In the present research, we designed
and studied the effectiveness of a a group CBT intervention for parents of children with autism who had associated
behavioral insomnia. A total of 26 children with ASD and their parents participated in the research, who were divided
into an intervention group and a control group. The inclusion criteria were as follows - a confirmed diagnosis of ASD
according to the ICD-10, made by a suitably qualified specialist (e.g. clinical psychologist, pediatrician, specialist in
child and adolescent psychiatry), the child’s age from 2 to 11 years, problems must be related to sleep to falling asleep
in the evening or frequent night awakenings or a combination of both (i.e. behavioral insomnia) and last for at least
3 months. To measure changes in sleep in children with ASD, we used the modified Sleep Habits of Children with Au-
tism Questionnaire (CSHQ-A). After completing the program, parents of children in the intervention group reported
a statistically significant reduction in sleep anxiety, night awakenings/parasomnias, and overall sleep problems that
persisted 3 months after the program was completed.

Keywords
autism spectrum disorders, sleep disorders, behavioral insomnia, children

PO80 Meaningful or Meaningless? Do gender and PhD-related factors

influence symptoms of anxiety, depression and work-related stress among
doctoral students?
Catarina Cardoso
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Fac-
ulty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Maria Cristina Canavarro
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Fac-
ulty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Marco Pereira
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Fac-
ulty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal

Abstract
Background: Recent evidence suggested that PhD students have an increased risk of developing a mental health
disorder when compared with the qualified general population. PhD students frequently experience high levels of
anxiety and depression, with studies showing prevalence rates ranging from 20% to 60%. In the scientific context, this

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symptomatology tends to be more prevalent among women and can lead to lower productivity and higher drop-out
rates. Factors related to the doctorate may also be associated with student’s mental health, however, this evidence is
more limited. This study aimed to analyze the prevalence of symptoms of anxiety, depression, and work-related stress
in doctoral students, as well as to study whether there are differences in symptoms and stress according to gender
and variables related to the doctorate (i.e., stage of PhD, funding, satisfaction with the supervision, progress and doc-
toral trajectory).
Methods: A sample of 286 PhD students (69.6% female; mean age = 35.06 years) completed a web-based question-
naire that collected sociodemographic, clinical, and PhD-related data, as well as self-report questionnaires assessing
symptoms of anxiety (GAD-7), depression (PHQ-9) and work-related stress (Health & Safety Executive Management
Standards Work-Related Stress Indicator Tool).
Results: Our results showed that 57.3% of PhD students exhibited clinically significant anxiety symptoms, while 41.6%
had clinically significant depressive symptoms. A total of 11.2% reported poorer work-conditions (i.e., higher work-re-
lated stress). There were no significant differences in anxiety and depression symptoms, nor work-related stress, con-
cerning gender. Regarding the stage of PhD, there were no significant differences in anxiety symptoms. However,
our results indicated that PhD students in the final stage of their studies exhibited more depressive symptoms and
work-related stress. No differences in anxiety and depressive symptoms were found in relation to the existence of
funding, but PhD students without funding reported significantly more work-related stress. Results also demonstrat-
ed that lower satisfaction with the scientific supervision, progress and PhD trajectory were significantly associated
with increased symptoms of anxiety and depression as well as work-related stress.
Conclusions: Our findings show concerning data about the prevalence of mental health problems among doctor-
al students, which is particularly high, as well as important information about the factors that are associated with
increased psychological symptoms and work-related stress. This information is important to help identify doctor-
al students who may need psychological support, either preventively or for treatment, and the best time to do so.
Moreover, our results highlight the importance of considering this diversity of factors when developing interventions
tailored specifically to the unique characteristics, challenges, and stressors inherent to the doctoral context.

Keywords
anxiety symptoms; depression symptoms; work-related stress; PhD students; gender; PhD context

PO81 Predicting treatment outcome for anxiety and depression using SLaM
NHS Talking Therapies
Nour Kanso
King’s College London, United Kingdom
Thalia Eley
King’s College London, United Kingdom
Ewan Carr
King’s College London, United Kingdom

Abstract
Introduction: Anxiety and depression affect 1 in 6 adults every week in England. They are characterised by similar
symptom patterns and shared risk factors and present challenges in their accurate diagnosis and effective treatment.
In 2008, the NHS Talking Therapies program was launched aiming to provide evidence-based psychological treat-
ments for common mental health conditions in England, with an emphasis on routine collection of patient outcomes.
However, annually reported outcomes show that only half of patients meet standard recovery definitions following
treatment. Analysing patient demographics, clinical history, and symptom severity before treatment starts can reveal
insights to improve therapy effectiveness and allocation strategies. While previous studies have identified some pre-
dictors of recovery, further analysis with larger and more ethnically diverse samples is necessary. By leveraging a large
and diverse sample collected until 2023, this study aimed to develop and validate a multivariable prediction model to
predict outcomes following NHS Talking Therapies treatment.
Methods: This study analysed data from the NHS Talking Therapies service within South London and Maudsley NHS
Foundation Trust collected from 2018 to 2023. We included patients who had 3-21 total sessions, defined as ‘high in-
tensity’ treatment in the NHS Talking Therapies manual. We considered standard NHS outcomes that are reported an-
nually based on predefined thresholds, including reliable improvement, recovery, and reliable recovery assessed us-
ing PHQ-9 and GAD-7 scales independently. We also assessed functional impairment using the WSAS scale to explore
the impact of patient mental health on their day-to-day lives. We considered a range of demographic and clinical pre-
dictors measured at baseline. Predictors had at least two-thirds of data completion. Missing predictor information was
imputed using the KNN algorithm. Multivariable models were developed using logistic regression elastic net, LASSO,

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and random forests models. Optimism-corrected model performance was assessed using bootstrapping. All model-
ling steps such as feature selection and imputation were repeated in each bootstrap resample to avoid data leakage.
Results: After data cleaning, the sample included 23,772 patients who completed a course of high intensity treatment,
with 58% identifying as White, 22% as Black, 9% as Mixed, and 7% as Asian. Elastic net logistic regression tended to
outperform the other models. Overall, model performance tended to be moderate to very good (e.g., AUC from 0.62
to 0.77, depending on the outcome), with models for functional impairment and reliable improvement achieving the
best predictive accuracy. Key predictors included caseness, severity, and socio-demographic factors such as employ-
ment status, medication, and receiving benefits.
Discussion: This is one of the first studies to use advanced machine learning methods to develop models to predict
outcomes following NHS Talking Therapies treatment. By incorporating demographic, clinical, and longitudinal symp-
tom data, we developed robust and well-calibrated prediction models with very good performance for identifying
patients at risk of poor outcomes. Key predictors at baseline aligned with clinician expertise. Future research should
assess the generalisability of these models across diverse populations and other NHS Trusts. Reliable outcome pre-
diction will enable screening tools to guide treatment adaptations and resource allocation, ultimately leading to
improved patient outcomes following therapy.

Keywords
Anxiety, Depression, Treatment Outcome, Predictors, NHS Talking Therapies

PO82 Mapping Emotional Memories in Depression: An Exploratory Analysis

Lotte Stemerding
University of Amsterdam, Netherlands

Abstract
Childhood maltreatment is an important predictor of the development and relapse of adult depression. While cur-
rent CBT-based treatments commonly target more proximal causes of depression such as maladaptive cognitions
and biases, memory-focused interventions like EMDR and Imagery Rescripting directly target emotional memories
of adverse childhood experiences, offering promising new avenues to treat depression. Few studies, however, have
systematically investigated what aspects of emotional memory relate to psychopathology, and could thus be key
targets for these interventions. We explored the relationship between childhood maltreatment, phenomenological
aspects of negative autobiographical memories and current depressive symptoms in a cross-sectional study. In an
online questionnaire, 119 first-year university students reported a formative negative emotional memory from child-
hood or adolescence and rated various aspects of this memory, such as the vividness, intrusiveness, and coherence.
We also introduced the aspect of “emotional impact” that indexed effects of the memory on current mood, emotions,
and identity. After correcting for multiple comparisons, only childhood maltreatment (CTQ-SF) and emotional impact
predicted current depressive symptoms (PHQ-9), and emotional impact scores partially mediated the relationship
between childhood maltreatment and depression. These findings suggest that emotional impact could be a poten-
tial pathway through which negative memories affect current depression, and thus a key target for memory-focused
treatments. Further study of the construct “emotional impact” is a critical next step in developing a clinically relevant
measure of emotional memory.

Keywords
Depression, Emotional Memory, Imagery Rescripting, EMDR, Childhood Maltreatment

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PO83 Relationship between Frustration Intolerance and Burnout among

Healthcare Workers and Mental Health Workers
Luka Perišić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Marija Lazić
Elementary school „Miodrag Matić“, Serbia
Marija Dotlić
freelance, Serbia
Tamara Jovanović
Euromedik, Serbia
Magdalena Njegić
freelance, Serbia
Rebeka Popov
freelance, Serbia

Abstract
As burnout is a leading problem of modern times and healthcare workers are a particularly sensitive group, the idea
emerged that frustration tolerance might be a good predictor of the occurrence of this phenomenon in this popula-
tion. Numerous studies show that high frustration tolerance is positively associated with resilience to various mental
health issues, making it reasonable to assume that the same correlation will appear in the case of burnout.
The aim of this research is to examine to what extent and in what way frustration tolerance is related to burnout
among healthcare workers and mental health professionals. Additionally, a secondary goal is to assess the prevalence
of burnout among healthcare workers and mental health professionals.
The research is exploratory and correlational in nature, using the following questionnaires: The Frustration Discomfort
Scale (Harrington, 2005) and the Copenhagen Burnout Inventory (CBI). The sample consists of healthcare workers and
mental health professionals. The projected sample size is about 500 respondents, with the current sample size being
around 100 respondents. Preliminary results indicate a positive correlation between high frustration tolerance and
low levels of burnout. More detailed results will be available once the research is completed.
The practical implications of this research can be used for the further development of preventive programs aimed at
preventing burnout among healthcare workers and mental health professionals.

Keywords
Burnout, Frustration Intolerance, Healthcare workers

PO84 Psychological symptoms and test anxiety among freshmen: Are there
gender differences?
Maria Inês Caçador
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Fac-
ulty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Maria Cristina Canavarro
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Fac-
ulty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Marco Pereira
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Fac-
ulty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal

Abstract
BACKGROUND: The transition to university encompasses several new challenges that may impair students’ psycho-
logical adjustment. Those who struggle with this transition are more likely to develop mental health problems, which
are increasingly prevalent and may impact their personal and academic lives. In the university context, academic eval-
uations are also stressful moments for the majority of university students, with many experiencing high anxiety. Since
the transition to university is critical for freshmen, assessing their mental health and identifying those most at-risk of
experiencing mental health problems, including in academic evaluations is crucial. Gender, which is being considered
a central variable in research, may play an important role in this context. In Portugal, few studies focused on freshmen
mental health and test anxiety and, to the best of our knowledge, no study has explored the prevalence of psycho-

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logical symptoms and assessed test anxiety considering gender differences. The aim of this study was to assess the
prevalence of clinically significant anxiety and/or depression symptoms and to examine gender differences in these
symptoms as well as in test anxiety among freshmen before, during, and after academic evaluations.
METHODS: A sample of 189 freshmen (75.7% female; mean age = 18.56 years) recruited at a Portuguese university
completed self-report measures of symptoms of anxiety (GAD-7) and depression (PHQ-9) and test anxiety (Automatic
Thoughts Questionnaire in Test Situations, QPAST).
RESULTS: Most participants (64%) reported clinically significant anxiety and/or depression symptoms. Statistically
significant gender differences were found on anxiety and/or depression symptoms and in their prevalence (female:
81.8% vs. male: 18.2%), as well as in test anxiety before, during and after evaluations (total scores and subscales). Over-
all, female students experienced significantly more clinically significant levels of anxiety and/or depression symp-
toms, as well as higher test anxiety before, during and after academic evaluations than male freshmen.
CONCLUSIONS: Our findings show concerning data about the prevalence of psychological symptoms among fresh-
men, which is particularly high, as well as a noticeable role of gender in this prevalence. These results suggest a critical
need to promote students’ mental health as they transition to university, with a focus on addressing their mental
health needs on academic evaluations, particularly for female students, who appear to be more vulnerable to mental
health problems and test anxiety.

Keywords
Transition to university, Freshmen, Anxiety symptoms, Depression symptoms, Test anxiety, Gender differences

PO85 The potential of Future Event Specificity Training (FEST) to decrease

anhedonia and dampening of positive emotions:
A randomised controlled trial
Liesbeth Bogaert
KU Leuven, Belgium
David Hallford
Deakin Univer, Australia
Eline Loyen
KU Leuven, Belgium
Arnaud D’Argembeau
U Liege, Belgium
Filip Raes
KU Leuven, Belgium

Abstract
Impaired episodic future thinking (EFT), reflected in reduced specificity, low levels of detail and less use of mental
imagery, is associated with depressive symptomatology. Recently, the beneficial impact of Future Event Specificity
Training (FEST) on impaired EFT has been demonstrated, as well as on anhedonia, the core symptom of depression
which reflects positive affective impairment. This study aimed to replicate these previous findings, and to examine
the potential of FEST to reduce engagement in dampening. Dampening is a maladaptive response style character-
ized by reducing the intensity and/or frequency of positive emotional states which is linked to depressive symptoms
and anhedonia. An RCT (FEST vs. waitlist control) was conducted in a large sample of Dutch-speaking undergraduate
students (N = 155). In line with prior research, FEST resulted in significant improvements in the majority of the EFT
features of interest. However, likely related to limited room for change detection, no significant improvements were
found for anhedonia and dampening. Given the positive impact of FEST on multiple EFT features and prior evidence,
future studies should address methodological issues to create optimal conditions for potential change detection. In
addition, further examination of the explored proposed theoretical change mechanisms is warranted.

Keywords
future episodic thinking; depression; Future Event Specificity Training; anhedonia; dampening

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PO86 Mental health in the transition to university: Prevalence of

psychological symptoms of anxiety and depression and associated
transdiagnostic dimensions
Maria Inês Caçador
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Fac-
ulty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Maria Cristina Canavarro
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Fac-
ulty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal
Marco Pereira
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Fac-
ulty of Psychology and Educational Sciences, Coimbra, Portugal, Portugal

Abstract
BACKGROUND: The transition to university is a critical period for the onset of emotional disorders as well as for in-
creased symptoms of anxiety and/or depression, with evidence showing high prevalence rates, often comorbid. One
approach to effectively address anxiety and/or depression symptoms focuses on the common risk and maintenance
factors of these symptoms, that is, the transdiagnostic dimensions proposed by Brown and Barlow (2009). The aim of
this study was to assess the prevalence of clinically significant anxiety and/or depression symptoms and to examine
which transdiagnostic dimensions of Brown and Barlow’s model for emotional disorders are associated with these
symptoms and test anxiety on freshmen.
METHODS: A sample of 140 freshmen (74.3% female; mean age = 18.69 years) recruited from a Portuguese university
completed self-report measures assessing symptoms of anxiety (GAD-7) and depression (PHQ-9), test anxiety (Auto-
matic Thoughts Questionnaire in Test Situations, QPAST) and transdiagnostic dimensions (Multidimensional Emotion-
al Disorder Inventory, MEDI). Multiple linear regression was computed.
RESULTS: The majority of the participants (63.6%) showed clinically significant symptoms of anxiety and/or depres-
sion (clinically significant anxiety: 60%; clinically significant depression: 48.6%). Overall, all transdiagnostic dimen-
sions were significantly associated with higher levels of symptoms of anxiety and depression as well as higher test
anxiety. The regression models indicated that the transdiagnostic dimensions depressed mood, autonomic arousal
and intrusive cognitions were associated with increased symptoms of anxiety (R2 =.54), and that depressed mood,
autonomic arousal and traumatic reexperiencing were the dimensions significantly associated with higher symptoms
of depression (R2 =.65). Depressed mood and traumatic reexperiencing were the dimensions more consistently asso-
ciated with increased test anxiety before (R2 =.40), during (R2 =.40) and after evaluations (R2 =.34).
CONCLUSIONS: Our results suggest that depressed mood is a common predictor of higher symptoms of anxiety and
depression, as well as of test anxiety. Autonomic arousal, traumatic reexperiencing and intrusive cognitions also seem
to be relevant transdiagnostic dimensions in the mental health of freshmen. These results highlight the need to prop-
erly address these transdiagnostic dimensions when screening and intervening with students during their transition
to university.

Keywords
Transition to university, Freshmen, Transdiagnostic dimensions, Anxiety symptoms, Depression symptoms, Test anx-
iety

PO87 What are the effects of CBT for insomnia on insomnia, depression and
abstract rumination ? A preliminary study
Audrey Krings
University of Liège, Belgium
Marie Dethier
University of Liège, Belgium
Sylvie Blairy
University of Liège, Belgium

Abstract
Introduction: Sleep difficulties are commonly reported by patients with depression and can have a detrimental im-
pact on mood. Abstract rumination are a predictor of depression but are also related to insomnia. According to pre-

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liminary data Cognitive Behavioural Therapy for Insomnia (CBT-I) is an effective treatment for insomnia which seems
to have an impact on depressive mood and abstract rumination. The aim of the present pilot study is to investigate
the acceptability and feasibility of a CBT-I with a group format and to test the effects on insomnia, depressive symp-
tomatology and abstract rumination.
Methods: The CBT-I consisted of five 2-hours group psychotherapy sessions. Two groups of 10 and 12 people respec-
tively underwent five treatment sessions with traditional cognitive behavioral therapy techniques, including stimulus
control, sleep restriction, sleep hygiene and a cognitive module of dysfunctional beliefs identification. Insomnia, de-
pressive symptomatology and abstract rumination were assessed using self-reported measures, before and after the
treatment period. We computed a change score assessing the proportion of individuals showing reliable change (RC)
at post-treatment, relative to pre-treatment to rule out the possibility that a difference between two scores was due
to a measurement error rather than to the intervention.
Results: Fourteen of the 22 participants completed the entire intervention (4 in the first group and 10 in the second).
The fourteen participants were adults aged between 25 and 61 (10 women and 4 men). Pre-post RC analyses suggest-
ed significant improvement in insomnia in six participants (43%), significant improvement in depressive symptoms
in four participants (28%) and significant improvement in abstract rumination in two participants (14%). Two partic-
ipants responded to all measures, 4 participants only responded to insomnia and 2 participants only responded to
depressive symptoms. Four participants did not respond to the intervention at all (43%). Twelve participants reported
satisfaction regarding the intervention but two of them would not recommand this intervention - one of them did not
respond to the intervention but the second have reported a significant improvement in depressive symptomatology.
Discussion: A minority of participants reported significant changes in the variables measured - including insomnia
which is however the main therapeutic target of the intervention. CBT-I effect on depressive symptoms and abstract
rumination does not seem to concern a majority of participants. A high rate of non-response to treatment was ob-
served but this rate is similar to previous studies (approximately 50%). No data on medication were reported; the
intervention was short (5 sessions); we have no feedback from people who have stopped the intervention, we have no
medium to long term follow-up data and we only have two assessment measures which do not informed us about the
variability of the measure. It would be appropriate to reiterate this study with a larger number of clinical subjects and
sessions, to multiply the number of assessments over time and to monitor medication intake and include follow-up
assessment points.

Keywords
CBT-Insomnia, Insomnia, depression, abstract rumination

PO88 Homework Compliance Observational Form for Cognitive Behavioral

Therapy- HOMCOM: Psychometric properties of the measure and implications
for research and clinical work in cognitive behavioural therapy with anxious
children
Sonja Breinholst
University of Copenhagen, Denmark
Monika Walczak
University of Copenhagen, Denmark

Abstract
The application of homework tasks is an integral and important part of cognitive behavioural therapy for children
with anxiety disorders. Homework in cognitive behavioural therapy is a crucial component that enables children to
increase their mastery of the different skills covered in the therapeutic session, by practicing these newly acquired
skills in different contexts (Hudson and Kendal, 2002; Klein et al, 2024).
In the current study, we present a newly developed observational schema called Homework Compliance Observa-
tional Form (HOMCOM). The HOMCOM is a 25-item measure used to assess both the child’s homework compliance,
the working alliance between the child and the therapist, the child’s motivation and involvement, as well as the ther-
apist’s fidelity including assigning and following up on homework in the cognitive behavioral therapy treatment for
childhood anxiety. The aim of the study was to investigate the psychometric properties of the HOMCOM. The results
of the two-way random effects inter- rater reliability test of the measure showed good to excellent reliability.
The final measure and its psychometric properties will be presented and discussed in light of potential clinical and
research applications.

Keywords
CBT; Childhood Anxiety; Homework; Compliance; Fidelity; Psychometric properties

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PO89 INFLUENCE OF MOBBING ACTIVITIES ON DEVELOPMENT OF CHRONIC

PAIN SYNDROME AS A FORM OF PSYCHOSOMATIC ILLNESS
Sanda Anton
Psychiatric Clinic, University Hospital Center Osijek1, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of
Osijek2, Croatia
Valentin Kordić
Psychiatric Clinic, University Hospital Center Osijek1, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of
Osijek2, Croatia

Abstract
Objectives: Reactions to mobbing at a working place begin with initial self-blame, loneliness, shame and personal
devaluation. The intensity and type of consequences depend on the intensity of the mobbing, the duration and per-
sonality traits of the victim. Changes are noticeabled on an emotional and social level, and with the duration of the
pressures, changes on the physical and health level are recorded, along with the development of mental and physical
disorders.
Aim: To show the gradual disintegration of the personality and the development of severe psychological and physical
symptoms in a person exposed to long-term mobbing.
Methods: In this work we present a person who has been mobbed for many years. The development of anxiety, de-
pression, and later a severe psychological disorder in the form of exhaustion depression is described. Parallel to the
psychological consequences and the duration of the pressure from the mobbing activities, we describe the develop-
ment of psychosomatic consequences (chronic pain syndrome). Complex family dynamics and the development of
mental disorders in other family members up to a complete breakdown are showed.
Conclusions: Mobbing is a widespread phenomenon, and its consequences are reflected on the individual, the work
environment, the social environment and the family. Systematic prevention, education, and in the case of the devel-
opment of mental disorders, psychotherapeutic procedures (cognitive behavioral techniques) can be used to reduce
its impact on mental and physical health.

Keywords
mobbing, psychosomatic reactions, chronic pain syndrome, CBT

PO90 The Influence of Attachment Quality on Adolescents’ Internalizing

Problems: The Role of Automatic Thoughts
Ionut Stelian Florean
Babes-Bolyai University, Romania
Anca Dobrean
Babes-Bolyai University, Romania
Gabriela Diana Roman
Institute of Criminology, University of Cambridge, United Kingdom
Costina Ruxandra Păsărelu
Babes-Bolyai University, Romania
Cristina Vilceanu
Iuliu Haţieganu University of Medicine and Pharmacology, Cluj-Napoca, Romania
Elena Predescu
Iuliu Haţieganu University of Medicine and Pharmacology, Cluj-Napoca, Romania

Abstract
According to a large body of literature, insecure attachment in adolescents is linked to internalizing problems. How-
ever, the mechanism connecting insecure attachment and internalizing problems is not well understood. This study
explores whether automatic thoughts could be a mechanism in the relationship between attachment to parents and
peers and internalizing problems. The sample consisted of 105 Romanian adolescents (mean age = 16.60), who had
been diagnosed with internalizing disorders. Analyses were conducted using R software via the RStudio interface
and Partial Least Square Structural Equation Modeling, allowing us to specify complex models without facing con-
vergence problems and with increased statistical power. Our hypotheses were supported, indicating that automatic
thoughts partially mediate the relationship between insecure attachment and internalizing problems. Attachment to
mother, father, and peers had distinct effects on automatic thoughts and internalizing problems. We also showed a
substantial overlap in the predictive power of attachment to mother and father.

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Keywords
Adolescents; Internalizing disorders; Insecure attachment; Automatic thoughts

PO91 Cognitive-behaviuoral therapy of insomnia – effective but not

sufficiently accessible treatment. In search of new ways to deliver the
treatment.
Joanna Salbert
Institute of Psychiatry and Neurology in Warsaw, Poland
Adam Wichniak
Institute of Psychiatry and Neurology in Warsaw, Poland

Abstract
Introduction
The prevalence of insomnia is constantly increasing. In Europe, it is about 10% of the adult population, another ap-
proximately 30% of European adults suffer from insomnia symptoms or short-term sleep problems. There is an effec-
tive therapy that responds to this medical problem and is considered the standard and first line treatment for insom-
nia - cognitive-behavioral therapy for insomnia (CBT-I). Unfortunately this treatment is not enough accessible mostly
due to the lack of trained professionals, wide spread knowledge of the treatment’s standards and general health care
policy problems. In this situation, many patients rely exclusively on pharmacotherapy. Practitioners and researchers
in the field of sleep medicine make efforts to increase availability of CBT-I. One of the currently proposed solution is
‘Stepped care model’, developed by Collin Espie. Using two dimensions – availability and the level of expertise it tai-
lors the CBT-I therapeutic offer according to complexity of the disorder. The interventions included in the model vary
from widely spread simple ones in a form of leaflets, self-help guides, videos up to specialized services with limited
access.
The aim of this study is to present effective solutions inspired by the model. An example of educating and treating
through simple leaflets will be given on a basis of materials developed during an on-going European project Be-Safe.
On the other hand an innovative approach from the area of highly specialized CBT-I conducted in a Psychiatric Day
Ward of Institute of Psychiatry and Neurology in Warsaw will be presented. The effectiveness of the programme will
be discussed in details. The innovation in the treatment was accelerating the protocol – 10 working days instead of
standard 8 weeks - and adding intensive chronobiological interventions. It was inspired by the work and of Tatiana
Croenlein team and latest findings showing the impact of chronobiology on the effectiveness of the CBT-I treatment.
Method
10 days CBT-I programme was evaluated during one year study and proofed to be an effective treatment. The medical
records of patients who participated in the programme were analysed. The sample size was 60 patients.
At baseline, patients completed a set of scales and questionnaires.
Patients then followed 10 days therapy programme based on the CBT-I protocol. Follow-up visits were conducted
2 weeks and 6 weeks after completing the programme. Symptom severity was measured again at these times. The
change was assessed by test t-Student, Wilcoxon test.
Results
Preliminary results indicate that the proposed insomnia treatment program is effective with a potency of at least
moderate effect.
Conclusions
In the time of growing needs for supporting mental health we need to look for flexible approaches. The study shows
how to use an approach tailored to the patient needs in the area of insomnia treatment. The results confirming the
effectiveness of the created solutions could become a contribution to their wider dissemination.

Keywords
insomnia, Cognitive-Beahavioural Therapy of Insomnia (CBT-I), stepped care model, insomnia treatment recommen-
dations, chronobiology, day care unit

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PO92 A case of Rumination Disorder – A common yet unheard disorder

Jayanath Bhandara Purayil
Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, United Kingdom
Renuka Arjundas
Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, United Kingdom

Abstract
Introduction
This case study presents a woman with the diagnosis of rumination disorder referred to a tertiary CBT centre. Rumina-
tion disorder/syndrome is a poorly understood Functional Gastroduodenal or Feeding and eating disorder marked by
repeated regurgitation of food with subsequent spitting or re-mastication and swallowing (American Psychiatric As-
sociation, 2013). Though it has community prevalence of 0.8-10.6 %, it is often inaccurately diagnosed or missed due
to limited awareness, and results in delay in treatment, leading to protracted symptoms and functional impairment
(Murray et al., 2019). In this study we aim to highlight these aspects along with how a simple CBT approach could be
helpful in reducing the symptoms and improving functioning of such individuals.
Presenting Problems
34-year-old woman presented with frequent, effortless, involuntary regurgitation of food after most meals, not asso-
ciated with nausea or retching. It had resulted in significant weight loss, and avoidance of social situations. She had
received extensive evaluation and input from primary care, secondary mental health services and specialist gastroen-
terology services over the years, with little benefit.
Case Conceptualisation and Interventions
Though exact aetiology is unknown; it is postulated that in rumination disorder food intake is followed by subcon-
scious contraction of the abdominal wall muscles. This leads to increased intragastric pressure which overcomes the
pressure at the gastroesophageal barrier resulting in retrograde movement of gastric contents into the oesophagus
and mouth. Stress is a priming factor for this.
A formulation developed with the client, noted her having high expectations of self with prominent self-criticism.
Self-criticism exacerbated stress and contributed to further rumination episodes. The resultant shame from perceived
social embarrassment fuelled the self-criticism thus maintaining the vicious cycle.
Interventions:
1. Psychoeducation about rumination syndrome.
2. Diaphragmatic breathing - A first line treatment for rumination disorder was introduced to the client. It involves
breathing by expanding and contracting the abdomen, with one hand placed on front of the chest and other on the
abdomen (Sasegbon et al., 2022). This simple and easy to learn technique is thought to work by acting as a competing
response to habitual contraction.
3. Behavioural experiments - were conducted to challenge her negative beliefs about the social impacts.
4. Self-compassion interventions were used to manage self-criticism.
Outcome
The qualitative data from the patient revealed an overall improvement of 60-70% in symptom severity and function-
ing. She was able to delay the rumination, managing to have full meals occasionally and snacks and drinks mostly
without rumination. The number of rumination episodes had reduced considerably. Her quality of life also improved
with a more compassionate view about self.
Discussion
Rumination syndrome is a common disorder which could be managed with simple, low-cost interventions even in
primary care. But the lack of awareness amongst health-care professionals leads to delayed or incorrect diagnosis
and treatment resulting in protracted symptoms, impaired quality of life and unnecessary use of resources. Increased
awareness and training of healthcare professionals may improve outcomes and reduce burden on the health care
system.

Keywords
Rumination disorder, Rumination Syndrome, Diaphragmatic breathing

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PO93 The therapeutic alliance: What behaviors favor and hinder agreement
between therapist and client?
Cristina Guerrero-Escagedo
Universidad Autónoma de Madrid, Spain
Diego Fernández-Regueras
Universidad Autónoma de Madrid, Spain
Ana Calero-Elvira
Universidad Autónoma de Madrid, Spain

Abstract
A substantial body of research has demonstrated that the therapeutic alliance is a good predictor of treatment out-
come. Indeed, most treatment manuals and professional guidelines in psychology place a strong emphasis on the
importance of developing a robust therapeutic alliance. However, these same manuals and guidelines do not pro-
vide specific evidence-based guidelines on how to achieve it. This is in part because most studies employ self-report
measures to assess alliance strength, rather than external observational measures that help to describe which verbal
interaction behaviors enhance the therapeutic relationship. Given the importance of mutual agreement between
therapist and client on matters such as therapeutic tasks and goals for the establishment of a strong alliance, the
present study aimed to identify which verbal behaviors and interactions facilitate and hinder this. Video recordings of
95 individual therapy sessions with adults belonging to 20 clinical cases treated by 16 cognitive-behavioral therapists
were analyzed. These were selected from a total sample of 72 cases, with the 10 cases with the best and the 10 cases
with the worst scores on the Working Alliance Inventory being included. To analyze the recordings, a system of cat-
egories was developed to study the therapeutic relationship through systematic observation of the therapist-client
interaction. Therapeutic interactions were analyzed using sequential analysis. The results indicate that there were
significant differences in the frequency of several behaviors, including the expression of optimism or the proposal
of tasks/techniques without justification. Moreover, significant differences were observed in certain behavioral se-
quences, including explaining behavior or collecting feedback. Based on the results, we propose a set of guidelines
and recommendations to facilitate the agreement between therapist and client. It is hoped that the results of this
study will help to make psychological interventions more effective and efficient. In addition, the findings may prove
useful in the training of novice therapists.

Keywords
Therapeutic relationship; Sequential analysis; Cognitive-Behavioural Therapy; Observational methodology; Thera-
peutic Agreement

PO94 Assertive Behavior in Adolescence – Role of Personality Traits and

Irrational Beliefs
Danijela S. Petrović
University of Belgrade, Faculty of Philosophy, Serbia
Uroš Drljača
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Mirjana Nikolić
College of Vocational Studies for Educators and Business Informatics - Sirmium, Sremska Mitrovica, Serbia
Tamara Đorđević Nikolić
Sixth Belgrade High School, Belgrade, Serbia

Abstract
Introduction. A lack of assertiveness in adolescence can have significant negative impacts on various aspects of a
young person’s life, influencing their relationships, self-esteem, mental health, academic success, and overall personal
development. Beside personality traits, irrational beliefs can significantly hinder an adolescent’s ability to be assertive.
These beliefs are often rooted in cognitive distortions and negative thought patterns that lead to maladaptive behav-
iors and emotional responses. Objective. The goal of the research is to examine extent of assertive behavior among
adolescents from Serbia and to determine the role of personality traits and irrational beliefs in the manifestation of
assertive behavior. Methods. The sample included 318 adolescents (M = 19.73, SD = 5.84), 67.5 % females. For collect-
ing data, we applied Assertiveness scale, Mini IPIP-6, General attitude and belief scale (GABS) and questionnaire for
demographic variables. Data were analysed using the IBM SPSS Statistics 21 Software. For data analysis, descriptive

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statistics, linear correlation and hierarchical regression analysis were used. Results. Serbian adolescents assess their
assertiveness predominantly as low (44.9%) or moderate (38.1%). Assertiveness correlate positively with Extraversion
(r=.525, p<.01), Conscientiousness (r=.268, p<.01) and Openness (r=.217, p<.01) while correlation with Neuroticism
(r=-.363, p<.01) and Agreeableness (r=-.124, p<.05) are negative. Furthermore, assertiveness correlate negatively with
Self-depreciation (r=-.428, p<.01), Demands for love and approval from others (r=-.344, p<.01), Demands for comfort
(r=-.338, p<.01) and Perfectionist demands toward oneself (r=-.140, p<.05). Assertiveness was not associated with
Demands for other persons’ correctness, as well as, Other-depreciation. A hieratical regression analysis revealed that
both personality traits (R=.644; ΔF=44.118; pΔF=0.000) and irrational beliefs (R=.709; ΔF=9.062; pΔF=0.000) can pre-
dict assertiveness. However, personality traits explain 41.4 % of variance (R2=0.414) while irrational beliefs explain
only additional 8.9 % of variance (R2=0.089). Result indicate that a lower degree of neuroticism (t=-4.735; p=.000) and
agreeableness (t=-2.731; p=. 007) predict a higher degree of assertive behavior while a higher degree of extraver-
sion (t=10.149; p=.000), conscientiousness (t=2.991; p=.003) and openness (t=2.857; p=.005) predict a higher degree
of assertiveness. When it comes to irrational beliefs, results indicate that less expressed Self-depreciation (t=-3.651;
p=.000) and less expressed Need for love and approval (t=-3.475; p=.001) predict a higher degree of assertiveness.
Conclusion. As CBT attempt to provide a comprehensive framework for helping adolescents develop assertiveness,
the results on how certain personality traits, irrational beliefs influence the expression of assertiveness provide useful
guidelines for the application of CBT in working with adolescents. In addition to adolescents with neuroticism trait
of personality, it is necessary to pay attention during CBT intervention with agreeable adolescents, who are also less
inclined to stand up for themselves. Although irrational beliefs influence the expression of assertiveness to a lesser ex-
tent than personality traits, the obtained results indicate the necessity of working on unconditional self-acceptance.

Keywords
assertiveness, adolescents, personality traits, irrational beliefs, CBT

PO95 Perceptions of self-readiness, barriers and specifics in psychotherapy

with adults with Asperger syndrome from the perspective
of CBT therapists in Czech Republic
Jakub Bednář
The Department of Psychology, Faculty of Arts at Masaryk University, Czech Republic Kateřina
Katerina Koros Bartošová
The Department of Psychology, Faculty of Arts at Masaryk University, Czech Republic

Abstract
Background: The number of individuals with Asperger's syndrome (AS) is increasing worldwide and although there is
no cure for AS, therapy can be an effective tool to help individuals with AS manage secondary comorbid difficulties
(Motlani, 2022). However, therapists rate the level of their education in formal training as the lowest compared to
other disorders. Outdated information and misconceptions about AS are also common in the therapeutic community
(Lipinski, 2022). Lack of information coupled with unwillingness or inability to accommodate therapeutic style to
clients with AS is the most common barrier to providing therapeutic care (Adams, 2021). Therapists then describe a
greater need to adapt their therapeutic style when working with people with AS (Doody, 2020; Spain, 2019). They also
perceive a feeling that they are in a one-sided or non-reciprocal relationship and also reflect frustration when working
with this target group (Doody, 2020).
Aims: This pilot study aims to explore therapists' perceptions of their readiness to work with adults with AS and their
subjective perceptions of the barriers and specifics they encounter when working with this target group. At the mo-
ment, there is no study that addresses this issue in the context of the Czech Republic and the local system of therapist
training.
Method: Semi-structured interviews will be conducted with at least 20 therapists from the Czech Republic who have
therapeutic training in CBT and at least three years of expirience working with clients. Subsequently, coding of the
interview transcripts and thematic analysis of the text will take place.
Results: It will be possible to identify themes that therapists in the Czech Republic perceive as important when work-
ing with adults with Asperger syndrome. Based on these, it will be possible to draw implications for further research.

Keywords
Asperger’s syndrome, self-readiness, barriers, Czech Republic, Cognitive behavioral therapy (CBT), thematic analysis

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PO96 Knowledge and misconceptions about OCD: an exploratory study

Romina Cazar Padilla
University of Valencia, Spain
Odalis Merchán Varas
University of Valencia, Spain
Yuliya Saman
University of Valencia, Spain
Martha Giraldo O’Meara
University of Prince Edward Island, Canada
Sandra Arnáez Sampedro
University of Valencia, Spain

Abstract
Introduction: Obsessive-Compulsive Disorder (OCD) is a chronic mental disorder characterised by obsessive thoughts
and compulsive behaviours that can have a significant impact on the quality of life of those who suffer from it. The
experience of self-stigma and public stigma can become significant barriers to seeking and accessing appropriate
treatment.
Aim: The principal objective of the present study is to assess the misinformation component of OCD-related public
stigma. This encompasses two principal areas: (1) the lack of knowledge about OCD in the general population; and (2)
the dissemination of misinformation about OCD through popular discourse. This would represent a preliminary step
in developing preventive actions aimed at improving society’s knowledge of the disorder, reducing associated stigma
and self-stigma, and promoting access to effective treatments.
Method: A total of 92 individuals from the general population (73.9% female) with a mean age of 23 years (SD = 1.5)
participated in the study. In order to gain insight into the general population’s knowledge, lack of knowledge, and
misconceptions about OCD, a questionnaire entitled the OCD Knowledge Stigma Assessment Scale (OKSAS) was de-
veloped. The instrument comprises 24 items, which are answered using a 5-point Likert-type scale, ranging from 1 =
Strongly Disagree to 5 = Strongly Agree. These items were selected from a preliminary version that initially included
49 items.
Results: Up to 45.7% of the participants were aware that obsessions were not simply everyday concerns, while 35.9%
incorrectly believed that they were. In terms of understanding of OCD symptoms, 33.7% recognized that having un-
wanted urges about assaulting someone could be a symptom, while 40.2% indicated that they were unaware of
this information. Additionally, a considerable proportion of participants, 44.6%, were unaware that sexual obsessions
could be a symptom of OCD. Furthermore, a significant proportion, 50%, indicated that they were unsure whether
ignoring intrusive thoughts could lead to the development of obsessions. Concerning the treatment and manage-
ment of OCD, 54.3% of the participants acknowledged that compulsions were not effective in overcoming OCD, while
43.5% indicated that they had no knowledge of this. Similarly, 56.5% of respondents were uncertain as to whether
cognitive-behavioral therapy was the most effective therapy for OCD. With regard to the causes and consequences of
OCD, 56.5% of participants indicated that they were aware that weakness of character was not a cause of OCD, while
35.9% expressed uncertainty. Finally, with regard to the perception of dangerousness associated with OCD, 43.5% of
respondents indicated that they believed that OCD could not make a person dangerous, while 28.3% indicated that it
could, and another 28.3% expressed uncertainty about this.
Discussion: The findings of this study indicate that, although there is some general awareness of OCD among the
general public, there are still significant areas of lack of information and misinformation. In light of this, there is a
clear need to develop educational and awareness-raising interventions to improve knowledge and reduce the stigma
associated with OCD in society.
Acknowledgements. Grant PID2021-124409OB-I00 funded by MCIN/AEI/10.13039/501100011033/ and by the ERDF
- A way of making Europe.

Keywords
Knowledge, misinformation, OCD, public stigma, scale, stigma.

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PO97 Psychological aspects of sleep problems

Julia Kamburidis
Sofia university, Bulgaria

Abstract
Insomnia is a common sleep disorder, with 30% to 50% of adults experiencing this problem at some point in their
lives. Approximately 10% of the population suffers from chronic insomnia, which significantly worsens the quality of
life. Most often, the causes of insomnia are not organic; its occurrence is not related to a medical problem but rather
has an emotional nature and includes psychological determinants such as stress, poor sleep hygiene, depression,
anxiety, etc. Chronic insomnia influences all aspects of the lives of those affected, impacting their overall functioning.
CBT-I is considered a first-line treatment approach for sleep problems, with several studies proving its effectiveness.
We plan to conduct a survey that includes patients with different sleep problems and healthy controls. We will exam-
ine personal traits, levels of anxiety, depression, and stress. We will use Beck’s Depression Inventory, General Anxiety
Disorder-7, Toronto Alexithymia Scale, Mini-Multi-R, and the Pittsburgh Sleep Quality Index. We aim to determine the
psychological factors that are related to different sleep problems. The results will be used for prevention and setting
treatment goals when working with patients.

Keywords
insomnia, cognitive-behavioral therapy, personality, mood disorders

PO98 Efficacy of cognitive training through a mobile app to address eating

disorder cognitions in adolescents: A Randomized Controlled Trial with a one-
month follow-up.
Odalis Merchán Varas
University of Valencia, Spain
Marta Corberán Vallet
University of Valencia, Spain
Ángel Carrasco Tornero
Hospital Universitario y Politécnico La Fe, Spain
Sandra Arnáez Sampedro
University of Valencia, Spain
María Roncero Sanchis
University of Valencia, Spain

Abstract
Introduction: Eating disorders (ED) are a complex mental health issue that affects a significant proportion of adoles-
cents, with prevalence rates ranging from 0.3% to 1.7%. Information and communication technologies offer a unique
opportunity to develop strategies to address these disorders. With this aim the mobile app GGED-AD was created to
tackle maladaptive beliefs related to eating disorders (ED) in adolescent population.
Aim: The objective of the present study was to analyze if the benefits of the GGED-AD app are maintained for one
month after their use.
Method: A parallel randomized clinical trial with 93 students (Mage = 13.93; SD = 0.58; 60,2% women) of a public school
in the Valencian Community was carried out. They were randomly allocated to experimental or control groups. The
experimental group used the GGED-AD app, while the control group employed another neutral app with an identical
interface, called GGNeutral. All participants completed the following questionnaires: Eating Disorder Beliefs Ques-
tionnaire (EDBQ), Eating Disorder Examination Questionnaire (EDE-Q), Body Appreciation Scale-2 (BAS-2), The Patient
Health Questionnaire (PHQ-4), The Single-Item Self-Esteem Scale (SISE) and interpersonal insecurity and perfection-
ism factors of the Eating Disorder Inventory (EDI-3). The questionnaires were completed before (T1) and after using
the apps (T2), and one month after the end of the app (T3). A mixed model repeated measures analysis was conduct-
ed to assess the intervention effect on the outcome variables. This analysis involved the study group (experimental
or control) x time interaction. Gender and baseline punctuation were controlled. Results: When T2 was compared
between both groups, the variables of food concern (EDE-Q) (p = 0.05), figure concern (EDE-Q) (p = 0.03) and weight
and shape as a means to acceptance by others (EDBQ) (p = 0.02) demonstrated significant differences. The remaining
eating symptomatology, eating concerns, body satisfaction, emotional symptomatology, and self-esteem variables
did not demonstrate a statistically significant change. Results obtained at T3 showed no statistically significant differ-

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ences compared to T2 in both groups. This means that the changes obtained between T1 and T2 in the experimental
group were maintained one month after the end of the app.
Discussion: GGED-AD represents a novel approach to adolescent eating disorder (ED) prevention. The results ob-
tained are limited, although they are maintained over time. This may be due to the fact that this is a universal preven-
tion study, not a selective one, where the results are usually modest. Future studies should analyze the efficacy of the
GGED-AD App in the adolescent population at risk of developing an ED.
Acknowledgments: Project [PID2021-124409OB-I00] funded by MCIN/AEI/10.13039/501100011033 and by ERDF A
way of making Europe.

Keywords
Adolescence, apps, ED, follow-up, maladaptive beliefs, mHealth, RCT.

PO99 De Jong-Gierveld Loneliness Scale – Description of Student Loneliness

and Psychometric Properties of the Scale
Marina Trbus
Private psychological practice, Croatia
Ana Petak
University of Zagreb, Faculty of Croatian Studies, Croatia

Abstract
Loneliness is a common issue among university students that may negatively affect their physical and mental health,
as well as their academic performance. This research intended to explore loneliness among students, describe its
incidence, and examine its relation to sociodemographic characteristics.
The study was conducted online during the fall of 2023. Students were invited to participate through student groups
on social media and group mailing lists. Out of 320 university students who accessed the survey, 228 completed it.
The final sample consisted of 228 students, predominantly female (82%), from various years and faculties. A total of
67.5% students report an average socioeconomic status, 24.1% above-average, and 11.9% below-average.
The measure of loneliness was The Loneliness Scale (de Jong-Gierveld & van Tilburg, 1999), translated into Croatian.
The scale consists of 11 items and provides a total score and scores on the subscales of emotional and social lone-
liness. Among several possible response formats, a Likert scale was applied (1-Strongly Disagree, 5-Strongly Agree),
with the result formed as average response score after recoding the reverse items.
The scale demonstrated good reliability of total score (α=.890) and subscales of emotional (α=.885) and social
(α=.821) loneliness. Both subscales were highly correlated with the total score (r=.834-.923, p<.001) and moderately
intercorrelated (r=.557, p<.001). Good internal consistency is also indicated by inter-item (r=.177-.651) and item-to-
tal (r=.580-.772) correlations. Confirmatory factor analysis (CFA) in the Mplus confirmed the presumed two-factor
structure (CFI=.933, TLI=.915, SRMR=.050, RMSEA=.09, 90% CI RMSEA [.072, .109]), as did exploratory factor analysis
in SPSS (principal axis component, direct oblimin rotation), according to which both factors explained 54.23% of the
variability in loneliness. Convergent validity is indicated by correlations of total score with anxiety (r=.200), depression
(r=.478) and stress (r=.331), measured by DASS-21 (Lovibond & Lovibond, 1995).
With slightly positively skewed distributions, the overall results were below the theoretical average of the scale for
total score (M=2.53, sd=.92, C=2.36) as well as emotional (M=2.62, sd=1.12, C=2.5) and social (M=2.42, sd=.94, C=2.4)
loneliness. Loneliness was not found to be associated with socioeconomic status and academic performance. There
were no gender differences in loneliness nor differences based on the level of study, place of study, or accommoda-
tion during studies. This result was unexpected - previous research has shown higher loneliness in females, freshmen
students and students with lower socioeconomic status. Given the excellent psychometric characteristics of the scale,
such a result can be attributed to non-probability sampling. It is possible that students who responded to the survey
and participated to the end had different characteristics comparing to the general population. Therefore, we can
conclude that the scale’s psychometric suitability was confirmed in the sample, but more extensive research with a
representative sample is needed for more detailed information on student loneliness.

Keywords
loneliness, students, De Jong-Gierveld Loneliness Scale, psychometric properties

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PO100 Social Anxiety: Challenge Accepted - Empowering Social Confidence

Through Cognitive Behavioral Therapy
Petra Kremenjaš
Society for Psychological Asisstance, Croatia
Nikolina Kanceljak
Ministry of Internal Affairs, Burkina Faso
Antonija Vrdoljak
Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Croatia

Abstract
Social anxiety disorder (SAD) is a prevalent and debilitating condition that significantly impacts individuals’ quality
of life, especially young people. The “Social Anxiety: Challenge Accepted” program is an group intervention designed
to address social anxiety by integrating principles of Cognitive Behavioral Therapy (CBT). This poster presentation
outlines the development, implementation, and preliminary outcomes of the program, highlighting its efficacy in
reducing symptoms of social anxiety and enhancing social functioning. The “Social Anxiety: Challenge Accepted”
program consists of 10 weekly sessions (120 minutes each), each focusing on key CBT techniques such as psihoedu-
cation, cognitive restructuring, exposure exercises, and social skills training and additionaly some mindfulness and
ACT techniques. Participants engage in both individual and group activities that foster a supportive environment,
encouraging peer interaction and mutual support. In order to maintain the impact of the intervention outside the
program, the participants had to do their homework regularly. There were a total of 9 participants in program, which
was carried out in Society for Psychological Assistance. Preliminary data from participant self-reports indicate signif-
icant improvements in anxiety symptoms and social engagement. The participants rated the program as useful, well
organized and average score on general satisfaction with the program was high. The structured yet flexible format
allows for personalized interventions, addressing the unique challenges faced by each participant. Additionally, the
group setting provides a safe space for practicing new skills, receiving feedback, and building confidence. The success
of the “Social Anxiety: Challenge Accepted” program underscores the effectiveness of CBT in treating social anxiety
within a group context. This poster presentation will discuss the program’s framework, therapeutic techniques, and
outcome measures, providing valuable insights for clinicians and researchers dedicated to improving mental health
outcomes for individuals with social anxiety simptoms.

Keywords
Social Anxiety, Cognitive Behavioral Therapy, Group Intervention

PO101 Functional Impairment in Young People with Features of Borderline

Personality Disorder
Ben Brandrett
University of Glasgow, United Kingdom
Ruchika Gajwani
University of Glasgow, United Kingdom

Abstract
This study aimed to comprehensively understand functional impairment in adolescents with Borderline Personality
Disorder (BPD) features, ranging from one or two symptoms to subthreshold or threshold levels, in the community.
Additionally, we examined whether the number of symptoms and the duration of untreated BPD features were asso-
ciated with functional outcomes. In this cross-sectional study, 35 young people were assessed using broad measures
of functioning, including Health-Related Quality of Life (HRQoL), general capability, and social/occupational function-
ing. Results indicated functional impairment across all domains compared to normed data from non-clinical samples.
Individuals with threshold BPD features had significantly lower HRQoL compared to those with just one or two BPD
features, based on measures of general functioning and HRQoL. However, no significant differences in functional im-
pairment were found between subthreshold and threshold participants. Additionally, no relationship was identified
between the duration of untreated BPD features and functional impairment. These findings highlight the importance
of incorporating broad functional assessments into the evaluation and intervention strategies for young people pre-
senting with BPD features.

Keywords
Adolescence, Borderline Personality Disorder, Functioning

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PO102 Understanding Attentional Bias Among Individuals Across the Bipolar

Spectrum: A Meta Analysis
Renata Gheorghiu
Babeș-Bolyai University, Department of Clinical Psychology and Psychotherapy, Romania
Oana Alexandra David
Department of Clinical Psychology and Psychotherapy; The International Institute for the Advanced Studies of Psy-
chotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania

Abstract
Bipolar Disorder (BD) is characterized by significant functional and cognitive impairment and stands as a leading con-
tributor to disability worldwide, with the World Health Organization (WHO, 2011) surveys ranking it as the second most
impactful factor on day-to-day functioning (Grande et al., 2016). As such, the following meta-analysis is being conduct-
ed at present to address dysfunctional information processing of emotional information (Scot & Pope, 2003 as cited
in Leyman, 2009), more so attentional bias, which is a preferential allocation of attention towards specific information
(Crombez et al., 2013) being linked to the development and maintenance of mood disorders and other psychopatholo-
gies (Pine et al., 2005; Sinclair et al., 2016; Faunce, 2002). The aim of this study is to investigate the magnitude of positive
& negative attentional bias in those affected or at risk of developing BD. This meta-analysis adhered to the PRISMA
guidelines. A systematic search for relevant published search was conducted by searching the following electronic data-
bases: PsycINFO, ProQuest, Scopus, Web of Science, PubMed and supplementing with Google Scholar for peer-reviewed
articles, written in English. Initial search was conducted on 2nd February 2024. Only published, peer-reviewed, studies
were included in our meta-analysis. The study included either individuals diagnosed with BD or at-risk for BD (whether
this be familial risk or screening-based risk e.g. HPS). Studies included a conclusive affective attentional bias probe / task
such as Emotional Stroop Task, Affective Go /NoGo and other similar tasks or variations of the ones already mentioned.
In the case that a study included an intervention (e.g. pharmaceutical drug), only pre-intervention data was extracted.
Studies were required to report data related to positive or negative emotions (e.g. “positive images”, “happy target”).
Articles were excluded if BD (or at risk) individuals were pregnant, peri- or post-partum, had significant cognitive deficits
or impairments (e.g. dementia), additional schizophrenia diagnosis or Autism Spectrum Disorder.
Our initial search yielded 2925 references, 1261 were eliminated due to being duplicates. The first reviewer screened
the titles and abstracts of the retrieved studies for our keywords of interest. As such, 266 references were included in
our full-text retrieval and were read for relevance by a second reviewer as well. Diverging viewpoints over inclusion
were resolved by consensus. 234 articles were excluded due to not meeting our criteria. Articles were excluded if they
did not offer data separately or a comparison that could be used for positive/negative bias, such as a cumulative re-
sponse time. Our final sample included 32 studies. For an integrative view, we’ve included at-risk individuals, whether
offspring of BD or screened using validated methods such as the Hypomanic Personality Scale (Eckblad & Chapman,
1986) and pediatric populations. Subgroup analyses will be used for a clearer and robust understanding in these
populations. We’ve coded bipolar type, current state, experimental task, whether the study is pediatric or risk-related,
the type of presentation of stimuli, exposure time, task design, age, gender, country, illness duration, age of onset,
number of mood episodes and medications. As such, a mixed-effects analysis is to be conducted.

Keywords
Bipolar Disorder, Attentional Bias, Meta-analysis

PO103 Effects of Positive Psychology Interventions on Loneliness: A

Systematic Review and Meta-Analysis of Randomized Controlled Trials
Daria Sintoma
“Evidence Based Assessment and Psychological Interventions” Doctoral School, Babes-Bolyai University, Cluj-Napoca,
Romania, Romania
Claudiu Negosanu
“Evidence Based Assessment and Psychological Interventions” Doctoral School, Babes-Bolyai University, Cluj-Napoca,
Romania, Romania
Aurora Szentagotai-Tatar
Department of Clinical Psychology and Psychotherapy; The International Institute for the Advanced Studies of Psy-
chotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania

Abstract
Objective: Loneliness is a widespread phenomenon associated with both mental and physical health concerns. Posi-
tive psychology interventions (PPIs), which are interventions designed to enhance well-being through methods con-

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sistent with positive psychology principles, have been proposed as a means to mitigate loneliness. While previous
systematic reviews and meta-analyses have demonstrated the effectiveness of PPIs for various psychiatric and somat-
ic conditions, none have investigated their impact on loneliness. Therefore, this systematic review and meta-analysis
aim to assess the efficacy of PPIs in alleviating loneliness across diverse populations by synthesizing evidence from
randomized controlled trials (RCTs).
Methods: This study, pre-registered in PROSPERO (CRD42024540283), adhered to Preferred Reporting Items for Sys-
tematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search was conducted across four major data-
bases (PubMed, PsycINFO, Web of Science, and Scopus) for RCTs comparing PPIs aimed at reducing loneliness to any
kind of control group. We found 1467 articles. Inclusion criteria encompassed RCTs of PPIs conducted on healthy or
clinical populations of any age, published in peer-reviewed English-language journals, utilizing validated measures
of well-being and loneliness. Two independent reviewers will conduct the screening, data extraction, and quality
assessment of the included studies, resolving disagreements through consultation with a senior researcher. The pri-
mary outcome will be the changes in loneliness score post-PPI and/or follow-up, while the secondary outcomes will
be changes in well-being scores. The study quality will be assessed based on the Cochrane collaboration tool for
assessing risk of bias (RoB 2) in randomized controlled trials (Sterne et al. 2019). For data processing, Comprehensive
Meta-Analysis software (Borenstein et al., 2013) will be used, employing a random-effects model and Hedges' adjust-
ed g as an effect size indicator. Heterogeneity is anticipated due to the broad definition of PPIs, and it will be quan-
tified using Q and I² statistics. Publication bias will be assessed via funnel plots and Egger’s test. Moderator analyses
will examine PPI characteristics, control group types, and participant characteristics, employing meta-regression for
continuous variables such as study quality, age, and percentage of females.
Results: Building upon prior meta-analyses (e.g. Carr et al., 2021; Bolier et al., 2013; Chakhssi et al., 2018), we expect
small to medium post-intervention effects on reducing loneliness and improving positive outcomes (e.g., well-being,
quality of life). We anticipate some maintenance of these gains at follow-up. Drawing from Carr et al.'s mega-analysis
(2024) we foresee three key moderators: longer and face-to-face PPIs may be more effective, studies with inactive
controls and lower methodological quality may show larger effects, and PPIs may benefit individuals with mental or
physical health issues.
Conclusions: This meta-analysis will shed light on the impact of PPIs on loneliness. Future research should delve into
the mechanisms underlying their effectiveness and optimize delivery methods for greater impact.

Keywords
Positive Psychology Interventions, Loneliness, Systematic Review, Meta-Analysis, Randomized Controlled Trials

PO104 Exploring the interplay of difficulties in emotion regulation, repetitive

negative thinking, and distress: A two-wave longitudinal mediation study
using a transdiagnostic approach
Catarina Raposo
Center for Psychology at the University of Porto, Faculty of Psychology and Educational Sciences of the University of
Porto, Portugal
Pedro Nobre
Center for Psychology at the University of Porto, Faculty of Psychology and Educational Sciences of the University of
Porto, Portugal
Pedro Rosa
Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Lisbon, Portugal
Patrícia M. Pascoal
Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Lisbon, Portugal

Abstract
Sexual distress is a critical factor in diagnosing sexual dysfunction, with recent cross-sectional research supporting
a transdiagnostic approach for its understanding. This exploratory study aimed to investigate the mediating role of
repetitive negative thinking between difficulties in emotional regulation and both sexual and psychological distress
within a community sample. Utilizing a quantitative longitudinal design, the study surveyed 64 partnered individuals.
The survey included a sociodemographic questionnaire, the Difficulties in Emotion Regulation Scale – Short Form, the
Persistent and Intrusive Negative Thoughts Scale and, as interrelated outcomes, the Sexual Distress Scale-Revised and
the Kessler Psychological Distress Scale. Correlational analysis over time showed significant associations between dif-
ficulties in emotion regulation, repetitive negative thinking, psychological distress, and sexual distress. Controlling for
sexual activity frequency, a positive total effect of difficulties in emotion regulation on sexual distress was observed.
Longitudinal mediation analysis revealed a significant negative indirect effect of difficulties in emotion regulation
on sexual distress through repetitive negative thinking, which acts as a buffer, but this effect was not observed for

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psychological distress. These findings underscore the importance of recognizing difficulties in emotion regulation
and repetitive negative thinking as coping strategies when examining sexual distress. They emphasize the necessity
to explore the efficacy of therapeutic interventions that address these cognitive processes to reduce adverse sexual
outcomes. The results suggest that repetitive negative thinking might have adaptive effects, highlighting a nuanced
role for these cognitive processes in coping strategies within the study's context.

Keywords
difficulties in emotion regulation; repetitive negative thinking; sexual distress; psychological distress; longitudinal
study; transdiagnostic approach

PO105 Cognitive behavioral therapy for anxiety disorders in children and

adolescents with autism spectrum disorders
Amalie Nielsen
Aarhus University, Denmark

Abstract
Background: Approximately 1-2% of all children and adolescents have an autism spectrum disorder (ASD). ASD is
characterized as a pervasive developmental disorder marked by deviations and delays in the development of so-
cial interaction and communication patterns, as well as limited, stereotyped, and repetitive behaviors. Children and
adolescents with ASD often experience an elevated risk of comorbid conditions such as ADHD, conduct disorders,
anxiety, and OCD. Studies have found that 44-60% of children and adolescents with ASD also have an anxiety disor-
der. This number is much higher compared to the 3-5% prevalence of anxiety in children without an ASD diagnosis.
The combination of ASD and comorbid conditions has been shown to have an even greater impact on the behavior
and well-being of the child than the ASD diagnosis alone. Therefore, treating these comorbid conditions is crucial for
improving the child’s well-being and overall functional level.
Purpose: To present experiences with cognitive behavioral therapy (CBT) for anxiety disorders in children and ado-
lescents with ASD using the Cool Kids autism spectrum adaptation. This is a 10-session program aimed at helping
autistic children and adolescents manage anxiety. Another purpose is to present and discuss some of the common
difficulties in treating this population, such as inclusion criteria, differential diagnosis, treatment format (group vs.
individual), manualized treatment, parental involvement, and challenges related to autism spectrum disorder such
as cognitive inflexibility, insistence on sameness, and sensory sensitivity. This poster will primarily have a clinical per-
spective and be case-based.

Keywords
Autism spectrum disorders, ASD, anxiety disorders, cognitive behavioral therapy, CBT, children, adolescents

PO106 The level of emotional intelligence among adolescent

with delinquent behavior
Ketevan Abdushelishvili
GACBT, Georgia
Natalia Mikeladze
GACBP, Georgia

Abstract
The objectives of the research is to study the impact of emotional intelligence as a personal trait and skill on delin-
quent behavior. To discover which areas and aspects of emotional intelligence should be paid attention to in order to
reduce delinquent behavior. 207 respondents have participated in the research. The target group was selected from
regional bureaus of the LEPL-National Agency for Crime Prevention, Execution of Non-custodial Sentences and Pro-
bation - 100 respondents, and the control group – 107 people, also from schools, colleges and university pupils and
students from different regions of Georgia.
On the basis of the research, most of the hypotheses were confirmed. Which means that adolescents with non-de-
linquent behavior have higher emotional intelligence than adolescents with delinquent behavior. All survey compo-
nents had a high reliability index with Cronbach's alpha of 0.84. Adolescent boys with delinquent behavior have low
levels of empathy, happiness and social intelligence, and high levels of emotion perception and expression.

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It has been found out that success in school is positively correlated with the level of emotional intelligence. Among
the interviewees, the higher the school success rate was, the higher was the overall emotional intelligence index.
The consequences of the study confirmed that teenagers with delinquent behavior have high self-motivation and
high level of optimism. In addition, the research showed that the level of emotional intelligence was significantly
influenced by factors such as school success, nuclear family, the presence of siblings in the family, and the place of
residence.

Keywords
delinquent behavior, adolescents, emotional intelligence, emotionality, sociality, self-control, well-being

PO107 An example of CBT in an adolescent with social anxiety

and test anxiety and important points
Nursen Bozkoyun
Kocaeli University School of Medicine, Department of Child and Adolescent Psychiatry, Turkey
İrem Damla Çimen
Kocaeli University School of Medicine, Department of Child and Adolescent Psychiatry, Turkey
Nursu Çakin Memik
Kocaeli University School of Medicine, Department of Child and Adolescent Psychiatry, Turkey

Abstract
16 years 5 months female patient was admitted to the child and adolescent psychiatry outpatient clinic with the
complaint of having too much anxiety. The patient was very anxious before the exams, started crying a week before
the exams, and was afraid of "what if I can't do it, what if I embarrass my family". She would try to prove herself to
her parents. The interviews revealed that she also had difficulty making friends. She did not make friends quickly
and preferred people like herself, people she could manipulate and get close to. She felt like an outcast in public and
wanted to cry. She thought they would laugh at her, that they would insult her. She didn't like talking on the phone
and kept the conversation short. She was afraid she wouldn't have anything to say and there would be silence. When
she went to stores, she wanted to buy what she wanted and leave immediately. When she met new people, she would
get very excited and her heart would race. The newness and changes in her life made her restless. It was learned that
the patient, who had no symptoms of anxiety before elementary school, started to be shy in friendships and anxious
in social settings after changing her teacher 3 times in the first grade of elementary school. In high school, when her
father's kidney disease progressed, they decided to move to another city and she entered a school with a different
teaching style. It was difficult for her to enter an environment where everyone knew each other. It was noted that the
pre-existing anxiety symptoms continued to worsen after this process. The patient, who had been suffering from anx-
iety for about 10 years, came to our clinic for treatment because she felt like fainting one day at school due to intense
anxiety and was diagnosed with social anxiety disorder and another defined anxiety disorder (test anxiety). During
the follow-up and treatment process, in-depth interviews were conducted with the patient and her family to identify
individual and family factors leading to the anxiety disorder. The patient refused medication due to cognitive distor-
tions. The patient's treatment was continued without medication, using cognitive behavioral therapy, problem-solv-
ing and communication skills, and family-focused approaches. The patient's functionality improved significantly. In
this case report, the CBT-based treatment approach applied to an adolescent patient who had been untreated for
many years and refused medication is presented in detail to highlight points that may be important in adolescent
therapies.

Keywords
Adolescent, Anxiety Disorders, CBT

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PO108 Candidate mechanisms of change in therapy for procrastination: a

randomized controlled trial with different cognitive-behavioral protocols
Magdalena Pietruch
Laboratory of Brain Imaging, Nencki Institute of Experimental Biology, Polish Academy of Science, Warsaw, Poland
Joachim Kowalski
Experimental Psychopathology Lab, Institute of Psychology of Polish Academy of Sciences, Warsaw, Poland
Weronika Maria Browarczyk
Institute of Psychology, SWPS University, Warsaw, Poland; Laboratory of Affective Neuroscience, Institute of Psycholo-
gy, SWPS University, Poznań, Poland
Jarosaw Michaowski
Laboratory of Affective Neuroscience, Institute of Psychology, SWPS University, Poznań, Poland
Marek Wypych
Laboratory of Brain Imaging, Nencki Institute of Experimental Biology Polish Academy of Science, Warsaw, Poland

Abstract
Procrastination is a self-regulatory failure that involves voluntarily delaying intended tasks despite the negative con-
sequences. As procrastination negatively affects a considerable number of individuals by impairing many aspects of
psychological well-being, psychotherapeutic interventions aimed at treating excessive and chronic procrastination
are developed. While CBT interventions are currently recognized as the most promising procrastination treatment
methods, little is known about the mechanisms underlying their effectiveness. In order to better understand factors
responsible for therapeutic change, in this randomized controlled trial we aimed to assess a variety of constructs,
including self-efficacy, self-regulation, emotion-regulation, perceived task value and time perspective to identify can-
didate psychological mediators of successful treatments for procrastination.
Two intervention groups with CBT protocols for procrastination (Realistic Planning and Timely Beginning, RPT, and Work-
ing Time Restriction, WTR) were compared with an active control intervention protocol (Pomodoro Technique, PT) and
with a waitlist control group (WL). All active protocols consisted of 5 online weekly meetings in a group setting and
included the same elements of psychoeducation and cognitive interventions, but differed in the implemented behav-
ioral interventions. To identify the candidate mechanisms of therapeutic change, we considered per protocol results of
participants who completed the allocated treatment (nRPT = 36, nWTR = 43, nPT = 41, nWL = 53). First, we assessed the
effect of treatment on changes in related constructs, and second, their mediating role in the relationship between treat-
ment and the primary treatment outcome (change in Aitken Procrastination Inventory). We initially hypothesized that
RPT would prove to be more effective than WTR in changing several aspects of self-regulation, emotion regulation and
time perspective, while WTR would affect self-efficacy and perceived value of tasks stronger than RPT.
In comparison to WL, both experimental intervention protocols (RPT, WTR) and the active control intervention (PT)
improved temporal orientation towards the future, planning, and proactive control, and with tentative effects for RPT
and WTR, influenced the perceived value (or meaningfulness, enjoyableness) of one’s tasks. Moreover, RPT and WTR
decreased some aspects of fear of failure and increased self-efficacy, while only WTR affected emotion regulation by
increasing access to emotion-regulation strategies.
For all active conditions, only the change in temporal orientation towards the future mediated the influence of treat-
ment on procrastination tendency (RPT: 19% of the effect of treatment was explained by the mediator, CI95%: 7%-
26%; WTR: 37%, CI95%: 23%-44%; PT: 32%, CI95%: 19%-39%). However, for PT also the change in the perceived value
of one’s tasks had a mediating effect (16%, CI95%: 5%-23%).
Contrary to a priori hypotheses, the results suggest that regardless of the varying behavioral modules of the inter-
ventions, in comparison to waitlist control all active psychotherapy protocols caused comparable changes in several
of the initially assumed candidate mechanisms. Only the change in temporal orientation towards the future (RPT,
WTR and PT groups) and the change in the perceived value of one’s tasks (PT group) partially mediated the effect of
treatment on procrastination tendency. No mediation model fully accounted for the therapeutic change, suggesting
the need for further research.

Keywords
procrastination, mechanisms of change in psychotherapy, randomized controlled trial

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PO109 A daily diary study of cancer-related pain and associated difficulties:

The role of Psychological Flexibility
Sean Perrin
Lund University, Sweden
Frida Köhler-Bjorkstrand
Lund University, Sweden
Joana Duarte
Lund University, Sweden
Lance McCracken
Uppsala University, Sweden

Abstract
Introduction: Approximately 40% of cancer patients/survivors develop chronic cancer-related pain (CRP), which is
associated with greater levels of fatigue, cancer worry, poorer treatment response, overall functioning and well-being.
Psychological Flexibility (PF) refers to one’s level of openness to experiences, awareness of circumstances, and engage-
ment in value-based action. A large body of research, based on group data, has shown that PF is positively correlated
with better day-to-day functioning and general well-being, despite the presence of chronic pain symptoms. However,
the relationship between PF, symptoms, symptom-specific impairments, and overall functioning within individuals
over time is less well understood. Objective: This study aimed to investigate the relationships between daily variations
in PF, the severity of CRP, fatigue, and cancer worry, and the impact of these individual symptoms on functioning in
cancer patients/survivors. Methods: Fifteen participants with chronic CRP completed bi-daily diary recordings of the
severity of pain, fatigue, cancer worry, interference from these symptoms, overall functioning and the six facets of PF
via a smartphone application, for 21 days, resulting in a total of 574 data points. Using mixed-level models, we investi-
gated whether daily variation in PF contributes to symptom interference, while controlling for symptom severity and
between-participant variability. We conducted three separate symptom-specific mixed model analyses; one for each
symptom (pain/fatigue/cancer worry). Furthermore, we investigated the contribution of PF on overall functioning,
while still controlling for between-participant differences, and controlling for all three symptom levels in the same
model. Results: For all three symptom-specific models, model fit parameters improved by adding symptom severity
and PF. In all models, symptom severity was the strongest predictor of symptom interference, while controlling for
between-individual variation. In all models, adding PF had a significant effect and improved model fit, indicating that
PF can explain variance in symptom impact beyond symptom severity, with a small to medium effect sizes (.11 - .21).
In the model predicting overall functioning, pain and fatigue severity added significantly to the model, while cancer
worry did not, with a medium effect size (.20) of symptom severity added together. PF added significantly with a small
effect size (.12). Conclusions: Consistent with other patient groups, PF appears to moderate the relationship between
chronic pain, fatigue, and illness worry, and the functional impacts of these symptoms in cancer patients/survivors.
Thus, treatments specifically targeting PF may yield similar improvements in pain and associated difficulties in cancer
patients/survivors as found in other pain groupsbe of use to cancer patients/survivors suffering from these types of
difficulties, particularly if the interventions can be tailored to specific deficits in the six aspects of PF and strong symp-
tom-impairment relations that may vary within individuals.

Keywords
Cancer, Chronic Pain, Fatigue, Cancer Worry, Psychological Flexibility

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PO110 Efficacy of cognitive-behavioral therapy for insomnia and pain and

therapy focused on trauma in physical symptoms: A pilot study in patients
with fibromyalgia
Ana Sánchez
University of Granada, Spain
M. Pilar Martinez
University of Granada, Spain
Coralie Maire
University of Granada, Spain
Germán Prados
University of Granada, Spain
Rafael Cáliz
Virgen de las Nieves Hospital, Spain
Aurora Muñoz
University of Granada, Spain
Elena Miró
University of Granada, Spain

Abstract
Introduction
Fibromyalgia (FM) is a syndrome that involves chronic widespread musculoskeletal pain of unknown cause. In ad-
dition to pain, FM is currently diagnosed by the presence of nonrestorative sleep, fatigue, mood disturbances (i.e.,
depression and anxiety), cognitive difficulties, and a variety of heterogeneous somatic complaints. Some studies have
highlighted the presence of physical trauma or injury as triggers that precede FM. Apart from physical trauma, several
retrospective studies have found a higher self-reported incidence of physical or sexual abuse in FM patients versus
non-FM controls. Due to insomnia is the most common sleep disorder in chronic pain patients a psychological treat-
ment based on cognitive-behavioral therapy focused on insomnia and pain (CBT-IP) was developed for FM patients.
The objective of this pilot study was to analyze the efficacy of cognitive-behavioral therapy for insomnia and pain
(CBT-IP) compared to trauma-focused therapy (TT) at improving sleep, pain, FM impact and fatigue, in women with
FM.
Method
Twenty-two participants with FM were randomly assigned to one of the two conditions: TT (n= 10) or CBT-IP (n = 12). The
research protocols received ethical approval from the University of Granada Ethics Committee, and patients signed an
informed consent form prior to their inclusion in the study. Patients will recruit from AGRAFIM (an association of FM pa-
tients) and the Rheumatology Service Virgen de las Nieves University Hospital, both in Granada (Spain). A semi-structured
interview was conducted in two sessions. Participants completed several self-report questionnaires at pre and post-treat-
ment (1 week after the completion of the intervention). The assessment and treatment sessions were conducted in the
Psychology Clinic of the University of Granada. The measures were: McGill Pain Questionnaire, short-form, MPQ-SF; Pitts-
burg Sleep Quality Index, PSQI; Multidimensional Fatigue Inventory (MFI) and Fibromyalgia Impact Questionnaire (FIQ).

Treatment Protocols
The protocol-based psychological treatments (CBT-IP and TT) were provided by therapists with a high level of profes-
sional training, and experience in the domain of chronic pain and sleep disorders. Ninety-minute sessions were con-
ducted in a group format (5–7 participants) once a week for 9 weeks. During the study all participants were required
to follow their usual medical care.
Data analysis
IBM SPSS Statistics were used. Groups were compared via Mann-Whitney’s U test

Results
Patients receiving CBT-IP and TT showed significant improvement in pain intensity, general fatigue, and functional
impairment in daily life at post-treatment, although these favorable changes were more pronounced in the group
that received TT. The CBT-IP was associated with significant improvements in sleep-related variables between pre-
and post-treatment.
Conclusions
The aim of this trial was to evaluate the effects of CBT-IP compared TT in patients with FM. The findings demonstrated
differential responses among treatments.
Funding:This study is part of the I+D+i project/ aid PID2019–109612GB-I00, funded by MCIN/AEI/10.13039/501100011033

Keywords
Fibromyalgia, cognitive-behavioral therapy for insomnia, compared with a therapy focused on trauma

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PO112 Long-term pain and health economic outcomes in adults receiving

multidisciplinary CBT for chronic pain
Sean Perrin
Lund University, Sweden
Sophia Åkerblom
Lund University, Sweden,
Marcelo Rivano
Lund University, Sweden
Lance McCracken
Uppsala University, Sweden

Abstract
Introduction: The first-line evidence-based treatment for chronic pain is multidisciplinary treatment involving pain-fo-
cused CBT. Studies have shown that changes in psychological flexibility (PF) during pain-focused CBT positively mediates
outcomes, even when the treatment does not specifically target PF. While CBT and PF-based treatments for chronic pain
yield small to moderate, but clinically meaningful improvements in chronic pain and associated difficulties, less is known
about their impact on healthcare utilization and the social cost of missed work due to illness. The present study aims
to address this gap in the literature using pain outcome data from a large multidisciplinary pain clinic in Sweden, com-
bined with healthcare and employment data from national registries. In an exploratory fashion, we also examine the role
played by changes in psychological flexibility during treatment on long-term outcomes. Methods: Pain-related and health
economic outcomes at post-treatment and one, two and three years after discharge were examined in 232 consecutive
referrals to the Pain Rehabilitation Unit at Skåne University Hospital. In an exploratory fashion, we investigated whether
sociodemographic characteristics, pain-related variables, and psychological inflexibility, predicted and/or mediated long-
term pain-related and health economic outcomes. Results: Moderate sized improvements in pain, pain interference, and
depression observed at post-treatment were all maintained at both the 1- and 3-year follow-up. A very similar pattern
was observed for the health economic outcomes, with gains attained by post-treatment being maintained at follow-up.
The largest improvements were found for the total number and costs of healthcare visits, with moderate effect sizes by
1-year follow up and remaining stable at both the 2-year and 3-year follow-ups. Healthcare costs declined by 48% during
treatment and by the time of the 3-year follow-up, by 59% relative to the year up to commencement of treatment. There
was a slight worsening in sick pay and the costs of sick pay at the 1-year follow-up, with small gains not observed until the
2-year- and 3-year follow-ups. While the decline in the number of days with sick pay and associated costs was in the small
range, this nontheless represented a 39% reduction in the cost attributable to days with sick pay by the time of the 3-year
follow-up. Psychological inflexibility predicted and/or mediated both long-term pain-related and health economic out-
comes. Conclusions: The present findings add to a small body of literature indicating that the improvements for pain and
related difficulties in multimodal, pain-focused CBT programs have a durability of at least three years following treatment.
There are also meaningful improvements in health economic outcomes up to three years post-treatment. Reductions in
psychological inflexibility appears to be an important treatment process for achieving reductions in impairment from
chronic pain and the associated costs of healthcare usage and sick days from work.

Keywords
Chronic Pain, Health Economic Outcomes, Psychological Flexibility

PO113 Efficacy of the therapy focused on trauma and combined cognitive-

behavioral therapy for emotional distress and pain appraisal in patients with
fibromyalgia: A pilot study
Ana Sánchez
University of Granada, Spain
Elena Miró
University of Granada, Spain
Coralie Maire
University of Granada, Spain
Germán Prados
University of Granada, Spain
Rafael Cáliz
Virgen de las Nieves Hospital, Spain
M. Pilar Martinez
University of Granada, Spain

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Abstract
Introduction
Fibromyalgia (FM) is a condition of centralized pain that entails a notable disability. Previous research in several
chronic pain conditions including FM has documented the negative influence of affective distress in the pain experi-
ence. In FM patients, anxiety and depression scores have been associated with a poorer subjective rating of general
health, higher pain intensity, poor sleep quality, and worse functioning. Several factors of pain appraisal contribute
to the pain experience. The most outstanding ones are pain catastrophizing, fear of pain, acceptance, self-efficacy
for coping and vigilance to pain. Previous evidence shows that FM patients often present traumatic life histories and
post-traumatic stress disorder (PTSD). Thus, the presence of traumatic events has been related to greater symptoms.
The objective of this pilot study was to analyze the efficacy of the trauma-focused therapy (TT) compared to that
of the cognitive-behavioral therapy for insomnia and pain (CBT-IP) at the cognitive-affective appraisal of pain (pain
catastrophizing, pain anxiety, chronic pain acceptance and self-efficacy copping), and distress emotional (anxiety and
depression) in women with FM.
Method
Twenty-two participants with FM were randomly assigned to one of the two conditions: TT (n= 10) or CBT-IP (n =
12). Patients were recruited from the Rheumatology Service and Pain Unit of Virgen de las Nieves University Hospital
(Granada, Spain) and the AGRAFIM (an association of FM patients) and referred to the Clinical Psychology Unit of the
University of Granada, where the psychological assessment and treatment sessions were conducted. A semi-struc-
tured interview was conducted in two sessions. The questionnaires were applied at pre-, post-treatment: Chronic
Pain Self-Efficacy Scale; Pain Catastrophizing Scale; Hospital Anxiety and Depression Scale;; Pain Anxiety Symptoms
Scale-20 and Chronic Pain Acceptance Questionnaire. All patients signed informed consent to participate in the re-
search. The study was approved by the Ethics Committee of the Universidad de Granada.
Treatment Protocols
The protocol-based psychological treatments (CBT-PI and TT) were provided by therapists with a high level of profes-
sional training, and experience in the domain of chronic pain, cognitive-behavioral therapy, and trauma therapy. All
sessions were conducted in group format (5–7 participants) once a week for 9 weeks and lasted about an hour and a
half. Patients in CBT-IP and TT groups continued with their usual medical care for FM (on stable doses of medication)
during the study.
Data analysis
IBM SPSS Statistics were used. Groups were compared via Mann-Whitney’s U test

Results
The results regarding emotional distress variables and other clinical parameters showed a significant improvement in
self-efficacy for coping, positive changes about pain catastrophizing, pain acceptance after TT. Patients receiving CBT-
PI also improved in post-treatment, but such improvements were less pronounced compared to the trauma group.
Conclusions
The aim of this trial was to evaluate the effects of TT compared to CBT-IP in emotional distress and pain appraisal in
patients with FM. Considering clinical improvements, the findings demonstrated positive changes in depression and
parameters of cognitive appraisal, with differential responses among treatments.
Funding:This study is part of the I+D+i project/ aid PID2019–109612GB-I00, funded by MCIN/AEI/10.13039/501100011033

Keywords
Fibromyalgia, distress emotional, therapy for trauma, pain appraisal

PO114 Research on the Relationship Between Cognitive Distortions,

Stigmatization, and Motivation to Seek Psychological Help
Julijana Vojinović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Ivana Đorđević
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Jelena Cvetković
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Lidija Zlatić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Aleksandra Maričić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Ana Saveljić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia

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Abstract
The concept of cognitive distortions, first proposed by Aaron T. Beck (1976), involves processing information in a
predictable, problematic manner, leading to identifiable errors in thinking (Beck, 1995). These distortions produce
automatic negative thoughts, which evoke or strengthen early symptoms of psychological distress and emotional
or behavioral disorders (Leung & Poon, 2001; Najavits et al., 2004). Individuals often act according to these distorted
thoughts, treating them as rules for behavior, which can lead to a limited behavioral repertoire, increased emotional
distress, and persistent maladaptive behavior (Torneke, Luciano, & Valdivia, 2008).
Stigma, as defined by Goffman (1963), is “an attribute that is deeply discrediting.” It refers to the devaluation of individ-
uals who possess a characteristic different from the norm. Stigmatization leads to the exclusion of these individuals
from certain social interactions (Kurzban & Leary, 2001). Stigma is a significant barrier to seeking psychological ser-
vices, causing individuals to avoid or delay seeking help for mental health issues. Stigma involves labeling, separation,
stereotype awareness, stereotype endorsement, prejudice, and discrimination, often reinforced by social, economic,
or political power (Link & Phelan, 2001).
The study sample consists of 117 students (100 females), aged 19 to 48. Among them, 75 are undergraduate students,
38 are master’s students, and 3 are doctoral students. The research was conducted using a questionnaire via Google
Forms, filled out independently by the respondents. The questionnaire included the Scale of Stigmatization When
Seeking Professional Help (Sanders, 2011) and the Cognitive Distortions Questionnaire (CD-Quest) by Irismar Reis de
Oliveira. The stigma scale was adapted by excluding irrelevant issues (race and ethics) and incorporated insights from
Vogel et al. (2013) on the cross-cultural validity of the Self-Stigma of Seeking Help (SSOSH) scale.
Preliminary results show no connection between stigma and cognitive distortions. However, there is a significant
correlation between self-stigma and general stigma. The research aims to explore the connection between cognitive
distortions and stigmatization regarding seeking psychological or psychotherapeutic help. It is hypothesized that
higher scores on the Cognitive Distortions scale will correlate positively with higher scores on the Stigmatization
scale. Additionally, it is anticipated that individuals scoring high on the Stigmatization scale will be less likely to seek
psychological or psychotherapeutic help.
The lack of a significant connection between stigma and cognitive distortions suggests that these two factors may
operate independently in influencing individuals’ behaviors and attitudes towards seeking help. However, the signif-
icant correlation between self-stigma and general stigma highlights the critical role of self-perception in the reluc-
tance to seek psychological services. These insights can help therapists better understand the barriers their clients
face and tailor interventions to reduce self-stigma, thereby potentially increasing the likelihood of individuals seeking
the help they need. Furthermore, the research underscores the importance of addressing stigmatization in mental
health campaigns to improve the utilization of psychological services.

Keywords
Cognitive distortions, stigmatization to seeking psychological help, students

PO115 Irrational Beliefs in Suicidal Youth

Elena Stevanović
Institute of Mental Health, Belgrade, Serbia
Ivana Peruničić-Mladenović
University of Belgrade, Faculty of Philosophy, Serbia
Željka Košutić
Institute of Mental Health, Belgrade, Serbia

Abstract
Suicide is the fourth leading cause of death in the age group of 15 to 29 years, with estimated lifetime prevalence rates
of suicidal ideation ranging from 12.1% to 33%, and suicidal behaviors ranging from 4.1% to 9.3%. When consider-
ing risk factors for suicidality, studies often point to both internal and external circumstances directly increasing the
likelihood of suicidal behavior. However, rational-emotional cognitive behavioral therapy suggests that people are
not disturbed by events themselves, but by the way they interpret those events. Irrational beliefs represent the most
relevant cognitive processes for interpreting events, which consequently results in specific emotions and behaviors.
Research on the role of irrational beliefs in individuals prone to suicide has indicated that people with suicidal ide-
ation tend to have a higher number of irrational beliefs compared to those without such ideation, and those beliefs
are: seeing oneself as a victim of past and future circumstances, demands for success, acceptance, and perfection,
and evaluating every failure as terrible because it indicates the person’s worthlessness. However, according to re-

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searchers’ knowledge, similar studies have not been conducted with adolescents. Therefore, this study examines the
role of irrational beliefs in suicide proneness in adolescents. All participants in our study were matched in terms of
the severity of depression, in order to discover specific beliefs related to suicidality and not caused by depression, the
most common predictor of suicide. Beck’s Depression Inventory and modified version of The General Attitude and
Belief Scale (GABS) – GABS-37 were completed by 100 adolescents and young adults clinically diagnosed with major
depressive disorder. They were divided into three groups: without suicidal thoughts and attempts, with only suicidal
thoughts, and with suicidal attempts. The results of our research indicate that self-devaluation permeates through all
three groups, representing an integral part of depression. However, in the group with suicidal attempts the derivative
related to self-devaluation was present in extremely high values. The demand for comfort emerged as the most rele-
vant variable in assessing suicidal tendencies, with higher values being associated with a greater inclination towards
suicidal attempts. The demand for comfort represents an aspect of the frustration intolerance, related to tendency
towards short-term pleasures at the expense of long-term gains. That often results in avoidant coping strategies that
prolong problems and consequently increase the likelihood of depression and suicidal ideation. Global devaluation
of others is another variable highlighted by the model in predicting suicide. This belief often accompanies feelings of
anger and aggression, which are established factors of vulnerability to suicide.

Keywords
youth, depression, suicide, irrational beliefs

PO116 The Impact of Educational Video Material on RE&CBT Therapy on

Willingness to Seek Psychological Help: A Study on a Convenient Sample
Milica Simonović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Aleksandra Rašić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Tamara Milutinović Marjanović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Nina Dragutinović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia

Abstract
This study explores individuals’ readiness to seek psychological help, focusing on the influence of educational video
material about the RE&CBT (Rational Emotive & Cognitive-Behavioral Therapy) approach on that readiness. To investi-
gate changes in responses based on received therapy education, we chose a methodology that includes a question-
naire, an educational video, and a follow-up questionnaire.
Our study is conducted in three main steps. First, participants will complete the Fisher and Farina ATSPPHS_SF ques-
tionnaire, measuring their current readiness to seek psychological help. They will then be divided into two groups: a
control group that will watch a neutral video about psychotherapy in general, and an experimental group that will
watch a video providing specific information about the RE&KBT approach. After viewing the video, participants will
again complete the same questionnaire on their readiness to seek psychological help.
Additionally, before the questionnaire on help-seeking readiness, we will collect basic demographic data about the
participants, including gender, age, income, and previous therapy experiences.
We plan to use a convenient sample of approximately 200 participants. Furthermore, we intend to exclude those par-
ticipants who already have experience with RE&CBT therapy to avoid potential confusion or bias.
We expect that short education through video material will increase the readiness to seek psychological help in both
groups of respondents. In particular, the group viewing the RE&CBT-based material was predicted to show greater
readiness compared to the control group. We expect this because we think that greater availability of information, in-
cluding information about the effectiveness of RE&CBT, will make clients more open to trying the therapy themselves
and achieving such results.
We chose this topic because we believe it is insufficiently researched in our area, and we think it is important to have
local findings that will contribute to a better understanding of people’s readiness to seek psychological help. The
results of this research would provide guidelines for CBT psychotherapist-beginners for working with clients at the
beginning of their psychotherapy practice.

Keywords
willingness to seek psychological help, RE&CBT, educational video materials

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PO117 A Case of Post-Traumatic Stress Disorder in an Adolescent with a

History of Developmental Multiple Trauma Treated with Cognitive-Behavioral
Therapy
Zeynep Uçar
Kocaeli University School of Medicine, Department of Child and Adolescent Psychiatry, Turkey
Merve Dilli Gürkan
Kocaeli University School of Medicine, Department of Child and Adolescent Psychiatry, Turkey
İrem Damla Çimen
Kocaeli University School of Medicine, Department of Child and Adolescent Psychiatry, Turkey
Burcu Kardaş
Kocaeli University School of Medicine, Department of Child and Adolescent Psychiatry, Turkey
Nursu Çakin Memik
Kocaeli University School of Medicine, Department of Child and Adolescent Psychiatry, Turkey

Abstract
Introduction: Posttraumatic Stress Disorder (PTSD) is defined as the development of specific symptoms following
exposure to a traumatic stressor. While many traumatic experiences can cause psychological difficulties in children,
childhood sexual abuse is known to be a particularly potent type of trauma that can lead to the development of PTSD.
According to the DSM-5 diagnostic criteria, PTSD symptoms are categorized under four main headings as hyperarous-
al and inability to calm down, avoidance of stimuli reminiscent of the trauma and social withdrawal, re-experiencing
the traumatic event, and negative changes in cognition and mood. The most common psychiatric comorbidity in
children with PTSD is major depressive disorder (MDD). In this case report, we present a female adolescent with PTSD
and MDD who was treated with structured cognitive-behavioral therapy (CBT) in addition to psychopharmacologic
treatment.
Case: A 17 years and 1 month old female patient was admitted to our clinic with complaints of self-injurious behavior,
inability to enjoy activities she used to enjoy, unhappiness, and inability to control her anger. The patient had symp-
toms such as frequent intrusive memories, nightmares, difficulty concentrating, overstimulation, anger outbursts,
inability to experience positive emotions, self-harming behavior, negative self-perception, and inability to enjoy her
activities for the past 2 months; she had presented to the psychiatry clinic with similar complaints 2 months ago and
was treated with sertraline 50mg/day, olanzapine 2.5 mg/day and alprazolam 0.5 mg as needed. The patient who con-
tinued the medication was admitted to the day clinic unit for close follow-up and intensive treatment after 2 months
of outpatient follow-up. The patient was diagnosed with PTSD and comorbid MDD. CBT was used for the PTSD and
MDD diagnoses in the sessions. Initially, psychoeducation about PTSD and the cognitive model were introduced.
PTSD symptoms and physical signs were explained using imagination technique, relaxation and breathing exercis-
es, and safe place exercises. Cognitive distortions and thought traps were identified and replaced with functional
thoughts. Clinical sessions revealed that the patient was beginning to perceive and make sense of her traumatic
childhood experiences of sexual and physical abuse. Relationship and emotional regulation skills were practiced.
Interventions to increase flexible thinking and resilience were applied to the patient. Emotional changes and triggers
for self-injurious behavior were explored in detail. Discussions were hold about managing self-injurious behaviors.
Basic social communication skills and problem solving methods were discussed. Inappropriate communication styles
and acceptance of emotions were discussed in family sessions. Medication was adjusted to sertraline 100 mg/day and
aripiprazole 10 mg/day, and the patient was discharged in remission.
Conclusions: As a result, with the application of CBT and psychopharmacotherapy, it was observed that our patient's
complaints clinically decreased, scale scores dropped, and functionality improved. The aim of this case report was to
share the application of structured CBT and psychopharmacological treatment in a female adolescent with develop-
mental multiple trauma and to discuss the treatment process.

Keywords
post-traumatic stress disorder, cognitive-behavioral therapy, adolescent

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PO118 Marital compatibility, the success of conflict resolution, and

perception of fairness in marriage and unmarried union in women of different
maternity statuses from the perspective of cognitive-behavioral therapy
Biserka Ćoso
Serbian Association of Behavioural and Cognitive Therapists, Serbia
Andrea Pančić
Serbian Association of Behavioural and Cognitive Therapists, Serbia

Abstract
Disagreements and conflicts are part of marriage and any other close relationship. One of the central features of a
successful marriage and partner relationship is the ability to manage conflicts, and poorly managed conflicts are the
risk factor for dissatisfaction and even for ending the relationship. This research compared 400 women of different
maternity statuses in their marital compatibility, satisfaction, resolution of conflict, and perception of fairness. In this
research, 80 women without kids, 94 pregnant women, 111 postpartum women, and 115 mothers of 7-year-old chil-
dren who were married or in an unmarried union from 1 to 10 years participated. A questionnaire on marital compat-
ibility, a Scale of the success of marital conflict resolution, and a Scale of perception of marriage fairness were used
for data collection. The results showed that women without children and pregnant women tend to rate their marital
compatibility and conflict resolution (p<.05) higher than postpartum women and mothers of 7-year-old children.
Women without children perceive higher fairness of relationship (p<.05) with their partner or spouse than mothers
of 7-year-old children, and pregnant women also perceive higher fairness of relationship than postpartum women
and mothers of 7-year-old children. These results follow previous research about the growth of marital disagreements
and conflicts after childbirth because of customization with new obligations and responsibilities and inequality in the
distribution of obligations between partners. In this sample, employed women also rate their happiness and marital
compatibility (p<.05) higher than unemployed. Happiness and marriage compatibility correlate with efficiency in
conflict resolution and perception of fairness in marriage and relationships. Based on these results, cognitive-behav-
ioral therapy might focus on feelings, behavior, and cognition using direct skill-based methods and communication
skills to decrease problematic behavior and increase mutual emotional support between the spouses.

Keywords
Marital compatibility, conflict resolving, perception of fairness, transition to parenthood, cognitive-behavioral therapy

PO119 Psychological difficulties of parents of children with a rare genetic

disorders: the contribution of intolerance of uncertainty, intolerance of
distress and tendency towards worry
Goran Čuturilo
University of Belgrade, Faculty of Medicine, Belgrade, Serbia; University Children’s Hospital, Belgrade, Serbia
Tatjana Vukosavljević-Gvozden
University of Belgrade, Faculty of Philosophy, Serbia
Nađa Vukašinović
University Children’s Hospital, Belgrade, Serbia
Matija Gvozden
University of Belgrade, Faculty of Philosophy, Serbia

Abstract
Objective: Research has indicated that parents of children with chronic health conditions frequently suffer from dete-
riorating life quality and stress-related disorders. However, we have not found any study investigating anxiety, depres-
sion and stress in a heterogeneous group of rare genetic disorders, which are complex, lifelong, and often progressive.
We formulated the following hypotheses: (1) parents of children with rare genetic disorders would be more likely to
develop anxiety, depression and stress compared to healthy controls, and (2) parents' cognitive vulnerability (intol-
erance of uncertainty, intolerance of discomfort and a tendency towards worry) would predict depression, anxiety
and stress above and beyond that which is achieved by knowing the child’s health status. In addition, we wished
to explore the possible role of gender, i.e. mother-father roles in predisposing individuals to develop mental health
difficulties.

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Method: The sample consists of 92 mother-father pairs in the target group (Mparent age = 38, Mchild age = 6) and
94 participants in the control group (28 pairs and 66 parents who were not in pair Mparentage = 34, Mchild age = 4).
Measures were taken of worry, intolerance of uncertainty and distress, as well as depression, stress and anxiety. Mea-
sures were also taken of the child's health status.
Results: There were significant differences between the target and control groups, with parents in the target group
reporting substantially higher rates of psychological distress, especially those parents whose children have moder-
ate-to-severe chronic health problems. The severity of the child’s health issues was positively related to increases in
worry, intolerance of distress and uncertainty, and depression, anxiety and stress. A moderating effect of gender was
recorded, with mothers' mental state worsening more severely in comparison to the fathers as the child's health sta-
tus worsens. Mothers in the target group reported higher rates of psychological distress compared to fathers in the
target group. There were no significant differences between mothers and fathers in the control group. Finally, psycho-
logical factors allowed researchers to predict depression, anxiety and stress above and beyond that which is achieved
by knowing the child’s health status. Worry, intolerance of distress and uncertainty were much more strongly related
to depression, anxiety and stress in the target group in comparison to the control group.
Conclusion: Mothers of children with genetic disorders are at particular risk of developing anxiety, depression and
stress. Cognitive vulnerability in the form of intolerance of uncertainty, distress and tendency to worry contributes to
these reactions beyond the evaluation of the child’s health status alone. These findings indicate that cognitive-behav-
ioral therapy and prevention strategies for parents, especially mothers, would be beneficial.

Keywords
parents, genetic disorders, worry, intolerance of distress, intolerance of uncertainty

PO120 Music, Psychology, and Awe: The Psychological Effects of Classical

Music Combined with REBT
Vlad-Antoniu Mărghitaș
Evidence-Based Psychological Assessment and Interventions Doctoral School, Babeş-Bolyai University, Cluj-Napoca,
Romania
Oana Alexandra David
Department of Clinical Psychology and Psychotherapy; The International Institute for the Advanced Studies of Psy-
chotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
Vladimir Agachi
University of Oradea, Romania

Abstract
Introduction
The present study investigates the impact of exposure to a cultural event, specifically a classical music performance
interspersed with Rational Emotive Behavior Therapy (REBT) psychoeducation, on participants’ emotions and ratio-
nality. The primary focus is on the emotion of awe, measured by the Awe Experience Scale (AWE-S), and its subsequent
effects on positive and negative emotions, assessed pre- and post-intervention using the Mood Wheel experience
sampling instrument. The study also examines changes in rational and irrational beliefs, measured with the short form
of the Attitudes and Beliefs Scale-2. Our main hypothesis is that the combined intervention leads to positive changes
in subjects’ emotionality and cognitions, mediated by an increased sense of awe. Additionally, we seek to evaluate
the effectiveness of the combined intervention compared to its virtual format, a psychoeducation-only version, and
a waitlist control to explore potential unique ingredients for the emergence of the awe experience and its effects on
emotion and cognition.
Methods
Participants were given the choice to join one of three groups: (1) live event attendance, (2) virtual event attendance
from home, (3) virtual attendance of only the psychoeducational portion. The first condition involved attending a
classical music concert with REBT psychoeducation segments between musical pieces. Emotional responses were
measured at four points: pre-intervention, post-intervention, and two follow-ups (2 and 4 weeks after the post-inter-
vention measurement). The Reality Judgement and Presence Questionnaire, adapted to exclude the Internal/External
Correspondence subscale, was used to control for the immersive quality of the event. This measurement facilitated a
more precise identification of potential mechanisms for the emergence of positive psychological outcomes, such as
the sense of shared experience with fellow participants at the live event or the differentiated psychological impact of
music and psychoeducation.

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Discussion and Implications
At the between-subjects level of analysis, the delivery format (live vs. virtual) significantly influenced emotional and
cognitive outcomes. In terms of mechanisms of change, the experience of awe was significantly associated with in-
creased positive outcomes, especially in the live event condition. Future research may consider designs that involve
randomization to better gauge the effectiveness of the interventions and obtain higher internal validity. Understand-
ing these dynamics could inform future interventions and their implementation in non-clinical settings and personal
development contexts, as the relationship between awe-inducing experiences and positive psychological outcomes
continues to be more rigorously examined.
Conclusion
By exploring the interplay between awe, emotions, and rationality, this research seeks to contribute to the literature
on the psychological benefits of musical events and psychoeducation. It also represents an attempt to bridge theoret-
ical gaps between positive psychology concepts, REBT, and music therapy. The findings will have implications for the
design and delivery of mental health programs, particularly those leveraging cultural and educational components
to enhance emotional and cognitive well-being.

Keywords
Awe, Classical Music, Rational Emotive Behavior Therapy, Emotional Well-being, Psychoeducation, Immersive Experi-
ence

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PS1 The connection between dysfunctional beliefs related to personality

disorders and adverse psychological outcomes such as stress,
anxiety, and depression
Jovana Vidojević
Nonaffiliated researcher, Serbia
Andrea Opačić
Unaffiliated Researcher, Serbia
Una Koruga
Unaffiliated Researcher, Serbia
Sofija Čepinac
Euroview, Belgrade, Serbia
Elena Stevanović
Institute of Mental Health, Belgrade, Serbia

Abstract
Background: According to the cognitive theory of personality disorders, each person has a specific set of dysfunc-
tional beliefs. These core beliefs are associated with tendencies toward certain personality disorders, which influence
the way people feel, react, and behave. The aim of this study was to examine the relationship between dysfunctional
beliefs related to personality disorders and adverse psychological outcomes such as stress, anxiety, and depression.
Methods: The research was conducted through a cross-sectional study that included a nonclinical sample of 117
young people aged between 20 and 30 years. The 65-item Personality Belief Questionnaire (PBQ-SF) was used to mea-
sure Z scores for avoidant, dependent, obsessive-compulsive, histrionic, passive-aggressive, narcissistic, paranoid,
schizoid, antisocial and borderline personality characteristics. On the other hand, the Depression, Anxiety and Stress
Scale - 21 Items (DASS-21) was used to estimate scores for depression, anxiety and stress. Both PBQ-SF and DASS-21
were anonymously filled out. Correlation coefficients were measured for the correlation between Z scores of each
PBQ-SF scale and for the correlation between DASS-21 scores and different PBQ-SF Z scores.
Results: The Z score for borderline type showed the strongest positive correlation with DASS-21 scores for depression
(r=0,562; p<0,01), anxiety (r=0,522; p<0,01), and stress (r=0,545; p<0,01). Intercorrelation between different Z scores
showed the strongest positive correlation between dependent and borderline types (r=0,855; p<0,01). Participants
who attended sessions of individual Cognitive Behavioral Therapy (CBT), Rational Emotive Behavior Therapy (REBT),
or Schema psychotherapy, had lower Z scores for schizoid type (p<0,05) compared to participants who did not attend
individual sessions.
Discussion: The strongest positive correlation between stress, anxiety, and depression in individuals with borderline
personality traits highlights the importance of prevention programs to identify these individuals in a nonclinical pop-
ulation and the importance of access to psychotherapy services to mitigate these issues.

Keywords
dysfunctional beliefs; stress; anxiety; depression; cognitive-behavioral psychotherapy

PS2 The Relationship Between Rejection Sensitivity and Social Anxiety:

Mediator Role of Post-Event Processing and Moderator Role of Difficulties in
Emotion Regulation
Gamze Sevin
Yankı Psikoloji, Turkey
Ayse Altan-Atalay
Kadir Has University, Turkey

Abstract
Introduction: Social anxiety disorder is one of the most prevalent anxiety disorders worldwide. Socially anxious indi-
viduals experience significant distress, interpersonal disability, and impairment in daily functioning. Therefore, it is
crucial to explore factors that play a role in the etiology of social anxiety. Growing evidence shows that rejection sensi-
tivity (RS), a cognitive-affective bias toward anxiously expecting rejection, is robustly linked to social anxiety. Howev-
er, the exploration of the mechanisms underlying this association has been scarce. This research aimed to examine the
relationship between RS and social anxiety among emerging adults and further investigate the roles of post-event
processing (PEP) and difficulties in emotion regulation (ER) in this relationship. PEP is a disorder-specific ruminative

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process where individuals excessively and negatively review social interactions after they occur, often focusing on
perceived mistakes or negative aspects. In comparison, ER difficulty refers to a transdiagnostic process involving the
challenges that individuals face in managing and responding to their emotional experiences, frequently associated
with heightened emotional distress. We expect PEP to significantly mediate the relationship between RS and social
anxiety. Furthermore, we expect the strength of the relationship of RS with both PEP and social anxiety symptoms to
change depending on the level of ER difficulty reported by the participants.
Method: Data were collected cross-sectionally through convenience sampling. A total of 392 participants (%74.7 fe-
male) aged 18 to 25 years (M = 20.94, SD = 1.63) completed an online battery of self-report measures for social anxiety,
depression, ER difficulties, PEP, and RS.
Results: Results indicated that RS is positively associated with PEP and symptoms of social anxiety. Besides, PEP is
positively linked to social anxiety. PEP partially mediated the association between RS and social anxiety. There was no
significant moderating effect of difficulties in ER in the association between RS and either PEP or social anxiety.
Discussion: These findings illustrate that high-RS individuals are more likely to engage in a negative and prolonged
review of their past social interactions, which is in turn linked with increased symptoms of social anxiety. The current
findings deepen our understanding of the psychological processes underlying the link between RS and social anxiety
by highlighting PEP as an important vulnerability for high-RS and socially anxious individuals.

Keywords
rejection sensitivity, social anxiety, difficulties in emotion regulation, post-event processing

PS3 The role of irrational beliefs in paranoia: a network approach

Radu Soflau
Babeș-Bolyai University, Department of Clinical Psychology and Psychotherapy
Lia-Ecaterina Oltean
Babeș-Bolyai University, Department of Clinical Psychology and Psychotherapy

Abstract
Paranoia is relatively common, both among individuals with psychotic disorders and within the general population.
Recent studies suggest that paranoia is the most central node among delusional beliefs, as well as the most central
of all psychotic symptoms in network analyses. These findings suggest that changes in paranoia may have the high-
est impact on the overall network and could significantly influence other associated psychotic symptoms. However,
despite the development of promising interventions aimed at reducing paranoia, the etiological factors that could
enhance their effectiveness remain relatively unclear.
In this study, we aimed to (1) construct a network of symptoms and cognitive factors potentially relevant to paranoia
and (2) identify the central nodes. We recruited 72 participants with and without a psychotic disorder (m age = 42.96;
65.75% female). Participants filled in self-report measures of paranoia, depressive and anxiety symptoms, interper-
sonal sensitivity, and irrational beliefs. We estimated a regularized Gaussian Graphical Model (GGM) using the graphi-
cal Least Absolute Shrinkage and Selection Operator” (glasso). Network analysis results indicated that irrational beliefs
represent the most central node in the network (p < .05). Bootstrapped CIs estimates supported edge and centrality
stability, with narrow 95% CIs. The clinical relevance of our findings is discussed.
*We acknowledge the financial support granted by Babeș-Bolyai University under projects (1) SRG-UBB
32989/23.06.2023, (2) SRG-UBB UBB 32992/23.06.2023, and through (3) the Postdoctoral Advanced Fellowship Pro-
gram (no. 21PFE/ 30.12.2021, ID: PFE-550-UBB).

Keywords
paranoia; irrational beliefs; network analysis

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PS4 The Link Between Depression and Perfectionism, Self-Esteem and Self-
Acceptance Among High School Students in Serbia
Tamara Čukić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Jovana Lazarević
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia

Abstract
In this research, the extent to which perfectionism, self-esteem, and unconditional self-acceptance are expressed in
high school-aged adolescents was examined, as well as the extent to which these factors contribute to the appear-
ance of depressive symptoms in this target group. The secondary goal is implementing a workshop based on the
theory of CBT, aimed at alleviating depressive symptoms and related factors, in order to determine the effects of such
an intervention on the level of expression of the aforementioned constructs in adolescents.
In the first phase of the study, the data were collected from 75 students over the course of several days through an
online platform.
The results of the first test phase show that the level of depression, measured by the Beck Depression Inventory (BDI),
is moderate on average, but with high dispersion (M=12, SD=11.43). Additionally, 20% of the students scored 24 or
above, indicating severe depression in one-fifth of the respondents. Correlation analysis showed that both the level of
self-esteem, measured by the Rosenberg Self-Esteem Scale (RSE), and the level of unconditional self-acceptance, mea-
sured by the Unconditional Self-Acceptance Questionnaire (USAQ), were significantly negatively correlated with the
BDI score (r = -.761, p < .01; r = -.722, p < .01, respectively). In contrast, perfectionism, measured by the corresponding
subscale of the Dysfunctional Attitudes Scale (DAS), showed a significant positive correlation with the BDI score (r =
.649, p < .01). Multiple linear regression analysis revealed a significant predictive contribution of low self-esteem and
high perfectionism to depression (F = 48.278, p < .01, R² = .671), while the level of unconditional self-acceptance did
not show a significant contribution in this analysis. Based on these results, a workshop for students is being prepared,
and the effects of the intervention will be measured by retesting with the same questionnaires. The final resultsof the
study will be presented at the Congress. If suggested workshop proves to be effective, the study confirms short CBT
interventions can be beneficial at school preventive programs.

Keywords
depression, perfectionism, self-esteem, self-acceptance, high school students

PS5 Probing the effectiveness of an online gratitude intervention on anxiety

symptoms. The moderating role of maltreatment.
Lia-Ecaterina Oltean
Babeș-Bolyai University, Department of Clinical Psychology and Psychotherapy
Radu Soflau
Babeș-Bolyai University, Department of Clinical Psychology and Psychotherapy

Abstract
Background: Anxiety disorders are highly prevalent, cause significant impairment, and are associated with increased
negative affect and decreased positive affect. Despite effective interventions exist, access to them is somewhat limit-
ed, and a significant proportion of those receiving such interventions remain symptomatic. While gratitude interven-
tions are an interesting, easily accessible alternative, their effectiveness in anxiety symptoms, as well as their effect
modifiers are unclear. Objectives: We sought to (1) investigate the effectiveness of an online gratitude intervention in
anxiety symptoms, negative affect, and positive affect, and to (2) investigate the moderating role of maltreatment for
this intervention. Methods: Following eligibility screening (aged 18-65, with self-reported anxiety symptoms), 90 par-
ticipants (m age = 30.20; SD = 10.33), were randomly assigned to either a gratitude intervention or an active placebo.
Results: Intent-to-treat analyses indicated that while both groups evolved similarly in terms of anxiety symptoms and
positive affect, negative affect decreased in the gratitude intervention only. Moreover, findings supported the mod-
erating role of maltreatment for the effectiveness of the intervention on both positive and negative affect, but not on
anxiety symptoms. Discussion: Following intervention, findings of this randomized controlled trial, indicated that anx-
iety symptoms and negative affect decreased, while positive affect increased, in both groups. While specific effects
of gratitude were documented for negative affect only, our findings underscore the importance of maltreatment for
these interventions in both positive and negative affect. Notably, the gratitude intervention was more effective in re-

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ducing negative affect and increasing positive affect among those with high levels of maltreatment. As such, findings
indicated that it is an accessible, feasible intervention in this highly vulnerable population.
*We acknowledge the financial support granted by Babeș-Bolyai University under projects (1) SRG-UBB
32989/23.06.2023, (2) SRG-UBB UBB 32992/23.06.2023, and through the Postdoctoral Advanced Fellowship Program
(no. 21PFE/ 30.12.2021, ID: PFE-550-UBB).

Keywords
anxiety symptoms; negative and positive affect; gratitude interventions; maltreatment

PS6 Školski uspeh i razlike u iracionalnim i racionalnim uverenjima učenika

Senka Vučić
Primary school Dule Karaklajic, Serbia
Ivana Đurić
UZAY, Serbia

Abstract
Jedan od osnovnih teorijskih principa racionalno-emotivne bihejvioralne terapije postulira da je kognicija najznača-
jnija proksimalna determinantna ljudske emocije. Jezgro funkcionalnih i disfunkcionalnih emocija i ponašanja čine
evaluativne kognicije, tj.uverenja osobe. Racionalna uverenja predstavljaju evaluacije koje su fleksibilne i neeks-
tremne, realistične, logične i funkcionalne, tj. samopomažuće u odnosu na ciljeve i vrednosti osobe. Iracionalna uv-
erenja su rigidne, ekstremne evaluacije koje su nerealistične, nelogične i disfunkcionalne, odnosno, samoosujećujuće
u odnosu na važne ciljeve i vrednosti osobe.
Glavni cilj istraživanja bio je utvrđivanje razlika u iracionalnim i racionalnim uverenjima učenika s obzirom na pol i
školski uspeh. Istraživanje je sprovedeno na prigodnom uzorku od 127 učenika završnog razreda osnovne škole „Dule
Karaklajić“ (68 dečaka i 59 devojčica), tehnikom upitnika koji je zadan elektronskim putem. Korišćeni metod je neeks-
perimentalno deskriptivno istraživanje. Za potrebe istraživanja, u skladu sa predmetom, ciljem i hipotezama rada, pri-
menjena je Skala racionalnih i iracionalnih uverenja (IRU-16; Tovilović i Popov, 2009), koja je na ovom uzorku pokazala
zadovoljavajuće metrijske karakteristike. Skala sadrži 16 stavki; 8 stavki na supskali racionalnih i 8 stavki na supskali
iracionalnih uverenja. Ispitanici su odgovarali tako što su na petostepenoj skali Likertovog tipa procenjivali učestalost
(od 0=nikada do 4=veoma često) javljanja iracionalnih i racionalnih uverenja definisanih REBT teorijom. Pored skale,
upitnik sadrži pitanja o polu učenika i školskom uspehu. Rezultati ukazuju na postojanje statistički značajnih razlika u
pogledu racionalnih uverenja, kao i u pogledu iracionalnih uverenja, s obzirom na uspeh učenika. Takođe, utvrđena
je statistički značajna razlika u pogledu iracionalnih uverenja s obzirom na pol ispitanika, dok na skali racionalnih uv-
erenja s obzirom na pol ispitanika nisu utvrđene statistički značajne razlike.
Istraživanje predstavlja doprinos proučavanju temeljnih principa REBT teorije u populaciji adolescenata, kao i u
školskom kontekstu. Nalazi o razlikama mogli bi da podstaknu dodatna istraživanja, edukaciju i primenu određenih
REBT tehnika u školskom okruženju, u cilju osnaživanja učenika za promenu njihovih iracionalnih uverenja u uverenja
koja bi bila racionalna i samopomažuća u ostvarivanju važnih ciljeva, među kojima je i bolje obrazovno postignuće.

Keywords
racionalna uverenja, iracionalna uverenja, školski uspeh

PS7 Assertiveness in Center for social work employees from Serbia

Miljana Dimitrijević
Serbian Association of Behavioural and Cognitive Therapists, Serbia
Ana Mihajlović
Serbian Association of Behavioural and Cognitive Therapists, Serbia
Biserka Ćoso
Serbian Association of Behavioural and Cognitive Therapists, Serbia
Nikola Stojanović
Serbian Association of Behavioural and Cognitive Therapists, Serbia

Abstract
In Republic of Serbia there is around 2600 employees which is far from a sufficient number of workers having in mind
that there is an enormous workload for them. Thus, this kind of organization might impact workers efficacy and could

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hamper the interactions with clients. Adequate communication with users/clients of the Centre for Social work is of
great importance since they belong to a sensitive population and the key in this process is assertiveness. The aim of
this work was to estimate assertiveness in Center for social work employees from Serbia using two questionnaires.
In this study a total of 54 examinees working in one of the Center for social work in South Serbia were included in
the study, which was conducted using online questionnaires. The initial part of the online questioner was designed
to collect data related to examinees age, gender, background education and work experience. One questioner was
designed for examinees to evaluate their assertiveness (‘How assertive am I?’), while the second one was designed to
recognize distinct types of communication (passive/assertive/aggressive). Out of all subjects 96% were females, with
an average of 9.7 years of work experience. According to the background education distribution of examinees was
almost equally divided to psychologists (n=18), sociologists (n=17) and pedagogists (n=19). The level of assertiveness
determined using a self-rated scale revealed that 81.4% of examinees in this study have high level of assertiveness.
On the other hand, using a questionnaire designed to determine the ability of the examinee to discriminate different
types of communication we found that the most of subjects (70.4%) had poor ability to discriminate different com-
munication modalities. These results might point out to the fact that although examinees are referring high level of
assertiveness, they still have poor ability to to discriminate different communication modalities suggesting that their
true communication might not be assertive as they refer. Finally, assertive trainings are necessary for workers in these
types of institutions in order continuously educate new workers and increase/perfect the skills of the already trained
ones.

Keywords
assertiveness, social workers, communication modalities

PS8 Conceptualization based on needs and cognitive map

for needs-based therapy
Albert Murtazin
Association for Cognitive Behavioral Psychotherapy (Russia), Russian Federation
Dmitrii Kovpak
Association for Cognitive Behavioral Psychotherapy (Russia), Russian Federation
Maksim Zriutin
Association for Cognitive Behavioral Psychotherapy (Russia), Russian Federation

Abstract
Needs-based psychotherapy is a development of concepts from the cognitive behavioral psychotherapy, aimed at
improving the quality of the diagnostic and therapeutic process through further scientific research into the genesis
and potential for change in the human belief system’s genetic, epigenetic, phenotypic, psychophysiological, neurose-
mantic, and cultural-historical factors.
Conceptualization based on human needs is intended to incorporate human needs as a part of the model for the
formation of core beliefs and schemas. An important aspect of the model is the division of needs into three domains
within the context of G. Engel’s biopsychosocial model. This model allows us to understand the genesis and devel-
opment of dysfunctional thoughts and beliefs at all levels, in close connection with unsatisfied (or frustrated) needs
during sensitive periods of development (significant childhood events and data) and throughout life.
There is an accurate collection of information about the context of different systems at various levels, including su-
per-systems, which include the personal system (family system) and the macro-system (collective, ethnic, country, hu-
manity, and civilization). The biological domain includes needs for survival (including the consumption of nutrients,
water, oxygen, etc.), and the preservation of physiological well-being. The psychological domain includes the need
for cognitive development, emotional needs (such as pleasure, love, and play), and other psychological needs. Finally,
the social domain encompasses the need for interaction and communication, as well as belonging (recognition and
acceptance), and other social needs.
The originality of this conceptualization lies in its use of a biopsychosocial model that integrates these needs into a
complex framework for cognitive therapy. This allows us to view the human experience as a complex and dynamic
system that is constantly evolving and changing. Conceptualization forms the basis for a therapy plan. In terms of
needs-based therapy, this strategy involves the formation of methods to realize the main needs and skills required for
their fulfillment. When this goal has been achieved, the mechanisms underlying the etiopathology of disorders and
the origin of problems associated with maladaptive ways of meeting needs that led the patient or client to seek help
are eliminated.

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A practical approach to using the conceptualization is by creating a cognitive map. There are two options for filling in
the map – either in the form of a table or a network graph.
The client’s cognitive map, in needs-based cognitive behavioral therapy, is a method and means of clarifying and
recording representations of the client’s subjective experience in the form of ideas about themselves, others, and the
world; elements of their belief system; and relationships and needs. The basic parts of cognitive map are complaints,
problems and hypotheses about beliefs, targets and values, client’s goals and meanings of achieving goals, analysis of
relevant problems via ABC, beliefs, coping strategies, needs and quasi-needs, maladaptive and adaptive environmen-
tal factors, history, resources, therapy goals, strategy and tactics of therapy, action plan. The cognitive map assists the
client in collecting important, relevant, and necessary information to form a case formulation based on their needs
and to develop a systematic treatment plan.

Keywords
cognitive conceptualization, biopsychosocial model, сonceptualization based on needs, needs-based therapy, client’s
cognitive map

PS9 Stressors and Irrational Beliefs as Predictors of Therapists’ Well-being

Anđela Vlaškalić Soković
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Atanas Ivanoski
Serbian Association of Behavioural and Cognitive Therapists, North Macedonia
Aleksandar Kuzmanović
Serbian Association of Behavioural and Cognitive Therapists, Serbia
Mina Amidžić
Serbian Association of Behavioural and Cognitive Therapists, Montenegro
Milena Knežević
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Vladimir Tošović
Serbian Association of Behavioural and Cognitive Therapists, Serbia
Dragana Kopil
Serbian Association of Behavioural and Cognitive Therapists, Serbia
Olivera Stojšić
Serbian Association of Behavioural and Cognitive Therapists, Serbia

Abstract
This study examines the relationship between stressors, irrational beliefs, and therapists’ well-being, focusing on 29
practitioners of Rational Emotive and Cognitive Behavioral Therapy (RE&CBT), comprising 7 males and 22 females.
Data were collected anonymously online. Preliminary results are reported here, with the main findings to be present-
ed at the forthcoming Congress.
By employing standardized measures, we seek to explore how irrational beliefs correlate with negative affectivity
and life satisfaction among psychotherapists. Additionally, we examine the potential moderating effect of supervi-
sion hours on the experience of negative affectivity. The findings from this research shed light on the importance of
addressing irrational beliefs to enhance therapists’ emotional well-being and suggest avenues for future research to
develop effective interventions aimed at improving life satisfaction among psychotherapists.
Utilizing standardized measures, we investigated the correlation between irrational beliefs, negative affectivity, and
life satisfaction among psychotherapists. The results indicate a significant positive correlation (p<0.01) between irra-
tional beliefs and negative affectivity, highlighting that higher levels of irrational beliefs are associated with increased
negative emotions. Conversely, no significant correlation was found between irrational beliefs and life satisfaction,
suggesting that irrational beliefs do not directly influence overall life contentment. Additionally, there was no correla-
tion observed between therapists’ hours of supervision and the experience of negative affectivity.
This study underscores the importance of addressing irrational beliefs in enhancing therapists’ emotional well-being.
By identifying factors that predict well-being among psychotherapists, this research contributes to the development
of interventions aimed at promoting mental health within the therapeutic community. Further exploration of these
findings may yield insights into effective strategies for improving therapists’ life satisfaction and overall well-being.

Keywords
RE&CBT psychotherapist, Stressor, Irrational beliefs, Well-being

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PS10 Cognitive-behavioural psychotherapy in clinical work with female

patients struggling with endocrine disruption
Joanna Marek-Banach
The Maria Grzegorzewska University, Poland
Agnieszka Olchowik
“Dialog” Therapy Centre, Poland

Abstract
Introduction
The health situation of patients struggling with endocrine disorders, such as polycystic ovary syndrome (PCOS), is
complex, and their health-related quality of life (HRQoL) is significantly reduced in various areas of their lives. This
experience can negatively affect the psychosexual health of a significant number of women of reproductive age. They
may need not only medical but also psychological care. Many times, they seek specialist help in the offices of sexolo-
gists. While medical treatment and the psychological disorders occurring in female patients from this population are
the subject of numerous scientific studies and analyses, psychotherapeutic management with proven efficacy still
leaves room for exploration.
Material and methods
A review of the literature and clinical observations of guided interventions in a cognitive-behavioural approach di-
rected at patients with an endocrinopathy such as PCOS was conducted with regard to their effectiveness in improv-
ing the psychosexual health of women in this population.
Results
According to current guidelines for the treatment of women with endocrinopathies, specialists recommend a mul-
tifaceted approach, providing interdisciplinary care. Due to their diversity, individually tailored medical and psycho-
logical management is important for the individual patient (Teede et al, 2018). In order to improve mental health in
women with an endocrinopathy such as PCOS, it is recommended to consider behavioural or cognitive-behavioural
interventions. The results of the analyses conducted to date using different protocols suggest that short-term struc-
tured CBT is likely to be effective in improving mental health, particularly in working with anxiety disorders, mood
disorders, eating disorders, and HRQoL in adolescent and adult women with PCOS (Jiskoot et al. 2020, 2022). The
protocols used in the clinical trials were aimed at developing coping skills (e.g., emotional disturbances, disturbed
body image) by means of psychoeducation, e.g., about PCOS and its accompanying physiological and psychological
symptoms, cognitive restructuring, learning to solve problems, behavioural activation, e.g., by increasing physical
activity and implementing a proper diet, or relaxation and mindfulness techniques. The patients’ own work between
sessions and the regular self-observation they carried out were important. In the case of adolescent girls, sessions
with parents were also held (Abdollahi et al., 2018; Cooney et al., 2018; Correa et al., 2015).
Conclusions
Despite the small number of studies conducted to date on the effectiveness of CBT among patients with endocr-
inopathies such as PCOS, it can be concluded that the results are promising. CBT, either as a monotherapy or as a
component of implemented interventions, seems to be an effective method for reducing the symptoms of experi-
enced disorders and contributing to improving women’s quality of life. Further randomised clinical trials are needed
to better understand the impact of the implemented interventions on the sexual health of women in this group, the
mechanism of change, and the persistence of the achieved effects over time, or taking into account the use of third-
wave CBT approaches and new technologies.

Keywords
cognitive-behavioural psychotherapy, endocrine disruption, polycystic ovary syndrome, mental health, psychosexual
health, health-related quality of life

PS11 The combined influence of Attention Deficit Hyperactivity Disorder and

childhood Trauma on the Substance Use Disorder severity
Thibault Hennequin
Laboratoire clipsyd EA 4430, Université Paris-Nanterre, France
Norman Therribout
Laboratoire clipsyd EA 4430, Université Paris Nanterre DUPMA, Hôpital Fernand Widal, FHU NOR-SUD Network of re-
search in substance use disorders Inserm UMRS-1144, Université Paris-cité, France
Emily Karsinti
Laboratoire clipsyd EA 4430, Université Paris Nanterre DUPMA, Hôpital Fernand Widal, FHU NOR-SUD Network of re-
search in substance use disorders Inserm UMRS-1144, Université Paris-cité, France

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Florence Vorspan
Département universitaire de psychiatrie et médecine addictologique, Hôpital Fernand WIdal (AP-HP), Paris, France
FHU NOR-SUD Network of research in substance use disorders , Paris Inserm UMRS-1144, Université Paris-cité, Paris,
France
Alexandra Dereux
Département universitaire de psychiatrie et médecine addictologique, Hôpital Fernand WIdal (AP-HP), Paris, France
FHU NOR-SUD Network of research in substance use disorders , Paris Inserm UMRS-1144, Université Paris-cité, Paris,
France
Romain Icick
Département universitaire de psychiatrie et médecine addictologique, Hôpital Fernand WIdal (AP-HP), Paris, France
FHU NOR-SUD Network of research in substance use disorders , Paris Inserm UMRS-1144, Université Paris-cité, Paris,
France
Lucia Romo
Laboratoire Clipsyd EA 4430 Université Paris Nanterre AP-HP,Hôpital Raymond-Poincaré, Garches CESP, U1018 INSERM
UPS UVQ, Villejuif, France

Abstract
Context: Attention Deficit Hyperactivity Disorder (ADHD) and childhood trauma (CT) are identified in 23% and up to
63% of patients suffering from substance use disorder (SUD), compared with 2.5% and 28%, in the general popula-
tion, respectively. A growing body of evidence suggests a negative impact of both CT and ADHD on SUD, including
an increased severity of the SUD. Yet, the combined influence of CT and ADHD on SUD remains poorly understood.
Notably, the type and number of CT could elicit different effects on SUDs in ADHD patients.
Objective: To investigate the frequency of combined ADHD and CT in treatment-seeking SUD outpatients and to
characterize their combined influence on the severity of SUDs.
Methods: outpatients seeking treatment for SUD were consecutively recruited and evaluated for the main SUD di-
agnosis and severity (number of criteria) using the MINI-S SUD module. ADHD was assessed using the MINI-S ADHD
module. CT was assessed using the Childhood Trauma Questionnaire (CTQ), allowing us to consider five trauma types
and their cumulative number. In the whole sample and in ADHD vs. non-ADHD patients, we compared the number of
DSM5 criteria of the main SUD according to the presence vs. absence of any CT, of each CT type, and as a function of
the total number of CT types. We performed Kruskal-Wallis tests, considering statistical significance at p <0.05.
Results: From 65 outpatients, 44 (68%) were male and 52 (80%) suffered from severe SUD. Thirty-six (55%) were diag-
nosed with ADHD, 30 (46%) reported at least one CT type and 19 (30%) reported multiple CT types. The number of CT
types were as follows: one, N =11 (37%); two, N =8 (27%), three, N =5 (17%); four, N =5 (17%) and five, N =1 (3%). Emo-
tional neglect was the most reported CT type (N =18, 28%), followed by physical abuse (N =16, 25%), sexual abuse
(N =14, 22%), emotional abuse (N =13, 20%) and physical neglect (N =6, 9%). In individuals with ADHD, we observed
a clear increase in the number of SUD criteria between patients without CT, with one or two CT types and with more
than two CT types (p =0.045).
Discussion: The present study underlines the high prevalence of CT and ADHD in patients suffering from SUD. These
findings demonstrate how the presence of both ADHD and multiple CT in SUD patients leads to increased SUD sever-
ity. This greater severity of TUS could be the result of a maladaptive response adopted in an attempt to better manage
ADHD symptomatology and the symptoms engendered by exposure to multiple CT. This study confirms the need for
systematic screening for CT and ADHD in the context of SUD management to optimize subsequent treatment.
Conflicts of interest: The authors declare no conflict of interest.

Keywords
Addictions; Substance Use Disorders; Psychotraumatism; ADHD; Assessment; Childhood Trauma; Addictology

PS12 Physical activity patterns in fibromyalgia and other central sensitization

syndromes
Germán Prados
University of Granada, Spain
MARTA Medina Casado
University of Granada, Spain
Elena Miró
University of Granada, Spain
M. Pilar Martinez
University of Granada, Spain

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Ana Sánchez
University of Granada, Spain

Abstract
Background and aims
Central sensitization implies that the brain amplifies or even “creates” pain in the absence of nociception in response
to a wide variety of stimuli. Central sensitization syndromes (CSS), such as fibromyalgia (FM), are characterized by
symptoms including fatigue, muscle pain, and functional limitations, leading to physical deconditioning. Prolonged
inactivity due to these symptoms results in reduced physical activity (PA) and diminished aerobic fitness, exacerbat-
ing dysautonomia and other clinical manifestations. Psychological factors related to pain also significantly influence
PA engagement in chronic pain patients.
The aim of this cross-sectional study was to compare PA parameters obtained with actigraphy over a week among
healthy subjects, FM patients, and women with other CSS, and to explore their relationship with clinical features and
pain self-efficacy.
Methods
Sample. A total of 68 women with FM, 35 women with others CSS, and 27 healthy controls (HC) were included in this
study.
Instruments. Participants were evaluated using actigraphy. Additionally, they completed a set of self-report measures
that collected sociodemographic and clinical data, pain , fatigue and pain self-efficacy. PA parameters were obtained
with actigraphy over a week, including sedentary time (ST), low activity time (LAT), moderate activity time (MAT), and
vigorous activity time (VAT).
Statistical analysis. Patients and healthy controls were compared regarding clinical and pain self-efficacy variables
using ANCOVA. Bivariate analyses were used to explore the relationship between PA parameters and self-report mea-
sures among patients with FM and CSS.
Results
FM patients and participants with other SSC showed higher ST and lower LAT, MAT, and VAT compared toHC. However,
significant differences were found only for FM patients in pairwaise comparisons. Neither were significant differences
observed between FM and SSC participants regarding these variables.
Bivariate analyses showed that in FM patients, higher ST was associated with increased fatigue and lower pain self-efficacy.
Conversely, they engaged in more hours of low activity when they experienced less fatigue and higher pain self-efficacy.
In the SSC group, higher pain self-efficacy contributed to performing more hours of low activity.
Conclusions
This study underscores the need for tailored interventions aimed at enhancing low and moderate activity levels, with
a focus on improving pain self-efficacy and reducing fatigue.

Keywords
central sensitization, fibromyalgia, physical activity

PS13 Behavioral Sleep Intervention for a Junior High School Student with
Difficulty in Attending School: A Case Study
Naoko Ayabe
Akita University, Japan
Sawa Tomiya
Akita Kita Child Guidance Center, Japan
Anna Yagisawa
Akita Higashi hospital, Japan

Abstract
Cognitive-behavioral approaches are used to treat delayed sleep-wake phase disorders; however, existing studies
on it are inadequate. This study presents a case in which an administration of a cognitive-behavioral intervention for
sleep problems improved the delayed sleep-wake phase of a junior high school student who had difficulty attending
school because of a lack of stable sleep pattern. Oral and written consent were obtained from the patient and her
parents to present the case.
Case Summary: The patient, referred to as “A,” is a Japanese junior high school girl. At the time of intake, she expe-
rienced anxiety regarding interpersonal relationships and learning, disorganization of her daily rhythm, and faced
difficulty in sleeping. She had a tendency to be absent from school since the end of summer vacation (August, year X).
At the time of the initial interview, A’s daily routine as reported by her, was as follows: “I get up around 11-12 a.m. After

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eating, I watch videos and study on my smartphone. I go to bed around 23:00-00:00, but sometimes I have trouble
falling asleep and staying up until approximately 04:00. After going to bed, I wake up two to three times in the middle
of the night. I often have trouble sleeping because I remember unpleasant memories.” During the intervention, the
therapist asked A to maintain a sleep diary. Sleep hygiene education was provided with an emphasis on no naps and
limited smartphone use. The waking time gradually advanced on a two-week to one-month basis. Although there
were periods of sleep phase regression and difficulties in waking up due to heightened anxiety about attending
school, A gradually began to achieve full night’s sleep, helping her to increase the frequency of her school attendance.
This increased school attendance was thought to have enhanced her enjoyment of school and motivation to wake
up more consistently.
Review and Evaluation: Counseling sessions with A were conducted in a manner that encouraged her to generate her
own ideas and gain self-control, rather than receiving one-sided instructions and advice. Consequently, owing to an
efficient intervention, even when her sleep-wake rhythm was temporarily disrupted, she could regain it independent-
ly. These findings suggest that a cognitive-behavioral intervention for sleep problems may be a clue to help improve
school refusal due to difficulty waking up.

Keywords
Delayed Sleep-Wake Phase Disorders, School refusal, Sleep disorders

PS14 Unconditional Self- Acceptance: The Silent Hero of Emotional Well-Being

Stanislava Popov
Faculty of sport and psychology -TIMS, Novi Sad, Serbia
Tamara Jovanović
Faculty of Sciences, University of Novi Sad, Serbia

Abstract
The philosophy of unconditional self-acceptance in RE & CBT represents an alternative to global self-evaluation, more
popularly-self-esteem. It is characterized by non-judgment of oneself while maintaining an evaluative attitude to-
ward one’s individual experiences, actions, thoughts, feelings, and traits. More broadly, as people are seen as active
participants rather than passive recipients in expressing their emotions, psychologists are particularly interested in
individuals’ strategies to influence their emotional responses. Emotion regulation is an individual’s conscious or au-
tomatic effort to influence the subjective experience of emotions and how they are expressed. Finally, one of the
most researched concepts in positive psychology, considered an essential indicator of mental health, is subjective
well-being, characterized by life satisfaction, positive affect, and a low negative affect. The question arises: What is the
relationship between unconditional self-acceptance and subjective well-being when considering the usual emotion-
al regulation strategies that the individual adheres to? Does unconditional self-acceptance make an independent or
moderating contribution to the relationship between emotional regulation and subjective well-being? This research
aims to answer those questions.
The study involved 1061 participants from the general population, with a majority being women (67%) and an
average age of 26.05 years. The data was collected through an online questionnaire using a Google form as part of
a comprehensive research project on the correlation between physical activity and mental health. Unconditional
acceptance was measured using the Serbian version of the Unconditional Self-Acceptance Questionnaire- short
form (USAQ-short), emotion regulation was assessed through the Serbian adaptation of the ERQ scale, and sub-
jective well-being was gauged using the Short Scale of Subjective Well-Being (SWBS). A hierarchical regression
analysis was conducted to explore the predictive role of emotion regulation strategies and unconditional self-ac-
ceptance on subjective well-being. The first model included cognitive reformulation and emotional suppression
as predictors, along with the score on the scale of unconditional self-acceptance. The second model examined
the interaction between individual emotion regulation strategies and unconditional self-acceptance in predicting
subjective well-being.
The study’s findings reveal that emotion regulation strategies and unconditional self-acceptance are significant in-
dividual predictors of subjective well-being. Specifically, cognitive reformulation in a positive direction contributes
to subjective well-being (β= .301; p<.001), while emotional suppression has a negative impact (β= -.168; p<.001).
Unconditional self-acceptance has a strong positive influence on subjective well-being, making the most significant
independent contribution among all predictors (β= .420; p<.001). Furthermore, unconditional self-acceptance mod-
erates the relationship between emotion regulation and subjective well-being, mitigating the effect of emotional
suppression and amplifying the impact of cognitive reformulation on subjective well-being.

Keywords
unconditional self-acceptance, emotion regulation, subjective well-being

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PS15 Systematic review of clinical prediction models for developing post-

traumatic stress disorder following a traumatic event
Loredana M. Fugaru
International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Department of Clini-
cal Psychology and Psychotherapy, Babeș-Bolyai University, Romania
Chrysanthi Blithikioti
Department of General Psychology, University of Padova, Italy
Pim Cuijpers
Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije
Universiteit Amsterdam, The Netherlands, Netherlands
Marianna Purgato
WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuro-
science, Biomedicine, and Movement Sciences, Section of Psychiatry, University of Verona, Italy
Corrado Barbui
WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuro-
science, Biomedicine, and Movement Sciences, Section of Psychiatry, University of Verona, Italy
Ewout W. Steyerberg
Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, Netherlands
Daniel O. David
International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Department of Clini-
cal Psychology and Psychotherapy, Babeș-Bolyai University, Romania
Ioana A. Cristea
Department of General Psychology, University of Padova, Italy

Abstract
Post-traumatic stress disorder imposes substantial burdens on individuals, significantly impacting their functionality
and overall quality of life. Accurately predicting who will develop the disorder after experiencing a traumatic event
would enable early interventions to prevent its onset.
In recent years, scientific efforts have focused on developing prediction models to estimate individual risk for PTSD.
However, few of these models undergo external validation, leaving their real-world applicability uncertain.
There is a significant need for scientific studies that synthesize existing literature and guide research development
in this area. To date, this study would be the first systematic review dedicated to analyzing externally validated pre-
diction models for PTSD. The focus of the study is identifying the best prediction models for informing clinical deci-
sion-making, including the deployment of preventive interventions.

Keywords
Multivariate prediction models, PTSD, external validation, clinical utility

PS16 CBT-based Psychological Interventions for Depression in Gynecological

Cancer Survivors: A Systematic Review and Meta-Analysis
Katarina Banfi
Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary, Hungary
Nóra Takács
ELTE Eötvös Loránd University, Hungary
Gabriella Vizin
ELTE Eötvös Loránd University, Hungary
Róbert Urbán
ELTE Eötvös Loránd University, Hungary
Bernadette Kun
ELTE Eötvös Loránd University, Budapest, Hungary, Hungary

Abstract
Backround: Global demographical trends, progress in cancer early detection, and medical treatment contribute to
an increase in the cancer survival rate, leading to significant rise in the prevalence of cancer survivors (53,504,187

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globally in 2022). Facing a cancer diagnosis, the burden of medical treatment, and changes in life are highly stressful
and challenging, leading to psychological distress, and a deterioration in quality of life and mental health. Helping in-
dividuals to cope with cancer by developing and implementing evidence-based, feasible, and effective psychosocial
interventions have become important problem to be solved.
Aim: The primary aim of this study is to systematically review all the studies that investigated the efficacy of Cogni-
tive-Behavioral Therapy (CBT)-based interventions for treating psychological distress (depression, anxiety) in popula-
tion diagnosed with some type of gynecologic malignancy. Moreover, our aim was to meta-analyze the clinical effec-
tiveness of CBT-based interventions for distress, evaluate their comparative effectiveness, and identify specific factors
(intervention-related, patient-related, setting-related) that contribute the most to the intervention effectiveness.
Methods: The search was conducted in PubMed, ScienceDirect, Web of Science, PsycInfo, EBSCO, Cochrane, and Goo-
gle Scholar databases. A total of 1021 records were screened for eligibility, and 42 intervention studies, both ran-
domized and quasi-experimental intervention studies were included. We extracted data for all reported measured
outcomes, such as depression, anxiety, any mental health symptoms (ex. sexual functioning, trauma, sleep disorder)
and quality of life to gain a comprehensive overview, and here we present preliminary meta-analysis on the effect of
interventions on depression symptoms.
Results: For calculating the depression effect score, we included 11 randomized controlled trials with a total of 1081
subjects, comparing the post-test mean differences between control and intervention groups. We calculated Hedg-
es’s g and found an indication of a medium combined effect size (-0.51, p<0.01; 95% [CI]: -2.09; -1.07). In the subgroup
analysis for the cancer cite (mixed, ovarian, cervical), results showed significant difference of subgroup effect sizes.
Results show smaller effect size for mixed gynecologic cancer cite (g = -0.38, p<0.01), indicate higher effect size for
cervical cancer (g = -0.86, p<0.05) while the effect size for ovarian cancer subgroup didn’t show significant difference
(g = -0.52, p>0.05) from combined effect size.
Conclusion: Based on preliminary results, CBT-based intervention for treating depression symptoms in gynecologic
cancer survivors is promising, especially when delivered to a homogeneous sample (by cancer type and age). Pre-
vious meta-analysis found that CBT-based interventions improve the overall well-being and quality of life of cancer
survivors, increase self-care, lessen depression, anxiety, insomnia and emotional distress in general. However, further
moderator analysis of intervention-related factors (type, length, delivery) is needed to provide more specific clinical
conclusions and identify research gaps.

Keywords
Systematic review, Meta-analysis, Gynecological cancer, Cognitive-Behavioral Therapy, CBT-Based Intervention, De-
pression

PS18 Effect of group cognitive-behavioral therapy on the quality of life and

negative emotional states in parents of children
with developmental disabilities
Marija Dronjak
Drama, Serbia
Dragan Dronjak
Opšta bolnica Kruševac, Serbia

Abstract
Parents of children with developmental disabilities (C-DD) face many challenges on a daily basis and risk experienc-
ing lower well-being and negative emotional states. Many studies showed negative outcomes, like chronic sorrow,
depression, high levels of stress, increased divorce rates, and a lack of free time. Parenting programs are recognized as
important for the successful outcome and cognitive behavioral therapy (CBT) as part of it.
The aim of this study was to examine the efficacy of group CBT, like a part of interdisciplinary „Drama“ programe for
treatment C-DD and family support. We used Satisfaction with Life Scale (SWLS) and Depression Anxiety and Stress
Scale (DASS 42) to measure life satisfaction and negative emotional state, at the beginning and after the end of the
targeted program. Sessions were organized twice a month with 4 parent groups (31 participants in total, mostly
female), for one year. The protocol of programe focused mainly on psychoeducation, cognitive restructuration, ex-
posure and relapse prevention. Also it used experiential group technique, reinforcement, and social support. The
topics of the sessions were semi-directed, they related to important life events, recognized stressors and resources, as
overwhelming feelings.
At the beginning, most participants expressed dissatisfaction with the quality of life, average with an moderate level
of anxiety, depression and stress. Scores on SWLS were correlated with D –DASS 42. The values ​​on the scales A-DASS

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42 and S-DASS 42 were mostly uniform. Several of parents (16,1%) with a pronounced level of complaints were reg-
istered, and they received psychiatric treatment. After the end of program, most of participants become „slightly
satisfied“, with mild level of depression, and threshold values (mild to normal) for anxiety and stress. It was noted that
more active participants in group achieved more significant improvements on the scales.
The results of this study confirm the effectiveness of CBT in the treatment of negative emotional states and indicate
the possibility of applying a group approach within the framework of support for parents of C-DD. Group techniques,
experiential learning and social support can enhance the power of the CBT approach, and facilitate professional sup-
port in conditions of limited resources.

Keywords
group CBT, parents of children with developmental disabilities, quality of life, negative emotional states

PS19 The Comorbidity of Adult’s Attention Deficit Hyperactivity Disorder and

Generalized Anxiety Disorder
İlknur Şen
Social Sciences University of Ankara, Turkey
Bilge Bilgin Kapucu
Psychiatrist, Turkey
M. Hakan Türkçapar
Social Sciences University of Ankara, Turkey

Abstract
Background and aims: Adult Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder char-
acterized by inattention, hyperactivity, and impulsivity with documented brain abnormalities and marked associated
symptoms that affect various aspects of daily functioning (APA, 2013; Curatolo et al., 2009). Generalized Anxiety Dis-
order (GAD) is an anxiety disorder characterized by excessive worry, restlessness, fatigue, and impaired concentration
(APA, 2013).There is increasing evidence that anxiety disorders are more common in individuals with ADHD (Full-
er-Thomson et al., 2016; Safren et al., 2001; Van Ameringen et al., 2010). However, studies are insufficient in terms of
number and quality. In this study, it was aimed to investigate the frequency of co-occurrence of adult ADHD and GAD.
Materials and Methods: Between September 2023 and May 2024, clinical interviews were conducted by psychiatrists
in two different private practices with 52 patients diagnosed with ADHD, GAD or both using the SCID-5-CV and MINI.
Informed consent was obtained from all participants and a Sociodemographic Data Collection Form was completed.
Adult ADHD Self-Report Scale (ASRS-v1.1), Wender-Utah Rating Scale (WURS), Generalized Anxiety Disorder-7 (GAD-
7) and Beck Anxiety Scale (BAI) were administered to each patient in order to determine the distribution and severity
of symptoms. Data were analyzed using SPSS 25.0. Ethics Committee Approval dated 04/09/2023 and numbered
87274 was obtained for the research.
Results: Of the patients (N=52), 39 were female (75%) and 13 were male (25%) and the mean age of the patients
was 31.23±9.87 years. Regarding the educational level of the participants, 2 (3.8%) were high school graduates, 29
(55.8%) were university graduates and 21 (40.4%) were Master's/Doctorate graduates. When the SCID-5-CV results
were analyzed, ADHD was diagnosed in 45 (85.4%) of 52 individuals. According to the MINI results, 50 of 52 (96.2%)
were diagnosed with GAD. Of the 50 individuals with GAD, 43 (86%) had a predominant pattern of attention deficit,
37 (74%) had a predominant pattern of hyperactivity/impulsivity, and 34 (68%) had a composite pattern of ADHD. A
significant, positive correlation was found between the SCID-5-CV total score for ADHD and Beck Anxiety Scale total
scores (p<0.01, r=0.497). As can be understood from this result, as anxiety increases, inattention and hyperactivity/im-
pulsivity increases. A significant, positive correlation was found between Beck Anxiety scale and Wender-Utah Rating
scale total scores (p<0.01, r=0.117).
Conclusion: Although the prevalence of ADHD in adults is estimated to be between 2.5% and 5% of the general pop-
ulation (Simon et al., 2009; Willcut, 2012), the lifetime prevalence of GAD in the USA is estimated to be approximately
5.7% (Kessler, 2008) and the 12-month prevalence is estimated to be 3.1% (Kessler, 2005). In the data obtained in our
study, the prevalence of ADHD (85.4%) and GAD (96.2%) was found to be high compared to the normal population.
In our study, high comorbidity was found between ADHD and GAD.

Keywords
Adult, Attention Deficit Hyperactivity Disorder, Comorbidity, Generalized Anxiety Disorder

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PS20 The efficiency of visual search depending on the subject’s

preference towards music
Tamara Đorđević Mauromihali
Serbian Association of Behavioural and Cognitive Therapists; Olympus travel services, Corfu, Greece
Željko Mladenović
The Academy of Applied Preschool Teaching and Health Studies - The Department of Preschool Education in Alek-
sinac, Serbia

Abstract
The main aim of the research was to explore the distracting effect of music on performing a visual search task, de-
pending on the subject's preference towards music. The distracting effect of music was measured in two ways - time
that was needed to complete the task and the number of mistakes.
This paper is a result of original research and describes results from two experiments, out of which one includes the
task of a simple visual search, while the second one includes the task of a complex visual search. Both experiments
were conducted while participants were listening to specific music, preferred, not preferred and neutral. All partic-
ipants were included in all situations. Experiments were performed in a laboratory environment, using computer
software for displaying stimuli and registering responses, "SuperLab".
The first experiment contained a simple visual search task and the criteria was - color. Participants were instructed to
press the “Yes” or “No” button, depending on the presence of the target stimulus, while listening to music from each
preference group. The target stimulus was a red line in the group of green lines. Data on average RT was analyzed
through ANOVA for repeated measures, F (2,57)= 0,047, p>0,05, and the post hoc Tukey HSD test shows that there
were no statistically significant differences between the three situations. For the number of mistakes, ANOVA shows
F(2,57)=0,788, p>0.05. No statistically significant results. The second experiment was identical to the first one except
that it contained a complex visual search task and the criteria were color and position of the target stimulus. Data
for average RT was analyzed through ANOVA for repeated measures, F(2,57)=0,664, p>0,05, and the post hoc Tukey
HSD test shows that there were no statistically significant differences between the three situations. For the number of
mistakes, ANOVA shows F(2,57)=0,684, p>0.05. No statistically significant results.
The sample of participants consists of 20 active members of dance groups in Nis, selected based on preliminary re-
search, age range between 19 - 39. The main criteria was that the participant is an active dance group member for a
time period longer than one year. All participants had normal or corrected to normal vision.
Experiments showed that the music the subject listens to while performing the visual search task does not have an
effect on efficiency, regardless of the subject's preference towards music. The analysis of the results indicated areas
that could be the subject of some future research to additionally explore the given topic.
The significance of this research would be better understanding if listening to music would have effects on perform-
ing the visual search task.

Keywords
visual attention, visual perception, visual search, preference towards music, distractors

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PS21 Psychological distress and willingness to seek professional help in

university environment
Smiljana Cvjetković
Faculty of Medicine, University of Belgrade, Serbia
Kristina Vrtić
Tratamento AG, Switzerland
Milica Todorović
Udruženje za kognitivne i bihejvioralne terapije Srbije, Serbia

Abstract
Background: Although, in general, students represent a healthy population when it comes to physical health, the re-
sults of numerous studies clearly indicate that they are at high risk of experiencing pronounced symptoms of psycho-
logical distress. Decision to start therapy is largely determined by willingness to seek professional assistance, namely
by the attitudes toward professional psychological help.
Aim: Determining the level and quality of psychological distress in students population and exploring the relation-
ship of psychological distress with attitudes toward professional psychological help and current use of counselling
and psychotherapy services.
Method: Total of 794 students from University of Belgrade were selected using a stratified multiphase sample design.
Psychological distress was measured using CCAPS-SR, Serbian version of Counselling Centre Assessment of Psycho-
logical Symptoms 62 (CCAPS-62). The willingness to seek professional psychological help was examined by the Atti-
tudes Towards Seeking Professional Psychological Help scale (ATSPPH-SF). Current use of professional psychological
services was assessed by single question „Are you currently using counselling or psychotherapy services? “ with di-
chotomous yes/no response options. Statistical analysis comprised descriptive statics, univariate and multiple linear
regression analysis and Firth’s logistic regression analysis.
Results: Symptoms of Academic distress (M=1.84, SD=1.08) and Social anxiety (M=1.37, SD = 1.06) appear as the
most pronounced symptoms, followed by Eating Concerns (M=1.18, SD=1.02), Hostility (M=1.16, SD=1.01) and Family
Distress (M=0.91, SD=0.86). The least pronounced were Alcohol Abuse (M=0.69, SD=0.94) and Generalized Anxiety
(M= 0.64, SD=0.84). Overall, students had moderately positive attitudes towards seeking professional psychological
help (M=3.03, SD=0.56), while lower hostility (β=-0.13, p<.05) and higher social anxiety (β=0.14, p<.01) emerged as
significant predictors of the willingness to seek help. Still, only 4% (n=32) of the respondents currently were using pro-
fessional psychological services, and present use of counselling and psychotherapy was associated only with higher
levels of academic distress (OR=1.66, p<.01).
Conclusion: The results indicate that interventions should primarily be aimed at increasing motivation for academic
activities and reducing social anxiety. In this sense, in order to increase well-being, it is possible to apply a wide range
of techniques and methods arising from cognitive-behavioural approaches, including motivational interviews and
other interventions to increase motivation intended for students and social skills training. The finding that, although
students’ attitudes towards psychotherapy or counselling are moderately positive very scarce number of them actu-
ally use the services, gives room for the mental health promotion in university environment. Additionally, this result
suggests that the availability of psychotherapy and counselling services should be increased.

Keywords
Psychological distress; Psychological help; University students

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PS22 Relations between professions (helping and non-helping),

perfectionism, personality traits, coping strategies, and burnout syndrome
Vesna Ilić
Primary school, Serbia
Tamara Milojković
HR, Serbia
Jelena Stanković
HR, Serbia
Alma Čolović Međedović
High School, Serbia
Anastasija Delić
Health Center, Serbia

Abstract
Burnout syndrome can be closely associated with helping professions in various ways (Maslach & Leiter, 2016). Helping
professionals, such as healthcare workers and educators, often face high levels of emotional and physical demands,
which can contribute to the development of burnout. The aim is to explore the relationship between occupation type
(helping vs. non-helping professions), coping strategies, personality traits, and perfectionism with burnout syndrome.
Understanding how these factors interplay can provide valuable insights for developing effective interventions. Pre-
vious research has shown that individuals in helping professions are more susceptible to burnout due to the nature
of their work (Schaufeli, Leiter, & Maslach, 2009). Additionally, coping strategies and personality traits significantly
influence how professionals manage stress and prevent burnout (Carver, Scheier, & Weintraub, 1989).
This study will investigate how different coping strategies, personality traits, and perfectionism interact with occu-
pational type to influence burnout levels. By identifying these relationships, we aim to develop preventive programs
utilizing principles of Rational Emotive Behavior Therapy (REBT) to reduce burnout among helping professionals.
In total, out of 275 participants, there were 141 from non-helping professions and 134 from helping professions
(age 20-65). The measurement tools applied in this study were Frost Multidimensional Scale (FMPS) which mea-
sures four dimensions of perfectionism, a longer version of the Big Five Plus Two Questionnaire (BigFive +) that
measures seven factors of personality: 5 core factors and 2 supplementary factors, Brief Cope Inventory (BCI) was
used to assess the coping strategies people use when they face problems and Copenhagen Burnout Inventory
(CBI) that consists of three scales measuring personal burnout, work-related burnout and client-related burnout.
The research was a descriptive correlational study and the statistical analysis was done through SPSS (version 22).
The current analysis indicates, that in the context of helping and non-helping professions, the correlation between
coping strategies and burnout syndrome highlights religion. For helping professions, behavioral disengagement and
self-blame (brief COPE) stand out. The correlation between perfectionism and burnout syndrome, both for helping
and non-helping professions, emphasizes concern over mistakes and doubts about actions. In non-helping profes-
sions, parental criticism and parental expectations are prominent. The non-helping model explains 52% of the vari-
ance through the following variables: neuroticism, negative affectivity, behavioral disengagement, and concern over
mistakes. The helping model explains 32% of the model through the following variables: extraversion, substance
abuse, and doubts about actions.
The practical aim of this research is to determine whether there are differences between helping and non-helping
professions regarding the prevalence of burnout syndrome, and consequently, to identify which factors contribute
to its development. The further aim is to develop preventive programs to reduce burnout among professionals in
helping professions, using principles of Rational Emotive Behavior Therapy (REBT). These programs will be based on
research findings that explore how coping strategies, personality traits, and perfectionism affect the relationship be-
tween occupation type and burnout. By incorporating REBT techniques, the programs will help identify and modify
the irrational thoughts and beliefs contributing to stress and burnout, creating targeted interventions to enhance
emotional resilience and overall well-being.

Keywords
burnout syndrome, perfectionism, coping strategies, Big Five plus Two, professions (helping and non-helping)

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PS23 To provide a case study of the effectiveness of Cognitive Behavioral

Sex Therapy based on the Sexual Tipping Point model for Compulsive sexual
behavior disorder (CSBD)
Angelika Kołomańska
Institute of Psychology, SWPS University, Warsaw, Poland

Abstract
Introduction:
Compulsive sexual behavior disorder (CSBD) is acknowledged by a persistent pattern of failure to control intense,
repetitive sexual impulses or urges resulting in repetitive sexual behavior. Compulsive sexual behavior has negative
consequences, including but not limited to distress or impairment in personal, family, social, educational, occupa-
tional, or other important areas of functioning, but also depression, anxiety, and a high risk of sexually transmitted
diseases.
The Sexual Tipping Point® (STP) model is an integrated approach to the etiology, diagnosis, and treatment of men
with CSBD. Men with CSBD have various bio-psychosocial-behavioral and cultural predisposing, precipitating, main-
taining, and contextual factors which trigger, reinforce, or worsen the probability of CSBD occurring.
Objective:
To provide a case study of the effectiveness of Cognitive Behavioral Therapy (CBT) based on the Sexual Tipping Point
model for Compulsive Sexual Behavior Disorder (CSBD).
Methods:
The patient is a 29-year-old male a student who at pre-treatment presented a diagnosis of CSBD. The patient was
initially complaining about anxious symptoms—feeling tense and frightful in the past weeks. He reported a daily pat-
tern of extreme frequency of masturbation related to the use of pornography. A pattern of repetitive, uncontrollable,
daily sexual behavior was found, with compromised functional capacity and high repercussions on personal life—the
incapability of finding a partner, academic failure, and incapacity for work.
For this patient, the interplay between excitatory and inhibitory factors were in dysbalance. In this context, social
factors, such as negative attitude to sexuality are important, but biological correlates, also have a role.
Therapeutic approach was based on the Dual – Control Model and the Sexual Tipping Point Model. The patient re-
ceived CBT once a week for a period of 50 minutes per session for a period of 12 weeks. Individual therapy sessions
were focused on important issues such as impulse control, emotional regulation, internalized stigma, strategies for
coping with stress, reacquiring control of sexual behavior and fostering a healthier approach to sexuality.
Results:
At termination the patient presented decreases in hypersexual symptoms at post-treatment. Patient’ overall psychiat-
ric well-being also improved significantly. CBT has been shown to improve the imbalance between sexual inhibition
and excitation into a more flexible balance. This was achieved by improving sexual self-control and self-regulation.
The changed understanding patient’s sexuality allowed him to use sexuality as a resource without having to forego
sex. The results also showed acquisition of a more adaptive thinking style and healthy coping mechanisms to support
the patient post-therapy.
Conclusions:
This approach emphasizes the utility of a biopsychosocial-cultural perspective. Cognitive Behavioral Therapy have
shown great promise in reducing excessive sexual behavior, emotional regulation, and improving sexual relationship,
supporting the hypothesis that CBT based on the Sexual Tipping Point model may be a promising treatment for CSBD.

Keywords
Compulsive sexual behavior disorder (CSBD); Sexual Tipping Point (STP); Cognitive Behavioral Therapy (CBT)

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PS24 Validation of negative automatic thoughts questionnaire

in the Serbian population
Nikola Stojanovic
Faculty of Medicine, University of Niš, Serbia
Jelena Stevovski-Radovic
VIZIM Health Center, Serbia
Vladan Radivojević
Institute for mental health protection, University Clinical Centre Niš, Serbia

Abstract
Automatic thoughts were first defined by Aron Beck and are considered to be the basis of cognitive therapy. These
thoughts are defined as spontaneous, fast, and frequent and represent a connection between thoughts and emotions.
In the case when these thoughts have a negative context, they are considered to be part of the Becks triad, which
describes the cognitive bases of depression. Negative automatic thoughts are a consequence of errors in information
processing and lead to the formation of cognitive distortions in the perception and interpretation of everyday events.
This study aimed to validate for the first time the questionnaire for negative automatic thoughts (NATQ) in the Serbian
population and to correlate the obtained score values with Patient Health Questionnaire-9 (PHQ-9) for the severity of
depression. A total of 513 examinees completed an online questionnaire comprised of three sections: the first section
was designed to collect general subjects’ data, the second section was a negative automatic thoughts questionnaire,
and the third was PHQ-9. The average age of subjects was 38 (±11.9), with 76.6% of subjects being female, and more
than 57% of them having a high level of education. The obtained mean value on NATQ was 49.1 (±20.1), with minimal
and maximal scores of 30 and 140, respectively. Cronbach alpha for NATQ was found to be 0.971. Regarding PHQ-9
results, around 80% of subjects could be considered as minimally and mildly depressed, while only around 2% were
severely depressed. Cronbach alpha for PHQ-9 was found to be 0.842. Correlation between the NATQ and PHQ-9 was
found to be both strong (0.778) and statistically significant (p>0.001). The scores for NATQ in the general population
are very similar to those obtained in the general population of a neighboring country, and the values of Cronbach
alpha indicate high reliability. Also, the correlation between the two scales indicates that the occurrence of negative
automatic thoughts is indeed associated with a higher degree of depression. Finally, we can conclude that the validat-
ed NATQ might be used in the Serbian population for the estimation of negative automatic thoughts.

Keywords
negative automatic thoughts, depression

PS25 Development of learning content based on cognitive behavioral therapy

for psychiatric home visit nurses: A feasibility study.
Motohisa Hirose
Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Japan
Eiji Shimizu
Chiba University, Japan
Tomoko Kawasaki
Chiba University, Japan
Yoshiyuki Hirano
Chiba University, Japan
Yoshikazu Noda
Chiba University, Japan
Isana Kaichi
Chiba University, Japan
Masayuki Katsushima
Chiba University, Japan
Yumi Abe
Chiba University, Japan

Abstract
Introduction

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While the need for home visit care for people with disorders has been receiving a lot of attention, nurses and practi-
tioners do not have enough opportunity to learn the skills based on the evidence for emotional support and how to
interact with patients. In the field of psychiatric home-visit nursing, which is the subject of this study, there are prob-
lems with patients and their families, such as a lack of staff knowledge and experience regarding psychiatric nursing,
the risk of psychiatric symptoms and suicide, and confusion about communication unique to patients with mental
illness. Communication difficulties have been cited as an issue. Cognitive-behavioral therapy (CBT) skills are currently
used as communication skills, not only treatment. Therefore, we developed the content that home visit nurses can
learn the communication methods based on cognitive behavioral therapy.
Method
First, we asked six psychiatric home visit nurses about their problems with patient support for patients and their
demands on nursing. Secondly, we conducted a single-arm study to examine the effects of the learning contents on
the seven psychiatric home visit nurses. Participants were assessed at pre-(0week) and post-(4week: 1week after in-
tervention). The learning program consists of a 3-week intervention (6 topics of counseling and CBT skills; each topic
comprises 7 minutes of lecture and 7 minutes of role-play). The primary outcome is the change in the Communication
skills scale for nursing for patients and families score from week 0 (baseline) to week 4. Secondary outcomes include
the competence of interpersonal communication scale, Patient Health Questionnaire-9 (PHQ-9), and Generalized
Anxiety Disorder-7 (GAD-7). For primary and secondary outcomes, the Wilcoxon signed-rank test or paired t-test was
used to compare the scores before and after the program. In addition to these scales, we searched for satisfaction with
the Japanese version of the Client Satisfaction Questionnaire 8 (CSQ-8J).
Results
A significant decrease in Patient Health Questionnaire-9 (PHQ-9 total=∸1.00, P<.005: Median (IQR) 3(1-6)0week-2(0-
3)4week) was observed in the post-assessment (1week after intervention) compared to the pre-test. Although there
was no significant difference except for PHQ-9, the total score of the Communication skills scale for nursing for pa-
tients and families and the competence of the interpersonal communication scale were increased. In the CSQ-8J,
Participants answered “mostly satisfied” or “very satisfied” in this program.
Discussion
This study aims to develop practical content for psychiatric home visit nurses. The decrease in depressive symptoms in
them was significant. It would suggest that they got self-care skills because of CBT learning. On the other hand, there was
no significant difference in other scales, including the Communication skills scale for nursing for patients and families.
Small numbers of participants might cause this situation. In the future, we need to investigate with large numbers.

Keywords
nurse, e-learning, home vist care

PS26 Spanish version of the “Emotional Processing Scale-25”: Psychometric

study in healthy people and people with central sensitization syndromes
M. Pilar Martinez
University of Granada, Spain
Elena Miró
University of Granada, Spain
Gabriel Medina
University of Granada, Spain
Nuria V. Aguerre
University of Granada, Spain
Ada Raya
University of Granada, Spain
Nahikari Pagola
University of Granada, Spain
Carmen Aguirre
University of Granada, Spain
Ana Sánchez
University of Granada, Spain

Abstract
Background and aims
Emotional processing plays a critical role in well-being of the person as it relates to the ability to identify, evaluate,

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regulate, and express emotions in an adaptive manner. Emotional dysregulation is present in various pathologies
such as substance abuse, eating disorders, borderline personality disorder, etc. Furthermore, the influence of the
difficulty of affective regulation on conditions of chronic pain and central sensitization has been raised, although
this is an issue that still requires more support. Having tools that evaluate these emotional processes in this type of
population can be of great clinical interest. The “Emotional Processing Scale-25” (EPS-25) is a recognized instrument
for examining this characteristic, but there are very few studies on its validation in the general Spanish population.
This study analyzed the psychometric properties of a Spanish version of the EPS-25 in healthy people and people with
central sensitization syndromes (CSSs).
Methods
A cross-sectional study was performed in 1542 adults from the general population who completed a battery of instru-
ments applied online through the LimeSurvey platform, and disseminated on social networks. The battery included
a Spanish version of the EPS-25, and several self-report about central sensitization, pain, sleep, emotional distress,
and perceived stress. In this sample, 861 healthy individuals and 467 participants with CSSs were selected. Data were
computed with IBM SPSS Statistics. At health sample, a principal components analysis (PCA) with oblique rotation was
applied. At CSSs sample, a confirmatory factor analysis (CFA) was applied with the Robust ML method and goodness-
of-fit indexes were computed. To analyze the internal consistency Cronbach’s alpha was calculated. Convergent and
divergent validity was established through the Pearson correlation coefficient. A ROC curve examined the predictive
value in identifying individuals with maladjusted levels of central sensitization. The cut-off score with the best sensi-
tivity and specificity was established.
Results
The PCA in the healthy sample indicated that a four-factor structure with 24 items was more appropriate than the
original five-factor composition. The scale showed strong internal consistency (α = 0.94) and adequate convergent,
divergent and predictive validity. The best cut-off point was 17.84. The CFA in the CSSs sample suggested, with reser-
vations, a moderate fit of the tetra-factorial model.
Conclusions
The Spanish version (EPS-24) has sufficient psychometric guarantees to be applied in community samples from our
sociocultural context. The inclusion of this instrument in the psychological exploration of patients with CSSs can con-
tribute to the identification of “risk” emotional patterns in this population.
Funding. This study was part of the I+D+i Project/aid PID2019–109612GB-I00, funded by MCIN/
AEI/10.13039/501100011033.

Keywords
Emotional processing, central sensitization, psychometric study

PS27 Trauma, psychological impact and emotional dysregulation in patients

with fibromyalgia and other central sensitization syndromes
M. Pilar Martinez
University of Granada, Spain
Ana Sánchez
University of Granada, Spain
Germán Prados
University of Granada, Spain
MARTA Medina Casado
University of Granada, Spain
M. Fernanda Ramírez
University of Granada, Spain
Rafael Cáliz
Virgen de las Nieves Hospital, Spain
Elena Miró
University of Granada, Spain

Abstract
Background and aims
Traumatic experiences and of high adversity are relatively common in the general population and can cause psycho-
logical distress and reduced quality of life. This type of experience seems to have a particularly accentuated presence
in central sensitization syndromes (CSSs), which constitute a heterogeneous set of conditions that share various man-

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ifestations, including allodynia and generalized hyperalgesia. Fibromyalgia (FM) is often considered a prototypical
expression of CSSs. From a neuropsychological perspective, in recent years there has been an increase in interest in
analyzing the role of traumatic events and post-traumatic stress disorder (PTSD) in CSSs, considering that the emo-
tional processes associated with trauma can sensitize the neural pathways of pain. However, there is still little knowl-
edge about these links and possible differential patterns between CSSs. The objectives of the study were to examine:
1) the presence of trauma, PTSD symptoms, and emotional regulation difficulties in FM patients, compared to patients
with other CSSs and healthy controls; and 2) the relationship between PTSD, emotional dysregulation and severity of
the clinical conditions (pain, sleep, anxiety, depression and daily functioning).
Methods
Sample. This cross-sectional study included 32 women with FM, 31 women with other CSSs (e.g., chronic fatigue
syndrome, irritable bowel syndrome and migraine) and 29 healthy women. The clinical groups were recruited in the
Rheumatology Service and Internal Medicine Service of the Virgen de las Nieves University Hospital and in AGRAFIM
(an association of FM patients), both in Granada (Spain). The healthy group was recruited in non-care community
settings.
Instruments. All participants were evaluated through: Clinical Interview for the Psychological Evaluation of FM and
other CSSs (except the healthy group), Global Evaluation of Posttraumatic Stress (EGEP-5), Emotional Processing
Scale-25 (EPS-25), another series of self-report measures of CS, pain, fatigue, sleep, cognitive-affective appraisal of
pain, emotional distress, psychopathology, daily functioning, and several objective measures.
Statistical analysis. IBM SPSS Statistics was used. Data were analyzed via one-factor ANOVA and Tukey and Tamhane
as post-hoc tests. The relationships between clinical variables were analyzed using the Pearson correlation coefficient.
Results
The characteristics of the traumatic events (type, age, duration, etc.) most frequently reported by the participants in
the study groups were described. The FM and other CSSs groups reported a greater number of traumas, more severe
manifestations of PTSD, and more deficits in emotional regulation than the healthy group. The severity of PTSD symp-
toms was significantly associated with more intense and disabling symptomatology in both clinical groups (FM and
other CSSs), with this relationship being of greater magnitude in FM.
Conclusions
Knowing the experiences of adversity and psychological consequences suffered by people with CS pain can help
better detect their individual needs and address trauma processing as part of multidisciplinary intervention.
Funding. This study was part of the I+D+i Project/aid PID2019–109612GB-I00, funded by MCIN/
AEI/10.13039/501100011033.

Keywords
Trauma, post-traumatic stress, emotional dysregulation, fibromyalgia, central sensitization

PS28 Self-reflection, Self-Insight, and Countertransference as Predictors of

Professional Quality of Life among RE/CBT Trainees and Psychotherapists
Iva Filipovski
KnowIT DOO, Serbia
Milka Škundrić Josipović
Private practice, Serbia
Aleksandra Maletić
Private practice, Serbia
Doris Momirović
Private practice, Serbia
Mirjana Marjanović
Private practice, Serbia
Ninoslava Milić
Philip Morris International, Serbia

Abstract
Self-reflection, defined as a therapist's ability to introspectively analyze their thoughts and feelings, is considered a
key aspect and predictor of professional well-being, reducing burnout and enhancing therapist effectiveness in the
therapeutic process. Bennett-Levy and Thwaites emphasize the importance of therapists' self-awareness and self-re-
flection in recognizing and managing countertransference reactions. They suggest that inability to manage counter-
transference can damage the quality of life.
This study aimed to examine the role of self-reflection, self-insight, and countertransference as predictors of profes-

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 POSTER PRESENTATIONS
sional quality of life and secondary traumatization among RE/CBT trainees and psychotherapists in Serbia and the
Balkan region. Participants were 72 RE/CBT psychotherapists and trainees who completed the online questionnaire.
The predictor variables used in the model are the frequency of self-reflection, the need for self-reflection, self-insight
(SRIS subscales), countertransference (Therapist Response Questionnaire), experience as a psychotherapist, time
spent in personal therapy, the number of clients seen per week, incorporating mindfulness techniques into work, and
completed mindfulness course. The criterion variables are secondary traumatization (STSS scale) and professional
quality of life (scale PROQOL 5, subscales compassionate satisfaction, burnout, and secondary traumatic stress). While
the PROQOL provides a more comprehensive assessment of various aspects of well-being in helping professionals,
the STSS offers a more focused evaluation specifically on secondary traumatic stress symptoms. Multiple regression
analyses were conducted. The results of multiple regression analysis showed that countertransference (β= 0.375, p<
0,05), completed mindfulness course (β= -0.311, p< 0,05), and incorporation of mindfulness techniques into work (β=
-0.269, p< 0,05) significantly predict secondary traumatic stress (STSS) in psychotherapists. Self-insight (β= -0,355, p<
0,05) and countertransference (β= 0,299, p< 0,05) are significant predictors of secondary traumatic stress subscale
from PROQOL. Statistically meaningful predictors for burnout are countertransference (β=0.420, p<0.05), self-insight
(β= -0.281, p< 0,05), and engagement in self-reflection (β= -0.279, p< 0,05). Time spent in personal therapy signifi-
cantly predicts compassion satisfaction (β= -.297, p 0.025).
Findings indicated that developing and incorporating mindfulness skills into work could prevent secondary trauma-
tization. Learning how to manage countertransference and gain self-insight can reduce secondary traumatic stress.
Similar to previous studies, results show that engagement in self-reflection, more self-insight, and managing counter-
transference can reduce burnout as well. Little or no time spent in personal therapy can lead to feeling less satisfied
regarding the ability to be an effective caregiver. The results of this research highlight the skills and activities that both
trainees and experienced psychotherapists should develop and incorporate into practice in order to protect them-
selves from secondary traumatization and maintain a higher professional quality of life.

Keywords
RE/CBT; Self-reflection; Countertransference; Self-insight; Mindfulness; Secondary traumatic stress; Professional qual-
ity of life

PS29 Looking at artworks as a method for self-reflection with different

conditions: laypeople, identified depression in the background, different
languages
Kristina Timonen
University of Turku, Finland
Tero Timonen
Åbo Akademi University, Finland

Abstract
Introduction: People have sometimes trouble expressing themselves verbally. This is especially challenging for people
with emotional moods, especially depressive. One possibility to enhance verbal expression is to discuss e.g. around
metaphors or artworks with someone. This can improve people’s – especially persons with mental health issues – ver-
bal skills and activate them in their daily life. The study examines benefits of the slow looking technique when viewing
artworks with special emphasis on depression. The study was conducted in the Ostrobothnia in West-Finland and as
initiated partly by the wellbeing services between 2020 and 2023.
Method: There were three Finnish speaking voluntary people with formerly identified depression (person group 1;
pg1) and six laypeople (person group 2; pg2) with three languages (Finnish, Swedish, East-European language). They
were asked to look at by them chosen visual artworks at Kuntsi Museum of Modern Art for 5-10 minutes each work
and discuss any thoughts the artworks evoked. One pg1-person and two pg2s did the exercise longitudinally, visiting
all six (pg-1.1), five (pg-2.1) and four (pg-2.2) exhibitions respectively, while the rest visited only the 5th exhibition. The
data from two pg1s. was gathered by their permission with an audio recorder during the museum visit by a therapist
and later transcribed by to them a blind researcher, otherwise participants themselves wrote about the experience.
Data was analysed with reflexive thematic analysis first by coding the texts, then creating themes and sub-themes.
Results: Six themes were created from the data which describe wide topics reflected by the viewers’ discussions at the six
exhibitions, 42 smaller sub-themes were made to reflect details of the topics. Individuals approach artworks in different
ways, but most people seem to find easiest connections with artworks that touch personal interests and/or encourage
personal discussions. Longitudinally it shows that art-related discussions deepen and become more reflective as viewers
become familiar with the exercise. Depression affects interest and ability to notice details. Once depression loses its hold,

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interest in art-discussions increases. It is also visible, that even when depression was present, art as a stimulating and ac-
tivating activity, influences on the variability of verbal associations, also new ones. This in its turn gives rise to more, also
personal, material to be used in therapeutic discussions. During general discussions, it deepens the personal interaction
between people by releasing more individual contents, which guides the discussion further. There are some variations,
how different language groups handle the contents.
Conclusion: The study shows that artworks stimulate thinking and be a valuable tool for unlocking different contents
in the discussions. It is however important to choose the exhibitions carefully to suit the individual situations. It is
advisable to balance between positively and negatively affecting artworks. One thing that is important in this re-
spect is the language and its role in handling the observed elements. Therapeutically art, artworks and visiting in art
museums seem to increase possibility in cognitive and emotional flexibility, which in its turn increases therapeutic
possibilities to balance the individual´s lives.

Keywords
Art, depression, wellbeing, language

PS30 REBT Education: Challenges and Attitudes From the Trainees

Perspective
Ivana Kokanović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Petar Kačar
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Tamara Krgović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Lejla Zornić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Milenko Paunović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Nataša Dragojević Savić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Slavica Jovičić Stamenković
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia

Abstract
Introduction: The decision to become a REBT psychotherapist entails a lot of work and overcoming numerous chal-
lenges. Although REBT therapy is supported by a significant body of research, the information available about the
process of education for REBT is limited. Many psychologists and professionals in related fields begin the education
process, but many of them do not complete it. However, there is still no direct answer to the question of how we
choose the psychotherapeutic direction we will pursue, what are the most common challenges faced by trainees, and
what motivates them to complete the education fully and become licensed REBT psychotherapists.
Objective: The study was designed to explore the motivation of trainees for training and the challenges they encoun-
ter, as well as the challenges faced by licensed REBT therapists during their education.
Method: The sample consisted of 73 trainees (the first group consisted of 52 trainees who are on their first and second
year of education, the second group consisted of 21 trainees who are on their third and fourth year of education) and 8
licensed REBT psychotherapists, who completed an online questionnaire. The questionnaire was designed to explore the
trainees’ motivation to choose this therapeutic approach, their expectations from the training, the greatest challenges
during the training (for beginner and advanced course participants), motivation to complete the education, reasons
for possible dropout (for final course participants), and the obstacles faced during education (licensed REBT therapists).
Results: 82,7% of the respondent were women, mostly psychologists by education (75.3%), who attended education on-
line (64.4%). As the main reason for choosing this therapeutic approach, 79.5% of respondents stated that they liked this
approach, and 65.8% believed that it could quickly lead to change in clients. Most beginner and advanced course partic-
ipants found peer counseling (71.2%) and comments of educators (63%) most useful during the education, while final
course participants found independent work with clients (47.6%) and supervision (38.1%) to be most useful. Although
93.1% of respondents plan to continue education and practice it, the biggest potential problem for continuing educa-
tion is coordination of education with their regular job (53.4%) and the cost of education (46.6%). Licensed psychothera-
pists most frequently cited “session recording” and its supervision as the biggest challenges during REBT training. Other

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major obstacles included regular job duties, changes in conditions and requirements of the education itself, finances,
and preparation for the final exam. The most common reasons psychotherapists continued with the training were the
efficiency, speed, and structure of the therapeutic modality.
Discussion and Conclusion: The results indicate that most trainees are women, psychologists by education, who attend
education online. Although most respondents plan to continue their education, the biggest potential problems on this
path are coordination with their regular job and the cost of training. Future research on this topic will be welcome.

Keywords
education, motivation, challenges

PS31 Good I, Bad I: A CBT-inspired intervention for reducing overconfidence

and superiority bias
Antea Stojiljković
University of Belgrade, Faculty of Philosophy, LIRA Lab, Serbia, ant070314@gmail.com
Aleks Mladenović
University of Belgrade, Faculty of Philosophy, LIRA Lab, Serbia, mladenoviccc97@gmail.com
Sanda Stanković
University of Belgrade, Faculty of Philosophy, LIRA Lab, Serbia
Predrag Teovanović
University of Belgrade, Faculty of Special Education and Rehabilitation, LIRA Lab, Serbia

Abstract
Overconfidence bias involves overestimating our own abilities and knowledge, while superiority bias refers to overes-
timating oneself relative to other people. Due to inaccurate self-perceptions, these biases can result in negative out-
comes, including lower academic and work performance, poor interpersonal relations, and discrimination. Recently,
attempts have been made to mitigate the effects of cognitive biases using different debiasing techniques. Our study
was inspired by Blanton et al. (2001), who aimed to reduce overconfidence bias by decreasing cognitive dissonance
in participants. They proposed that participants would realistically assess their task performance if an affirmation ma-
nipulation first enhanced their self-worth. However, the study reported weak effects. In our study, we compared the
effects of reduced cognitive dissonance and balanced self-image on overconfidence and superiority bias. We intro-
duced a CBT-inspired intervention, “Good I, Bad I”, that included listing three positive and three negative characteris-
tics of oneself together with specific behavioral examples. This intervention was expected to result in a more balanced
self-perception, leading to more realistic evaluations of one’s abilities, thus reducing the overconfidence and superi-
ority bias. The study included three groups: the first experimental group underwent the “Good I, Bad I” intervention;
the second experimental group had only the “Good I” intervention; and the control group had a neutral activity. The
“Good I” intervention aimed at reducing cognitive dissonance by listing three positive self characteristics with corre-
sponding behavior. Participants completed 18 tasks from Raven’s Progressive Matrices (Pallier et al., 2002), expressing
confidence in their performance after each task. The sample consisted of 182 participants recruited through social
networks - 65 participants in the control group, 57 in the first experimental group, and 60 in the second experimental
group. While our expectations were not entirely met, the results suggest a trend toward reduced overconfidence bias.
Scheffe’s post hoc test results revealed that the group subjected to the "Good I, Bad I" intervention demonstrated
lower levels of overconfidence bias than the control group (mean difference was 1.59, SD = 0.59, p = .03). This trend
was not observed in the "Good I" group (mean difference was -0.49, SD = .62, p = .73). Our results provide preliminary
evidence that eliciting a balanced self-image is a more effective debiasing mechanism than merely reducing cogni-
tive dissonance, at least for overconfidence bias. Further research is needed to elucidate the underlying processes
and optimize debiasing strategies, with potential applications of CBT-inspired interventions in non-clinical contexts.

Keywords
debiasing, overconfidence bias, superiority bias, self-image, “Good I, Bad I”

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PS32 Fear of Failure, Depression, and Anxiety Symptoms: Insights from a

Large-Scale Screening Study
Julia Bączek
SWPS University, Poland
Stanisław Karkosz
Laboratory of Affective Neuroscience, Institute of Psychology, SWPS University, Poznań, Poland, Poland
Jarosław Michałowski
Laboratory of Affective Neuroscience, Institute of Psychology, SWPS University, Poznań, Poland, Poland

Abstract
This study presents findings from a screening assessment involving 5399 participants, forming part of a larger inves-
tigation into the efficacy of imagery therapeutic techniques. During the screening, participants completed an online
set of questionnaires and scales measuring psychopathological symptoms, fear of failure and childhood experiences
of violence. A comprehensive series of analyses was conducted to test the role of fear of failure and diverse anxiety
symptoms in predicting depression. The results showed that fear of failure (PFAI) predicts the level of depression (BDI)
(b=.645, p<.001). Further, mediation analysis revealed that fear of failure predicts depression not only directly but also
indirectly (b=.339, p<.001): with increasing fear of failure the level of generalized anxiety, panic and social anxiety
also increases, which is partially responsible for higher levels of depressiveness. The study also examined differences
in fear of failure among individuals who experienced psychological violence, other forms of violence, or no violence
during childhood. Repeated measures ANOVAs revealed that individuals who did not experience violence had sig-
nificantly lower levels of fear of failure than those who experienced psychological violence or other forms of violence
(F(2,5395)=78.309, p<.001, n2=.028). There were no significant differences in fear of failure between groups experi-
encing psychological violence and other forms of violence. Overall, this study emphasizes the multifaceted nature
of the interplay between fear of failure and depression, and it sheds light on the pivotal mediating roles of different
types of anxiety. These insights are crucial for developing targeted therapeutic interventions aimed at addressing the
underlying mechanisms linking fear of failure to depression.

Keywords
Fear of failure, depression, anxiety disorder, mediation analysis

PS33 Improving Emotional Wellbeing of University Students Using Cognitive

and Dialectical Behavioural Psychotherapeutic Approaches in Group Settings
(UniWELL): A Protocol
Ayse Akan
Bogazici University, Turkey

Abstract
Global estimates indicate that approximately one-third of students enter university exhibiting symptoms suggestive
of a common mental disorder, with many experiencing these during late adolescence, a developmental phase asso-
ciated with a heightened risk for the onset of mental disorders. Research indicates that group-based cognitive and
behavioural therapies, such as Cognitive-Behavioural Therapy (CBT) and Dialectical Behaviour Therapy (DBT), can
significantly enhance the mental health and overall wellbeing of university students.
While some studies with Turkish university students have explored the effectiveness of group CBT for various condi-
tions, these studies often feature small sample sizes, focus solely on statistical significance rather than clinically sig-
nificant change, and neglect the feasibility of future randomised controlled trials. Furthermore, to our knowledge, no
studies have been conducted in Turkey with university students to investigate the effectiveness of DBT-based groups
for emotion regulation.
This project, consisting of three stages within a four-step framework, named "Improving Emotional Wellbeing of Uni-
versity Students Using Cognitive and Dialectical Behavioural Approaches in Group Settings" (UniWELL), aims to en-
hance the emotional wellbeing of university students, specifically focusing on anxiety management and emotion
regulation. This will be achieved by adapting and localising evidence-based group therapy intervention programmes
based on CBT and DBT, and assessing their feasibility and effectiveness.
Following adaptation and localisation by a panel of experts led by the project lead, these group therapy programmes
will be offered to Bogazici University students through the Bogazici University Student Guidance and Psychological
Counselling Centre (BUREM) and the Translational Clinical Psychology Lab (T-ClinPsyLab) at Bogazici University, Istan-

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bul, Turkey. A total of 32 to 120 volunteers who meet the inclusion criteria will be recruited to participate in either a
group-based CBT psychotherapy intervention for anxiety management or a group-based DBT-informed psychother-
apy intervention for emotion regulation.
The feasibility and effectiveness of these interventions will be assessed using a mixed-methods approach. Quanti-
tative data on anxiety, depression, stress, borderline symptoms, general wellbeing, and service evaluation will be
collected and analysed using descriptive and inferential statistics. Additionally, qualitative data will be gathered from
12 to 40 participants post-intervention to explore their experiences and perspectives on the group interventions re-
ceived. This qualitative data will be analysed using Thematic Analysis.
The findings from this study will be disseminated through various channels, including journal publications and con-
ferences.

Keywords
anxiety management, emotion regulation, university student mental health, student mental health, culturally adapt-
ed CBT, culturally adapted DBT

PS34 Therapists’ reservations in using mindfulness techniques in anxiety

treatment.
Duška Dostanić Živković
Serbian Association of Behavioural and Cognitive Therapists, Serbia
Isidora Pavlović
Serbian Association of Behavioural and Cognitive Therapists, Serbia
Nenad Đukanović
Serbian Association of Behavioural and Cognitive Therapists, Serbia
Aleksandar Tanović
Serbian Association of Behavioural and Cognitive Therapists, Serbia
Nikolina Dobraš
Serbian Association of Behavioural and Cognitive Therapists, Serbia
Vesna Filipović
Serbian Association of Behavioural and Cognitive Therapists, Serbia
Jelena Boljanović
Serbian Association of Behavioural and Cognitive Therapists, Serbia
Jelena Latković
Serbian Association of Behavioural and Cognitive Therapists, Serbia

Abstract
The aim of this study is to explore how frequently CBT practitioners in Serbia use mindfulness techniques in their
daily practice and potential reservations in using it when it comes to treating anxiety. Mindfulness cognitive ther-
apy represents a psychotherapeutic approach that emphasizes directing attention to the present moment without
judgment, with an attitude of acceptance towards what is observed in the present moment. In this way, mindfulness
facilitates coping with internal sensations, thoughts, feelings, and emotions, excluding the demand for circumstances
to be different from what they are. It is employed within the framework of traditional cognitive-behavioral therapy
as a potent tool in the treatment of anxiety disorders, reducing worries, sadness, and many other dysfunctional feel-
ings. Mindfulness offers a unique strategy for addressing fear and anxiety in both the mind and body. By engaging
in advanced mental processes like attention, awareness, and positive attitudes such as kindness, curiosity, and com-
passion, mindfulness can assist in controlling emotional responses by inhibiting the limbic system through cortical
control (Greeson & Brantley, 2009, as cited in Kabat-Zinn, 2005, 1994, 1990). In addition, while positive effects of
mindfulness have been reported in some of the outcomes research for anxiety disorders (Vollestad, Nielsen, & Niel-
sen, 2012), other research studies have not found mindfulness to be effective for treating anxiety disorders (Canadian
Agency for Drugs and Technologies in Health, 2015; Strauss, Cavanagh, Oliver, & Pettman, 2014; Toneatto & Nguyen,
2007). Data from available literature do not provide sufficient information on the frequency of use of the mentioned
technique by CBT therapists in their daily practice.
This paper presents reports from CBT therapists and trainees (N=62) from Serbia contacted through EABCT member-
ship association in Serbia (ACBTS). We have used an online survey with 18 items (Likert scale) to check potential ther-
apist’s reservations in using mindfulness in anxiety treatments. We have adapted the scale previously used in research
(Brett et al., 2013). Additionally, scale has sociodemographic variables which were used to see potential difference
between groups. Data collection started in April 2024 and is currently ongoing.
Preliminary results suggest that most practitioners (51,6 %) sometimes use mindfulness techniques in their everyday

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practice and 16 % use them very often. The most frequent techniques used are Breath Awareness, Body Scan and
Thought Awareness.
Furthermore, there are indications that therapists under supervision have significantly more negative attitudes to-
wards the use of mindfulness compared to certified psychotherapists. The difference is observed in items related to
fear of client abandonment, the belief that client resistance will increase, and the impression of being inadequately
trained to apply mindfulness techniques. Generally, it is evident that therapists who use mindfulness techniques less
frequently also have more negative attitudes towards them.
Our findings suggest that therapists with limited knowledge and experience in utilizing mindfulness techniques may
exhibit more negative attitudes towards incorporating them into anxiety treatment. The practical significance is that
beginners have reservations about using these techniques, indicating a need for further education to reduce resis-
tance among therapists who are starting to engage in therapy.

Keywords
mindfulness anxiety CBT practitioners education

PS35 Assessing Chronic Social Role-Related Stress: Validation of the Turkish

Chronic Stress Scale
Hale Yapici Eser
Koc University, Turkey
Merve Yalçinay İnan
Koc University, Turkey
Defne Ertuna
Koc University, Turkey
Muhammed Balli
Koc University, Turkey
Imren Kurt Sabitay
BAŞAKŞEHİR ÇAM SAKURA HOSPİTAL, Turkey
Oya Güçlü
BAŞAKŞEHİR ÇAM SAKURA HOSPİTAL, Turkey
Ömer Aydem ̇r
MANİSA CELAL BAYAR UNIVERSITY, Turkey

Abstract
Stress is a ubiquitous aspect of human life, with individuals facing various challenges daily. Chronic social role relat-
ed stress plays a significant role in the development and progression of mental and medical disorders Despite the
knowledge about the effects of stress and social factors’ role on dynamic changes in human behavior, tools about
measuring social role stressors are limited and better scales to measure and follow social role stress is needed. Chronic
Stress Scale developed by Turner et al, was developed for this purpose, however due to its limited use in the literature,
it has bot been used in different cultures and countries. As social role related stressors can vary based on the commu-
nity attributed roles, it is important to assess its assessment in different countries. This study aims to assess chronic
social role-related stressors, focusing on the translation and validation of the Chronic Stress Scale (CSS) to Turkish and
describing the role of social role stressors on depression and anxiety.
Methods:
A total of 524 participants, including 260 from the general population and 264 with psychiatric diagnoses, were recruited
from Koç University Hospital and Basaksehir Cam Sakura Hospital (Mean age of 31.59 years, 68% women. Clinical group:
116 with depressive disorders, 148 with anxiety disorders. ). Inclusion criteria were ages 18-65, literacy, and primary edu-
cation. Exclusion criteria included bipolar disorder, schizophrenia spectrum disorders, dementia, head trauma, brain sur-
gery, intracranial lesions, and substance use disorders. The study involved translating the CSS into Turkish and validating
it through reliability and validity analyses, using Cronbach’s alpha, exploratory factor analysis, and correlations with the
Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Perceived Stress Scale (PSS-14).
Results:
The CSS demonstrated good internal consistency with a Cronbach’s alpha of 0.90. Exploratory factor analysis revealed
13 dimensions of chronic stress. These factors were partner-related stressors, children-related stressors, work-relat-
ed stressors, loneliness-related stressors, financial stressors, workload-related stressors, debt-related stressors, lack
of romantic relationship-related stressors, family health-related stressors, residence-related stressors, family-related

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stressors, ex-partner related stressors and a general factor. Convergent and divergent validity showed significant cor-
relations of CSS with BDI (r: 0.611, p < 0.001), BAI (r: 0.558, p < 0.001), and PSS-14 (r: 0.222, p < 0.001). The correlation of
CSS with BDI and BAI were significantly higher compared to PSS-14 scale. Discriminative validity indicated significant
differences in CSS, BDI, BAI, and PSS-14 scores between clinical and healthy populations.
Conclusion:
The Turkish version of the CSS is a reliable and valid instrument for assessing chronic social role-related stressors. This
tool can be effectively used in both clinical and general population settings to identify and address chronic stress,
contributing to better mental health outcomes. This tool can also be used as a measure to document social role
stressess during a therapy process and target the stress related to social role factors.

Keywords
stress, social role, depression, anxiety

PS36 Emotional Awareness and Expression Therapy for trauma in patients

with fibromyalgia: A qualitative approach to patient subjective experience
Elena Miró
University of Granada, Spain
M. Pilar Martinez
University of Granada, Spain
Ana Sánchez
University of Granada, Spain
Coralie Maire
University of Granada, Spain
Rafael Cáliz
Virgen de las Nieves Hospital, Spain

Abstract
Background and aims
Fibromyalgia (FM) is a chronic pain disorder characterized by widespread musculoskeletal pain, associated fatigue,
sleep disturbances, and other cognitive and somatic symptoms. It is classified as a central sensitization syndrome
(CSS), where a hyperreactive pain neuromatrix is ​​observed. CSS, such as fibromyalgia, have been linked to traumatic
experiences and symptoms of post-traumatic stress disorder (PTSD).
Treatment approaches for fibromyalgia have often overlooked the impact of unresolved trauma. Recently, Emotional
Awareness and Expression Therapy (EAET) has emerged as a promising approach, helping patients identify, under-
stand, and express trauma-related emotions, to reduce pain and improve overall functioning. Despite promising re-
sults of the few studies existing, much more research is needed to validate its effectiveness. Our team is conducting
a randomized controlled trial currently in progress combining psychoeducation, CBT and emotional awareness and
expression techniques. Before having the final results of the clinical trial, the objective of this work is to analyze some
clinical outcomes and the subjective experience of patients who have already completed the treatment.
Methods
This study consists of a qualitative analysis of the EAET component within an ongoing randomized controlled trial
The participants were referred from the Rheumatology Service of the Virgen de las Nieves University Hospital and re-
ceived evaluation and treatment at the Psychology Clinic of the University of Granada. The treatment consisted of 12
weekly sessions, each lasting 90 minutes, conducted both in groups and individually. The EAET techniques included
therapeutic writing supported by the therapist, and 1 to 3 individual sessions focused on emotional processing of a
patient-chosen topic.
Results
The sample included 36 women, mean age 55 ± 7.5 years, mostly married (97%) and with a low education level (61%).
55% were retired, unemployed, or on sick leave. 64% had been diagnosed with fibromyalgia for over 5 years, and the
mean pain intensity in the past week was 8 ± 1.35 (VAS 0-10). Trauma analysis showed that 25 women experienced
a severe (n=11) or extreme (n=14) stressful event. In 10 cases, this began in childhood or adolescence. Trauma was
single event in 8 cases, multiple in 3 cases, and repeated or ongoing in 15 cases. At the time, 20 women completed
therapy. Common trauma themes included domestic abuse, abandonment, neglect, and physical violence. Emotions
of loss, sadness, fear, anger, guilt, and shame were the most frequently addressed. After 1-3 sessions, 7 patients report
complete emotional processing, 6 patients report having deepened their understanding of the traumatic situation,
and 4 women enhanced their knowledge of FM and the mind-body relationship. The main clinical results of these
patients and an analysis of their subjective experience during therapy are presented.

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Conclusions
The preliminary clinical results and the subjective experience reported by the patients regarding overcoming the
trauma and its impact on the rest of the FM symptoms are promising. Possible mechanisms are suggested by which
post-traumatic stress symptoms and fibromyalgia could be connected.
Funding. This study was part of the I+D+i Project/aid PID2019–109612GB-I00, funded by MCIN/
AEI/10.13039/501100011033.

Keywords
Chronic pain; trauma; aproach to treatment; assessment

PS37 The impact of teenage bullying experiences on a person’s mental

well-being in adulthood
Ekaterina Kukshina
Association for Cognitive Behavioral Psychotherapy (Russia), Russian Federation

Abstract
Bullying exists across geographical boundaries and is highly damaging to a person’s mental health. The purpose of
the study was to determine the relationship between the experience of bullying during adolescence and the psy-
chological wellbeing of the individual later in adulthood and to understand if bullying has a detrimental effect on an
individual later in life, in terms of their mental health and wellbeing.
Among the countries where the issue of bullying is currently being actively addressed are Russia and the UK. Russia
was one of the top 10 countries in terms of bullying among children of both genders (Craig et al., 2009). Particularly in
the UK, a 2017 UK Department for Education regulation requires all schools to take legal action to prevent and tackle
bullying among pupils and to inform teachers, pupils and their parents about these measures (Arseneault, 2018). The
fact that the government is allocating money to tackle the last issue shows that the topic of bullying is relevant to
the UK. UK citizens and Russian citizens between the ages of 16 and 70 were invited to take part in a questionnaire
comprised of the Mental Health Continuum Short Form (MHC-SF) and the Child Adolescent Bullying Scale (CABS).
Participants completed the questionnaires electronically, via the Qualtrics platform. A total of 223 participants took
part in the study.
The results suggested that an increase in the level of bullying by one on average decreases the participant’s level of
mental health by 0,202. This hypothesis is consistent with past research in the field. Therefore, сhildren who have ex-
perienced bullying subsequently have higher levels of stress, tend to be mentally ill, have difficulties building relation-
ships in society and are prone to drug use, alcohol abuse and delinquency. The current research perfectly underscores
the idea that that bullying can have different types as well as lasting temporal effects, i.e. persisting over the years
(Arsenault et al., 2018). The study thus adds to the existing literature on the correlation between childhood bullying
experiences and their impact on mental health in adulthood.
The study has a number of strengths. Firstly, the MHC-SF and CABS scales were developed and validated in a number
of different countries. Secondly, the number of participants allowed a quantitative analysis of the data. Thirdly, the
study focused on two countries where resources are spent on this type of research. The limitation of the study is the
cross-sectional design which is an obstacle to the establishment of causal relations.
In the future, smaller sub-themes may be the focus of research on bullying. The topic of the relationship between
mental health and bullying is crucial to the development of anti-bullying programs and to identify the most problem-
atic aspects of bullying. The future research should also focus on developing and improving the quality of antibullying
programmes, using a variety of techniques from cognitive behavioural therapy.

Keywords
Bullying

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PS38 Examining the Relationship Between Psychological Mindedness and the

Big Five Personality Traits in Adults
Büşra Canan Çiçek
Social Sciences University of Ankara, Turkey
Sude Öykü Yıldırım
Social Sciences University of Ankara, Turkey
Esmanur Genel
Social Sciences University of Ankara, Turkey
Hilal Demir
Social Sciences University of Ankara, Turkey

Abstract
Psychological mindedness is a concept that includes the motivation and ability to understand and explain an in-
dividual’s behaviors, emotions and thoughts. This concept corresponds to concepts such as insight, introspection
and self-awareness. Five Factor Personality Theory defines personality with five main traits and sub-traits of these
traits: Extraversion, Agreeableness, Openness to Experience, Neuroticism and Conscientiousness. While psychological
mindedness involves noticing details and connections about an individual’s emotions, thoughts, and behaviors, the
Five-Factor Model of Personality is a widely used model to describe personality traits. This study aims to examine the
relationship between the subdimensions of the Five-Factor Personality Model and psychological mindedness. While
the hypotheses predict a correlation between psychological mindedness, positively correlated with Agreeableness
and negatively correlated with Neuroticism, no significant correlation is expected between the factors Extraversion,
Conscientiousness, and Openness to Experience. From 232 participants aged 18-65 whose native language is Turkish;
The data collected with Depression Anxiety and Stress Scale-21 (DASS-21), Psychological Mindedness Scale, Quick
Big Five Personality Test and demographic form were analyzed by data entry via SPSS. Participants scored highest on
Agreeableness (M = 5.38, SD = 1.13) and Openness to Experience (M = 5.06, SD = 1.10). The mean scores for Consci-
entiousness, Extraversion, and Neuroticism were 4.58 (SD = 1.27), 4.17 (SD = 1.31), and 3.95 (SD = 1.22), respectively.
Stress and Mindedness had mean scores of 1.93 (SD = 0.58) and 2.91 (SD = 0.32). Positive correlations were found be-
tween psychological mindedness and Agreeableness (r = .278, p < .01), Extraversion (r = .169, p = .01), and Openness
(r = .338, p < .01). No significant relationships were found with Neuroticism (r = -.119, p > .05), Conscientiousness (r =
.056, p > .05), or Stress (r = -.097, p > .05). these results contribute to our understanding of the connections between
psychological mindedness and personality, emphasizing the importance of agreeableness, extraversion, and open-
ness to experience. Further research is warranted to explore these relationships in more depth and to investigate the
potential mechanisms underlying these associations.

Keywords
psychological mindedness, neuroticism, extraversion, openness to experience, agreeableness, conscientiousness

PS39 Cognitive-behavioural therapy and the level of hope

in patients with schizophrenia
Agnieszka Olchowik
“Dialog” Therapy Centre, Poland
Joanna Marek-Banach
The Maria Grzegorzewska University, Poland
Beata Hintze
The Maria Grzegorzewska University, Poland

Abstract
Introduction
Schizophrenia significantly affects the patient’s functioning in all areas of life. The course of schizophrenia is often
associated with reduced functioning in the professional, family, and social spheres (Heszen and Sęk, 2020). Nowadays,
a distinction is made in schizophrenia between positive and negative symptoms. Accordingly, sufferers may need
professional care that is not only pharmacological but also psychological.
The APA, in its 2020 recommendations, recommends for adults experiencing schizophrenia pharmacological treat-
ment with antipsychotic drugs. The recommended psychotherapeutic interactions are mainly based on CBT and pay

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attention to psychoeducation, cognitive rehabilitation, and social skills training. In contrast, NICE’s 2014 recommen-
dations recommend a combination of family or individual CBT psychotherapy and pharmacological treatment as the
treatment of choice for adults experiencing a first episode of psychosis and subsequent acute episodes of psychosis
or worsening in schizophrenia.
Material and methods
The study used a battery of self-report tests with verified psychometric properties. People with schizophrenia - par-
ticipants of community self- help centres, the Patient’s Club and the Occupational Therapy Workshop in Poland - were
surveyed.
Results
The results of the study suggest that higher levels of hope increase the ability to share one’s difficulties with loved
ones. However, it is difficult to formulate conclusions regarding therapeutic indications due to the lack of a uniform
definition of hope and the few studies related to these issues. For the practice of psychology, it would be valuable to
develop research towards assessing factors that enable higher levels of these psychological variables in people with
schizophrenia.
The results of our own research indicate that people with schizophrenia who are participants in community self-help
homes receive the most emotional support, which is an important resource in coping with the disease. It is note-
worthy that there is a deficiency in the information support received, according to the subjects, which refers to the
exchange of information that promotes a better understanding of the situation, life situation, and problem. This type
of support also responds to the need to understand the meaning of stressful events and their causes, as well as the
attribution of causation (Sęk and Cieślak, 2024). As such, it appears to be an important element that can stimulate
hope and provide a greater sense of agency for this group of patients.
Conclusions
These results also suggest that psychoeducation should be an important element of support in community-based
forms of treatment for patients. The results obtained may provide valuable guidance in psychological work, especially
in therapy with people with schizophrenia, and in this regard, cognitive-behavioural therapy, including metacognitive
training, psychoeducational interactions about the disease, its symptoms, causes, and learning to recognise relapses
and how to deal with them appropriately, seems to be an important part of working with people with schizophrenia.
Conducting further research on the relationship between hope and the support received could help establish guide-
lines for professionals working with people with schizophrenia, which could help improve functioning.

Keywords
cognitive-behavioural therapy, psychoeducation, hope, social support

PS40 Challenges that RE&CBT trainees encounter in the process

of becoming psychotherapists
Danijela S. Petrović
Department of Psychology, Faculty of Philosophy, University of Belgrade, Serbia
Marko Nikolić
Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
Milana Prebudjila
HR business partner at DTS, Belgrade, Serbia, Serbia

Abstract
Introduction. Trainees in Rational Emotive & Cognitive Behavioral Therapy (RE&CBT) face various challenges as they
work towards becoming competent psychotherapists. These challenges often involve mastering complex theoretical
concepts; bridging the gap between theoretical knowledge and practical application; becoming proficient in apply-
ing a variety of cognitive, behavioral and emotive techniques; building and maintaining a therapeutic relationship
with clients; dealing with ethical issues, confronting their own irrational beliefs and biases, etc. Supervision is a critical
component of training for RE&CBT. It provides a structured and supportive environment where trainees can develop
their skills, integrate theoretical knowledge with practice, and grow professionally and personally. Trainees may find
it difficult to accept and integrate critical feedback from supervisors without feeling discouraged or defensive. Addi-
tionally, balancing training with other responsibilities such as jobs and family or managing the financial requirement
of training can be stressful for RE&CBT trainees. Objective. The aim of this study is to explore how RE&CBT trainees
perceive the importance of various challenges that they encounter during supervision and psychotherapy work with
clients. Method. RE&CBT trainees (n = 55) completed an online questionnaire aimed at identifying challenges encoun-
tered during their educational process. The questionnaire was designed specifically for this study and encompassed

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assessing challenges related to therapist skills, completing educational requirements, and addressing technical ob-
stacles (e.g. client acquisition). Results. Regarding therapy skills, the greatest challenge lies in the ability to structure
therapy sessions. As much as 56% trainees face moderate to high difficulties in maintaining a focus on a single prob-
lem/goal within a session (51% encounter this issue across multiple sessions). Difficulties in structuring the sessions
also occur in initiating by reviewing the previous homework task(s) and concluding with an agreement on future
homework task(s) (40%). One of the challenges involves exploring resistances when clients do not complete home-
work activities (35%). Trainees also struggle to achieve the optimal level of directiveness (40%). The greatest challeng-
es concerning educational requirements are selecting material for individual supervision sessions (60%), finding time
for additional literature reading (55%), and preparing case studies (47%). Other notable difficulties involve balancing
education with professional (73%) and family (53%) obligations, securing funds for education expenses (65%) and
personal therapy (49%). Trainees face challenges in acquiring new clients (49%) and finding certified RE&CBT thera-
pists for personal therapy (38%). Conclusions. Although the results were obtained on a relatively small and convenient
sample, they are significant because they provide an insight into the perspective of trainees, and point to some possi-
ble directions for improving the education process. For example, emphasizing the significance of structuring sessions
in RE&CBT therapy and providing additional assistance to trainees in cultivating the necessary skills to accomplish the
needed structure. It is important to reiterate the importance of homework assignments and the necessity to explore
the reasons why clients may have failed to complete them. Trainees could benefit from examples which illustrate dif-
ferent levels of directiveness and their outcomes. Some of the issues could be ameliorated by creating a directory of
certified RE&CBT therapists and negotiating discounted rates for trainees.

Keywords
Training, supervision, professional development, challenges, CBT

PS41 Who’s at Risk? Key Predictors and Prevalence among Youth at the “MoSt”
Support Center in Croatia
Amalija Hrepić Gruić
Udruga MoSt, Croatia
Janina Pavić Jadrić
Psychology Center Terra, Croatia

Abstract
According to some studies, the prevalence of anxiety disorders in children ranges from 10% to 20% (UNICEF, 2021).
They are represented in both sexes, although they are more common in girls and occur more frequently after the age
of six (Poljak & Begić, 2016). The MoSt Association’s Support Center for Children and Youth with Behavioral Problems
is designed as an intervention that includes individual counseling, individual psychosocial counseling, treatment
groups, leisure activities, work-occupational workshops, and learning assistance activities for children and youth with
behavioral problems. The sample consisted of 28 children (50% girls) aged 10 to 18, with an average age of 14.32
(SD=2.056), who participated in activities at the Support Center. Children included in the sample reported external-
izing (28.6%) and internalizing (71.4%) symptoms. The research included the results of respondents who completed
the Fear and Anxiety Scale for Children and Adolescents (SKAD-62; Vulić-Prtorić, 2004) from 2016 to 2024. The study
aimed to examine the prevalence of anxiety symptoms in adolescents and predictors of somatization. The results of
the study show a high level of worry, moderate levels of performance, and social anxiety symptoms, as well as ob-
sessive-compulsive symptoms, low levels of separation anxiety, and anxiety sensitivity/panic attacks/agoraphobia.
Additionally, significant predictors of somatization in this study were female gender, older age, performance and
social anxiety, anxiety sensitivity/panic attacks/agoraphobia, and worry. No differences in the severity of the symp-
toms investigated were found in children and adolescents before and after the COVID-19 pandemic. The results were
discussed within the framework of the biopsychosocial health model.

Keywords
anxiety, somatization, children, adolescents

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PS42 Psychotherapists’ attitudes towards treatment outcome measures and

the relationship between these attitudes and professional self-doubt
Branka Mlinar
Private practice, Serbia

Abstract
Psychotherapists mostly rely on unstructured diagnostic interviews and their clinical judgement when assessing and
monitoring clients. Research data shows discrepancies between the conclusions obtained through unstructured in-
terviews and those obtained through standardized questionnaires. Additionally, data points to psychotherapists’ ten-
dencies to overestimate their efficacy, and to underestimate the number of clients whose state deteriorates and of
those that don’t show any progress. Routine administration of self-report measures has been shown to both reduce
therapists’ self-assessment bias and to lead to more favorable therapeutic outcomes.
The purpose of this study was to determine the attitudes of Serbian psychotherapists towards treatment outcome
measures. The differences in these attitudes regarding ones psychotherapy orientation, level of psychotherapy ed-
ucation and professional background was also examined, as was the connection of said attitudes with professional
self-doubt and general self-efficacy.
The sample consisted of 125 psychotherapists, certified and uncertified, between 25 and 63 years of age, with 0 to
30 years of experience. The sample included 95 psychologists and 30 members of other professions (pedagogues,
general practitioners, and others), and it consisted of therapists of various orientations, with the majority being CBT
and Gestalt oriented therapists.
The research was conducted online, using a questionnaire for the collection of selected professional and sociodemo-
graphic data, Outcome Measure Questionnaire – OMQ, Professional Self-Doubt - PSD scale and a General Self-Efficacy
scale – GSE. All four questionnaires were combined into a single online form.
The results show that Serbian psychotherapists have positive attitudes towards outcome measures, similar to those
recorded in samples in other countries. Most therapists are familiar with outcome measures, but don’t have experi-
ence using them. Although outcome measures seem to be perceived as useful tools for improving certain elements
of treatment, respondents also expressed doubts related to their comprehensiveness and relevance, as well as some
hesitation regarding their implementation. CBT therapists have more experience with the use of measures as well
as a more positive attitude towards them, compared to psychotherapists of other orientations. More experienced
therapists have less favorable attitudes towards outcome measures. Therapists that score higher on self-efficacy show
more positive attitudes towards outcome measures.

Keywords
psychotherapy, outcome measures, attitudes, treatment evaluation, clients progress, general self-efficacy, profession-
al self-doubt

PS43 Effectiveness and Uptake of a Transdiagnostic Emotion Regulation

Mobile Intervention among University Students:
A Superiority Randomized Controlled Trial
Tajda Laure
Erasmus University Rotterdam, Netherlands
Marilisa Boffo
Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Netherlands
Rutger CME Engels
Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Netherlands
Danielle Remmerswaal
Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Netherlands

Abstract
Background and Objectives: The transition to university can be stressful and negatively impact mental health. How-
ever, it also provides an opportunity to lay the groundwork for positive life trajectories. Emotion regulation (ER), a key
factor underlying various mental health issues, is crucial for students, a group particularly vulnerable to mental health
problems. A mobile transdiagnostic (ER) intervention has been developed to support university students, offering
universal and targeted preventative support. It includes 26 ER exercises rooted in a variety of therapeutic approaches,

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including ACT, CBT, Positive Psychology, Mindfulness, and Self-Compassion so that (almost) every student can find
exercises that suit them. The exercises include transfer elements (i.e., tools for applying ER techniques in real-life
settings), a self-assessment module, a mood tracker, and an intelligent recommendation system tailoring exercises to
users’ needs and preferences. This study aims to evaluate the impact of the mobile intervention on students’ distress
levels, ER skills, resilience, and user engagement with the intervention.
Methods: This superiority parallel-group RCT involved 208 participants randomized to either the intervention group
(full access to the mobile intervention, n = 104) or a waitlist control group (n = 104). Primary outcomes included ER
skills and stress symptoms. Secondary outcomes encompassed mental health parameters (anxiety, depression), resil-
ience, and intervention uptake (engagement, and real-life application of ER skills). Assessments occurred at baseline
and weeks 3, 8, and 12, with continuous log-data collection for user engagement.
Discussion: The study began on February 5th and n = 140 participants completed the last follow-up. We expect the
intervention group to report improved ER skills and reduced distress compared to the waitlist group. As users become
proficient in the skills, real-life application will increase, leading to decreased app usage, with the app used mainly for
additional support or refreshing techniques. This study will validate our intervention approach and show if focusing
on learning transfer and personalisation enhances the real-world application of skills and intervention impact.

Keywords
Mobile intervention, Transdiagnostic approach, Mental health, Emotion regulation, University students, Randomized
controlled trial

PS44 Intolerance of Uncertainty and Resilience as Pathways from Adverse

Childhood Experiences to Psychopathology in Emerging Adults
Vida Vasilj Perković
Croatian Association for Behavioral and Cognitive Therapy, Croatia
Iva Matijašić Lončarević
Croatian Association for Behavioral and Cognitive Therapy, Croatia

Abstract
Background:
Adverse childhood experiences (ACEs) are defined as stressful and potentially traumatic events that occur before the
age of 18, which can have lasting negative effects on health and well-being. Numerous studies have examined the
relationship between exposure to ACEs and later physical and mental health, concluding that ACEs can negatively
affect both. However, the mechanisms underlying this relationship remain unclear. This study is part of a broader
project aimed at validating the Adverse Childhood Experiences Questionnaire in a Croatian sample. The aim of this
study is to explore the mediating roles of intolerance of uncertainty and resilience in the relationship between the
extent of adverse childhood experiences and levels of psychopathology (anxiety, depression, and stress) in emerging
adulthood. Additionally, the study compares the mediating effects of these potential mediators.
Methodology:
The research was conducted via the online platform SurveyMonkey, with a sample of 287 participants aged 18 to 29
years (emerging adults). Participants were recruited by psychology students based on specific criteria, ensuring equal
gender distribution and education level. The participants completed the following instruments: Adverse Childhood
Experiences Questionnaire, the Depression, Anxiety, and Stress Scales (DASS), the Intolerance of Uncertainty Scale,
and the Brief Resilience Scale.
Results:
The results indicated significant associations between the extent of adverse childhood experiences and levels of anx-
iety, depression, and stress in emerging adulthood. Intolerance of uncertainty and resilience were statistically signifi-
cant mediators. Higher levels of adverse experiences were associated with greater intolerance of uncertainty, which in
turn was linked to higher levels of stress, anxiety, and depression. When resilience was the mediator, higher levels of
adverse experiences predicted lower resilience, which then predicted higher levels of psychopathology. Comparisons
of the indirect effects revealed that intolerance of uncertainty was a stronger mediator than resilience across all three
associations.
Limitations:
As a cross-sectional study, causal relationships between variables cannot be inferred. Additionally, various other po-
tential mechanisms may influence these associations. Future research, particularly longitudinal studies, is needed to
further elucidate the complex relationship between early adverse experiences and later mental health outcomes.
Conclusion:
This study highlights the importance of understanding the link between adverse childhood experiences and levels
of psychopathology in early adulthood. The validated Adverse Childhood Experiences Questionnaire allows for more

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accurate identification of individuals at high risk for anxiety, depression, and stress. Individualized therapeutic plans
and early identification of high-risk individuals enable timely interventions. Enhancing resilience and tolerance of
uncertainty through tailored cognitive-behavioral strategies can potentially reduce symptoms of anxiety, stress, and
depression.

Keywords
adverse childhood experiences, anxiety, depression, stress, intolerance of uncertainty, resilience

PS45 Understanding the Role of Education in the Link Between Psychological

Flexibility and Religiosity: A Focus on Values and Acceptance
Asude Zeynep Erbay
Ibn Haldun University, Turkey
Saliha B. Selman
Ibn Haldun University, Turkey

Abstract
This study examines the association between psychological flexibility—specifically acceptance and value alignment—
and the centrality of religiosity. Previous research has linked psychological well-being with spirituality and religiosity
(Koenig, 2019), but the role of religiosity in specific components of psychological flexibility remains unexplored. A to-
tal of 183 participants (M = 27, 90% female) completed an electronic survey that included the Psychological Flexibility
Scale and the Centrality of Religiosity Scale, alongside demographic questions. Two multiple linear regression analy-
ses were conducted, controlling for key demographic variables such as gender, age, economic level, and education.
The first regression model was not significant, F(6, 176) = 1.87, p = .08, explaining 3% of the variance, with no signifi-
cant link found between religiosity and acceptance (β = .14, p = .07). After splitting the data based on education level,
religiosity was significant for participants with a university education (β = 1.13, p = .05) but not for those with less than
a university education (β = 2.44, p = .09). The second model, however, was significant, F(6, 176) = 5.46, p < .001, explain-
ing 13% of the variance, showing a significant association between religiosity and value alignment (β = .37, p < .001).
After splitting the data based on education level, religiosity was significant for participants with a university education
(β = 3.58, p < .001) but not for those with less than a university education (β = -2.47, p = .41). While religiosity did not
significantly predict acceptance, it was significantly associated with value alignment, indicating that individuals with
higher religiosity tend to align their behaviors with their personal values. Education played a crucial role, with religi-
osity predicting both acceptance and value alignment for university-educated participants but not for those with less
education. This suggests that higher education levels may enhance the integration of religiosity and psychological
flexibility, particularly in aligning personal values, possibly due to greater cognitive complexity or critical thinking
skills. These findings highlight the potential for well-being interventions to focus on culturally sensitive value align-
ment, especially for those with higher education levels. Future research should further explore these intersections to
develop more tailored and effective interventions for promoting well-being across different demographic groups.

Keywords
Keywords: psychological flexibility, religiosity, value alignment, acceptance, education level

PS46 Integrating Religion/Spirituality into Psychotherapy Practice

Jelena Kostić
Serbia
Marija Grunauer
Serbia
Adrijana Marković
Serbia
Ljiljana Plavšić
Serbia

Abstract
Introduction and objectives: In the ever-evolving landscape of mental health treatment, the incorporation of religion
and spirituality (R/S) into psychotherapy has emerged as a topic of significant interest and debate. As individuals seek

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holistic approaches to healing, understanding the perspectives of psychotherapists on the relevance and integration
of these aspects becomes very important. Conducted survey aims to explore the perspectives of RE&CBT psychother-
apists (both certified and in training) in Serbia on the integration of R/S into psychotherapy practice. The survey seeks
to understand the opinions of psychotherapists regarding how incorporating these aspects can potentially benefit or
hinder therapeutic outcomes. Additionally, the aim is to investigate the extent of knowledge and training that psy-
chotherapists believe is necessary to effectively incorporate R/S into psychotherapy practice.
Method: For this purpose, online questionnaire survey was conducted among RE&CBT psychotherapists (both certi-
fied and in training) in Serbia. The questionnaire comprised three sections: psychotherapists’ views towards R/S, their
attitudes about the importance of having knowledge in the field of R/S and attitudes about introducing elements of
R/S into psychotherapy practice.
Results: According to preliminary results 85% of survey participants think that R/S can play a significant role in mental
health and well-being. If they thought it could be useful for the client, as well as if they possessed enough necessary
knowledge, 75% would include elements of R/S in their therapeutic practice. At the same time, 66% of survey partici-
pants believe that they do not have enough knowledge and skills to include R/S in their psychotherapy practice, and
90% of respondents think that training and education about cultural and religious diversity is important for therapists
who incorporate R/S into therapy. Among our sample, only 14% of the respondents have participated in specific
training or education to improve their knowledge of incorporating R/S into psychotherapy, and only 3% received for-
mal training in the field. Incorporating R/S into therapy is believed to be beneficial for clients by 73% of respondents.
Opinions about the benefits and hinders of introducing R/S into the psychotherapy process are almost divided, 60%
think that the benefits outweigh the hinders, up to 40% that think the opposite.
Final and more detailed results will be presented at the conference.
Conclusions: The insights gathered from this survey could provide valuable information on the current attitudes of
RE&CBT psychotherapists towards integration of R/S into psychotherapy practice and highlight the required knowl-
edge, skills and additional educational programmes needed for successful implementation.

Keywords
religion, spirituality, psychotherapy, psychotherapist, REBT, CBT

PS47 Low-intensity mindfulness-based smartphone interventions to improve

self-compassion in working women: a randomized controlled trial
Mai Sugie
The University of Tokyo, Japan
Riko Uwagawa
The University of Tokyo, Japan
Koichiro Adachi
The University of Tokyo, Japan
Mariko Shimoda
The University of Tokyo, Japan
Kohki Kaji
The University of Tokyo, Japan
Yukari Kimura
The University of Tokyo, Japan
Takumu Kurosawa
The University of Tokyo, Japan
Ryu Takizawa
The University of Tokyo, Japan

Abstract
Objectives
Mindfulness is defined as the awareness that emerges through paying attention on purpose, in the present moment,
and nonjudgmentally to the unfolding of experience moment by moment (Kabat-zinn, 2003). Golden et al. (2021)
indicated that self-compassion has been implicated as one of the processes of change in mindfulness-based pro-
grams (MBPs). Self-compassion is defined as the recognition that suffering, failure, and inadequacies are inherent
in the human experience and that everyone, including oneself, deserves compassion (Neff, 2003). It has also been
connected to a range of beneficial mental health outcomes (Kirby et al., 2017). Golden et al. (2021) reviewed the evi-
dence for the effect of MBPs on self-compassion and suggested that MBPs can increase self-compassion in nonclinical
populations. However, recent studies have shown barriers to participation in such programs (Bégin et al., 2022). A

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lot of programs ask participants to engage in a group session of several hours and to meditate for quite a long time
each day, for the duration of the program (Neff & Germer, 2013). These general face-to-face mindfulness programs
are too burdensome, especially for working women with the stress of the dual role of balancing family and work. The
use of digital technologies such as smartphone applications and web-based platforms is a way of overcoming these
obstacles. Mrazek et al. (2019) indicate digital mindfulness-based interventions could potentially be more accessible
due to their low cost, flexibility, and availability from anywhere and anytime. Golden et al. (2021) report only one app
study and further empirical studies using applications are required. Therefore, the current study examined whether
an 8-week mindfulness-based meditation intervention using a smartphone app would improve self-compassion in
working women.
Methods
209 healthy working women (mean age ± SD 36.8 ± 10.7) fulfilling the conditions were included in the study. The SCS
(Self-Compassion Scale; Raes et al., 2011; Arimitsu et al.,2016) was measured before and after the 8-week intervention.
Participants were randomly assigned to either a mindfulness group (N = 105) or a waitlist group (N = 104). The study
was approved by the Life Science Research Ethics and Safety, the University of Tokyo (reference number: 23-144, 23-
227, 24-020) and registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry
(UMIN000051796).
Results
150 participants who responded to both the pre-assessment and post-assessment were included in the analysis. AN-
COVA was carried out to determine the effects of intervention, controlling for baseline values. There was a significant
intervention effect on SCS (b = 1.60, p = .05) .
Conclusion
The 8-week mindfulness intervention using our smartphone app improved the self-compassion in Japanese healthy
working women. Future research of low-intensity intervention needs to replicate the findings in other samples and
examine the underlying mechanism. It is also necessary to examine how improvements in self-compassion through
meditation interventions are related to other mental health factors. (This study was supported by JP19K03278,
22H01091, 22K18582, AL150003, and JPMJSP2108)

Keywords
mindfulness, self-compassion, online intervention, randomized controlled trial (RCT)

PS48 The Mediating Role of Trait Mindfulness in Academic Stress: A Cross-

Sectional Study Among Italian University Students
Alessandro Ocera
Department of Psychology, Sigmund Freud University, Milan, Italy
Sofia Colombo, Department of Psychology, Sigmund Freud University, Milan, Italy
Sonia de Paz-Cantos
Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacio-
nal de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
Antonella Frisiello
LINKS Foundation, Italy
Silvia Gilotta
Adequat s.r.l., Italy
Silvia Grazioli
Artificial Intelligence and Data Analysis Lab, Metacognitive Therapy Lab, Department of Psychology, Sigmund Freud
University, Milan, Italy; Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy
Giovanni Michelini
Department of Psychology, Sigmund Freud University, Milan, Italy
Antonella Roella
Independent senior UX researcher, Italy
Regina Gregori Grgič
Department of Psychology, Sigmund Freud University, Milan, Italy

Abstract
Background: Stress can be the most predominant factor influencing the mental well-being of students, yet mindful-
ness strategies have proven effective in reducing academic stress. Nevertheless, there is a limited body of research
investigating stress and trait mindfulness in a sample of Italian university students. This study aimed to explore the
relationship between academic stress, effort-reward imbalance and trait mindfulness.

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Methods: Perceived stress, effort-reward imbalance, and trait mindfulness in 442 Italian university students (mean age
= 23.37 ± 4.33) were assessed through the Perceived Stress Scale (PSS), Effort-Reward Imbalance – Student Question-
naire (ERI-SQ) and Five Facet Mindfulness Questionnaire (FFMQ).
Results: Pearson correlation analysis showed that PSS negatively correlates with FFMQ, positively correlates with ERI-
SQ, and that FFMQ negatively correlates with ERI-SQ. Furthermore, mediation analysis revealed that FFMQ facets
partially mediates the effect of ERI-SQ on PSS.
Conclusions: This is the first study to examine the relationship between PSS, ERI-SQ, and FFMQ in Italian university
students. These preliminary findings suggest potential clinical and therapeutic relevance of these factors, especially
in relation to MCBT. To a broader extent, it provides insights into how trait mindfulness mediates academic stress,
which could influence policymakers, health experts and academic institutions in developing targeted interventions
to enhance student well-being.

Keywords
Academic Stress; Effort-Reward Imbalance, Mindfulness; Trait mindfulness; Mindfulness Based Cognitive Behavioral
Therapy (MBCBT)

PS49 Effectiveness of Cognitive Behavioral Group Therapy in the Treatment of

Somatic Symptom Disorder: A Systematic Review
Büşra Kahraman
İzmir Katip Çelebi University, Turkey
Seda Tokgünaydin Aritürk
İzmir Katip Çelebi University, Turkey

Abstract
This study aimed to review the effectiveness of the treatment in experimental studies applying cognitive behavioral
group therapy in the treatment of somatic symptom disorder. For this purpose, English and Turkish articles published
at all times in Wiley Online Library, PubMed, EBSCOhost, YÖK Tez and ULAKBİM databases were scanned and studies
conducted between 1997-2023 were accessed. A German study published in the search was also found and includ-
ed in the study. Studies that were not completed as a result of the screening, those that did not include group CBT
intervention, those that did not apply the intervention to adult groups, and those that did not have an effectiveness
study were not included. 10 studies that met the inclusion criteria were compared in terms of the methods used and
the applications performed. As a result, cognitive behavioral group therapy in the treatment of somatic symptom
disorder has been shown to be effective in reducing the symptoms of both the disorder and accompanying disorders
such as depression and anxiety.

Keywords
somatic symptom disorder, cognitive behavioral therapy, group therapy

PS50 An integrative approach of help-seeking attitudes in a sexual minority

sample. The role of self concealment.
Alexandra Tulcan
West University of Timisoara, Romania
Mona Vintilă
West University of Timisoara, Romania
Andrei Rusu
West University of Timisoara, Romania

Abstract
This paper focuses on the construct of self-concealment, the active concealment from others of personal informa-
tion related to sexual identity or sexual orientation that one perceives as negative or distressing based on previous
meta-analysis identified. We propose a working model for the psychology of SC and the mechanisms of action for its
effects on well-being and how self-concealment could influence the adressability to professionel help among sexual
minorities. A dual-motive conflict between urges to conceal and reveal is seen to play a central role in these health ef-

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fects. The main results we expected for are that Self-Concealment can affect both, mental and physical health through
maladaptive emotion regulation processes which in turn affects the intention to seek for professionel help. We hy-
pothesize that high levels of SC increase dysfunctional emotion regulation processes. These, in turn, affect health
through direct and indirect pathways, including inauthentic behaviors and reduced social well-being. Although it is
too early to draw any solid conclusions from intercultural studies, researchers note the relevance of SC for Asian cul-
ture and psychology (e.g., Masuda & Boone, 2011), and the possibility that SC may be less injurious in certain cultural
groups (Constantine, Okazaki, & Utsey, 2004). Finally, initial findings (e.g., Mohr & Kendra, 2011; Pachankis & Goldfried,
2010; Potoczniak, Aldea, & DeBlaere, 2007) suggest a valuable role for SC in the study of LGBT persons and others
with concealable stigmatized identities. Future research can investigate the validity of this working model, examine
how SC produces negative health effects, and test predictions based on our dual-motive conflict theory. Longitudinal
studies may reveal whether SC levels change throughout the lifespan, particularly in response to negative life events
or varying social constraints.

Keywords
self-concealment, secrets, suppression, mindfulness, help seeking

PS51 Effects of the 8-week app-based mindfulness interventions on trait

anger in working women: A randomized controlled trial
Riko Uwagawa
The University of Tokyo, Japan
Koichiro Adachi
The University of Tokyo, Japan
Mariko Shimoda
The University of Tokyo, Japan
Mai Sugie
The University of Tokyo, Japan
Kohki Kaji
The University of Tokyo, Japan
Yukari Kimura
The University of Tokyo, Japan
Ryu Takizawa
The University of Tokyo, Japan

Abstract
Objectives:
According to the American Psychological Association (2023), women have higher stress levels than men and tend
to have more difficulty coping with them. Furthermore, in working women, the stress of the dual role of balancing
family and work has a negative impact on their physical and mental health (Poms et al., 2016). Since psychological
distress is one of the causes of angry feelings in daily life (Kashdan et al., 2016) and anger have been shown to predict
child abuse (Hien et al., 2010), preventive interventions that reduce anger in working women not only improve their
own wellbeing but also help to improve the mental health of the next generation. This study focused on mindfulness
meditation. Mindfulness-based interventions have been shown to be effective on depression, anxiety, and perceived
stress (Khoury et al., 2015; Galante et al., 2021). However, the effects of mindfulness interventions on anger are incon-
sistent. While the effects of mindfulness interventions on state anger have been shown (Xu et al., 2016; Bergman et
al., 2016), few studies have examined the effects on trait anger (the tendency to experience intense feelings of anger)
and the two subfactors for this trait anger (temperament and reaction). In addition, general face-to-face mindfulness
programs are too burdensome for healthy workers to implement for mental health prevention. Therefore, we used a
smartphone application to enhance accessibility. This study examined whether mindfulness meditation can improve
trait anger in working women.
Methods:
209 healthy working women (mean age ± SD 36.9 ± 10.8) fulfilling the conditions were included in the study. “Trait an-
ger (T-Ang),” the subscale of the State-Trait anger expression inventory (STAXI-2; Spielberger, 1999; Mine & Ohki, 2001;
Mine & Sato, 2005) was measured before and after the 8-week intervention to assess traits anger reaction. T-Ang has 2
subfactors: T-Ang/Temperament (T-Ang/T; trait of feeling anger with or without stimulus) and T-Ang/Reaction (T-An-
g/R; frequency of experiencing feelings of anger in situations involving irritation or negative evaluation). Participants
were randomly assigned to either a mindfulness group (N = 105) or a waitlist group (N = 104). The study was approved
by the Life Science Research Ethics and Safety, the University of Tokyo (reference number: 23-144, 23-227, 24-020) and

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registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN000051796).
Results:
192 participants who responded to both the pre-assessment and post-assessment were included in the analysis.
Both ANCOVA (A)controlling for baseline values and (B)controlling for baseline values and demographic data (age,
employment status, psychiatric history, education, and marital status) were revealed that significant group effect on
Trait Anger/R (A: b = -0.59, p = .04; B: b = -0.75, p = .012).
Conclusion:
The 8-week mindfulness intervention reduced reactive anger in Japanese healthy working women. Future research
should examine the mechanism of the effect to increase the effectiveness of the intervention and develop interven-
tions to manage angry temperament. (This study was supported by JP19K03278, 22H01091, 22K18582, AL150003,
and JST SPRING, Grant Number JPMJSP2108)

Keywords
mindfulness, randomized controlled trial (RCT), mental health

PS52 Metacognitive therapy of an adolescent with major

depressive disorder – a case report
Nejra Capin
Private practice, Bosnia and Herzegovina

Abstract
This case report delves into the implementation of metacognitive therapy as an intervention for the adolescent diag-
nosed with depression. Metacognitive therapy targets metacognitive processes and regulatory strategies, and diverges
from traditional cognitive therapies by focusing on cognitive processes rather than content. The subject of this study, a
16-year-old male, exhibited symptoms consistent with major depressive disorder, including pervasive sadness, anhedo-
nia and feeling of despondency. Through a series of structured metacognitive therapy sessions, the therapist engaged
the adolescent in identifying and challenging dysfunctional cognitive processes underlying his depressive state.
The therapeutic intervention aimed to enhance the adolescent’s metacognitive awareness and control over rumina-
tion and worry, as well as other maladaptive cognitive strategies that perpetuated his depressive symptoms. The ses-
sions involved psychoeducation, metacognitive restructuring, attention training techniques, detached mindfulness
and behavioural experiments tailored to the individual’s cognitive profile. Throughout the course of treatment, the
adolescent demonstrated improvements in his mood, cognitive flexibility and overall functioning, as evidenced by
standardized assessments and clinical observations (BAI, BDI, MMPI-A, MDD-S).
This case report underscores the potential efficacy of metacognitive therapy as a targeted intervention for adolescent
depression, shedding light on the importance of addressing underlying cognitive processes in addition to symptom
reduction. The findings contribute to the growing body of literature supporting the utility of metacognitive therapy
in the treatment of depression among adolescents, emphasizing the need for further research and clinical exploration
in this area.

Keywords
metacognitive therapy, adolescent, major depressive disorder

PS54 The Role of Reinforcement in Cognitive Behavioral Therapy

for Chronic Pain
Helena Bieniek
Jagiellonian University, Institute of Psychology, Pain Research Group, Poland
Przemysław Bąbel
Jagiellonian University, Institute of Psychology, Pain Research Group, Poland

Abstract
The aim of this poster is to illustrate the role of operant conditioning in chronic pain therapy and the regulation of
pain-related behaviors, as well as to identify ways in which an approach based on operant conditioning can enhance
the effectiveness of cognitive-behavioral therapy (CBT) in pain treatment.
Cognitive-behavioral therapy is a method successfully used in the treatment of chronic pain, offering patients a range
of techniques to help cope with and alleviate pain (Niknejad et al., 2018). This approach considers the influence of

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psychosocial and behavioral factors on the experience, maintenance, and intensification of pain (Bao et al., 2022).
Operant conditioning principles are widely used in chronic pain therapy, and their effectiveness has been confirmed
by scientific research (Gatzounis, 2016). Consequences (in the form of positive and negative reinforcements), such as
attention received from loved ones or withdrawal from unpleasant activities, can reinforce pain behaviors and thus
affect the pain experience itself (Fordyce, 1976). The goal of behavioral therapy is to reduce the frequency of undesir-
able behaviors and increase those that are beneficial from the patient’s well-being perspective.
To illustrate the impact of reinforcements on pain modulation, experimental research findings on the influence of var-
ious types of reinforcements on the intensity of perceived pain will be presented on the poster (Adamczyk et al., 2019;
Bieniek & Bąbel, 2023). These findings indicate that the type of reinforcer matters, with social reinforcers seeming to
have the strongest influence on pain (Bieniek & Bąbel, 2023).
Effective pain therapy is crucial for improving patients’ quality of life. By incorporating principles of operant condi-
tioning, cognitive-behavioral therapists can enrich their therapeutic repertoire, offering more comprehensive and
effective pain management strategies.

Keywords
pain therapy, operant conditioning, reinforcement, chronic pain

PS55 Gender-Specific Pathways from Childhood Experiences

to Adult Mental Health
Mariia Vabulnik
The University of Tokyo, Japan
Makiko Hibi
The University of Tokyo, Japan
Mariko Shimoda
The University of Tokyo, Japan
Yukari Kimura
The University of Tokyo, Japan
Yumika Aoki
The University of Tokyo, Japan
Takumu Kurosawa
The University of Tokyo, Japan
Ryu Takizawa
The University of Tokyo, Japan

Abstract
Introduction:
Childhood adversity, encompassing a wide range of stressful and traumatic experiences (ACEs), is a recognized public
health concern with demonstrably negative consequences for long-term mental and physical well-being (Armitage,
2021). Research consistently links exposure to ACEs to a heightened risk of developing mental health problems in
adulthood (Kessler et al., 2010).
However, whether the long-term impact of ACEs is uniform remains unclear. Growing evidence suggests that protec-
tive and compensatory experiences (PACEs) during childhood can buffer the negative effects of adversity, promoting
resilience and fostering positive mental health outcomes (Masten, 2007). These PACEs encompass a variety of factors,
including strong social connections with family and friends, positive role models outside the home, and opportunities
for participation in enriching activities.
Specifically, research suggests that males and females may respond differently to adversity and may benefit from
distinct protective factors (Sun & Steward, 2012). This study aims to address this gap by investigating the influence of
various ACEs and PACEs on adult psychological distress between genders, considering the potential role of adverse
experiences.
Method:
A longitudinal study with data collected every three months, including demographics and Adverse Childhood Expe-
riences (ACEs; Felitti et al.,1998) at wave 1, Protective and Compensatory Experiences Scale (PACEs; Morris et al., 2018)
and Kessler Psychological Distress Scale (Kessler et al., 2002; K6 >12) at wave 2. The final sample included 2420 partic-
ipants (1472 females, 948 males; mean age 36.25 ± 8.52). The study protocol was approved by the ethics committee
at the University of Tokyo (No. 23-476). To identify patterns within the complex dataset, we leveraged a supervised
machine learning approach with a Logistic Regression algorithm, for each gender.
Results:
Results indicated gender-specific patterns toward adult mental health, with distinct predictors for males and females.
For females, unconditional love (p=.011, OR=.597) and having an intimate friend (p=.001, OR=.551) significantly im-

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pacted future psychological health, while sports-related activity (p=.008, OR=.662) was prominent for males. The
presence of a non-parent significant adult (p=.015, OR=.674) emerged as important for both genders. Unexpectedly,
helping others or volunteering was associated with increased psychological distress in males (p=.008, OR=2.261) .
Bullying experiences, both as a victim (p=.002, OR=1.607) and perpetrator (p=.043, OR=1.366), were significant only
in males, whereas psychological abuse (p=.009, OR=1.632), sexual abuse (p=.026, OR=1.441), lack of attachment
(p=.048, OR=1.431), and early alcohol-related household disfunction (p=.013, OR=1.783) were prevalent for females.
Conclusion:
The significant role of positive social connections in childhood is well-supported by existing research (Steward &
Sun, 2004). However, this study aligns with emerging research suggesting that males and females may navigate ad-
versity and build resilience through distinct pathways. The good model fit (p= .942) suggests promise for utilizing a
gender-specific approach in risk assessment for adult mental health problems. By accounting for the unique vulner-
abilities and protective factors associated with each sex, we can develop more accurate assessments and tailor pre-
ventative and treatment strategies to maximize effectiveness. (This study was supported by JP19K03278, 22H01091,
22K18582, AL150003.)

Keywords
Childhood Adversity, Protective and Compensatory Experiences, Resilience, Bullying, Gender-Specific

PS56 Complex movement in Tic Disorder: illustration and treatment.

Dipesh Patel
University College London, United Kingdom
Himanshu Tyagi
University College London, United Kingdom

Abstract
Objective: We present an adult single-subject study of a complex movement in Tic Disorder (TD) and the implemen-
tation of Habit Reversal (HRT).
Background: The systematic study of individuals with TD can be traced back to the 19th century with the reports of
Jean-Marc Itard and George Gilles de la Tourette. In his classic study of 1885, Gilles de la Tourette documented nine
cases of chronic TD characterized by motor tic(s). The term tic or tique (in French) for centuries denoted an ‘unpleas-
ant gesture’. Later, the term refered to distasteful motor acts. Contemporarily, a tic can be defined as a sudden, rapid,
recurrent, non-rhythmic, stereotyped movement or vocalization. Further classification takes the form of determining
whether the tic is simple or complex. Potentially due to the expansion of knowledge pertaining to TD, the argument
can be made that the spectrum of type of tic is often not recognized or fully appreciated.
Method: A twenty-five-year-old male with a childhood onset of motor tic presented to a tertiary-care neuropsychiatry
outpatient clinic. At intake, reported were a variety of bothersome tics but sought was specific input for a particular
tic. The tic took the form of initially pushing the tongue out of the mouth toward the right whilst extending and
tensing the cervical spine toward the right. Whilst in this movement, the individual would exhale whilst attempting
to build up a ‘shiver’ like sensation in his pharynx. This build up would continue until it ‘felt right’ after which a final
exhale was produced - thus marking the end of the tic sequence. Temporarily and with significant restlessness, pur-
poseful suppressibility of the tic for a few minutes at a time was achievable. However, an inner tension of discomfort
built up which was relieved only by a consistent and repetitive bout of tic. Over the past year, following a considerable
increase in tic frequency and severity, fifty-minute weekly one-to-one and in-person sessions were agreed.
Results: By the end of a six-week intervention window, standardised self-reported assessments displayed a tic reduc-
tion score of forty percent. The tic reduction was attributed to the competing-response training which was geared
around disrupting the negative reinforcement cycle that was produced by the performance of tics (i.e., individuals
completing a physical behaviour that is incompatible with the expression of their tic).
Conclusion: Notwithstanding the limitations of a single-subject study design, an attempt has been made to draw
attention to the effectiveness of HRT. This attempt may well serve as a model for the effectiveness of HRT for the man-
agement of tics which go beyond what is commonly described as complex tics, where the reduction of symptoms
can be seen in a relatively short period of time. Future research on complex tics should include comparisons of the
relative efficacy of HRT versus pharmacotherapy. Additional research should be conducted on treatment sequencing
and decision-making and for which clinical profile of TD particular sequences of treatment are most effective.

Keywords
Tic Disorder, Movement Disorder, Tourette Syndrome, Tic Disorder, Habit-Reversal

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PS57 Group Based Metacognitive Therapy for Alcohol Use Disorder

Julia Kroener
Christophsbad Goeppingen, Germany
Zrinka Sosic-Vasic
Christophsbad Goeppingen, Germany

Abstract
Alcohol use disorder (AUD) is a profound clinical condition that has been linked to 5.3% of global mortality. Despite
the development of multiple interventions to enhance the symptoms of AUD, the treatment outcomes were only
moderately effective, and a subset of patients experienced a worsening of symptoms after the completion of therapy.
Furthermore, the availability of outpatient treatment placements is diminishing, which requires the implementation
of more efficient treatment alternatives. Hence, the objective of this study was to examine the effectiveness, feasibili-
ty, and acceptability of a recently developed, brief, group-based metacognitive treatment (MCT) for individuals diag-
nosed with Alcohol Use Disorder (AUD). A total of seven patients underwent treatment consisting of eight sessions of
group-based Metacognitive Therapy (MCT), following a single case series approach. The treatment was applied across
patients using an A-B replication methodology. Patients underwent assessments at four time points: one month and
one week prior to treatment initiation, one week and three months following treatment completion. Patients ex-
perienced significant improvements in dysfunctional metacognitive beliefs, desire thinking/craving, and depressed
symptoms for up to three months after treatment termination. The symptoms of AUD, as well as positive and negative
metacognitive beliefs showed improvement after treatment. However, these changes were not sustained during the
follow-up period. All patients who were part of the study completed the treatment and expressed a high level of
satisfaction. The present findings provide evidence supporting the effectiveness, feasibility, and acceptability of the
group-based MCT treatment for AUD. Conducting extensive randomized controlled trials (RCTs) is necessary to vali-
date the efficacy of the designed program for patients diagnosed with AUD.

Keywords
metacognitive therapy, CBT, group therapy, alcohol use disorder

PS58 Acceptability Study of the Blended Version of the Unified Protocol for
Transdiagnostic Treatment of Emotional Disorders in Children
Ana Pereira
CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Portugal
Daniela Cordeiro
Faculdade de Psicologia, Universidade de Lisboa, Portugal
Bruna Paulino
CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Portugal
Mariana Saraiva
Faculdade de Psicologia, Universidade de Lisboa, Portugal
Ana Maria Pereira
CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Portugal
Bárbara Pereira
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC),
Coimbra, Portugal, Portugal
Ana Gois
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC),
Coimbra, Portugal, Portugal
Margarida Perdigão
CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Portugal
Vitória Nunes Vicente
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC),
Coimbra, Portugal, Portugal
Helena Moreira
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC),
Coimbra, Portugal, Portugal

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Abstract
This study aimed to examine the acceptability of a Blended version of the Unified Protocol for the Transdiagnostic
Treatment of Emotional Disorders in Children (UP-C) using mixed methods. The sample included 39 Portuguese chil-
dren (Mage = 9.84, 61.5% female) with a primary diagnosis of anxiety disorder enrolled in UP-C and their parents.
Session-to-session data was collected, including the child’s assessment of the session and the child´s in-session and
out-session involvement. A semi-structured interview was conducted with a subsample of parents (n = 14) to collect
their perspectives concerning the program. The results show a low dropout rate and a moderate to high involvement
in the intervention. Most of the parents interviewed considered that their objectives for participation in the program
were fulfilled and identified the main changes in the child (e.g., improved emotional regulation, acknowledgment of
cognitions, global competencies) and for themselves (e.g., improved capacity to manage the child’s problems, more
close relations). In conclusion, the results indicate high acceptability of the blended version of the UP-C.

Keywords
Acceptability Study; Blended therapy; Unified Protocol for Transdiagnostic Treatment; Emotional Disorders in Children

PS59 Depressed and non-depressed persons across the lifespan: changes in

personality and (ir)rational beliefs
Ivana Peruničić-Mladenović
University of Belgrade, Faculty of Philosophy, Department of Psychology, Serbia
Tatjana Vukosavljević-Gvozden
University of Belgrade, Faculty of Philosophy, Department of Psychology, Serbia
Matija Gvozden
University of Belgrade, Faculty of Philosophy, Department of Psychology, Serbia

Abstract
Objective: Studies indicate that with advancing age people generally become more emotionally stable, agreeable,
and conscientious, but less active and less open to new activities and ideas than younger individuals. There are none-
theless substantial benefits for those who remain open to novel ideas and unconventional values. Much is still un-
known in this area, especially when it comes to aging-related changes in cognitions, such as core beliefs and schemes,
and the aging trajectories of those who suffer from clinical problems, such as depression.
Method: The sample consists of 403 healthy control participants (age from 16 to 60) and 223 inpatients (age from 16
to 69) who were diagnosed as having Major Depressive Disorder (127 patients with first depressive episode and 96
patients with recurrent depressive disorder). Measures were taken of (ir)rational beliefs with the General Attitude and
Belief Scale (GABS) and personality dimensions were measured with NEO-PI-R five factor model.
Results: There were significant differences between the target group and control group, with depressed individuals
reporting higher scores on neuroticism and agreableness, and lower scores on extraversion, openess and conscien-
tiousness. Depressed participants also had on average higher scores on irrational beliefs. In the healthy control group,
significant negative correlations were found between age and scores on neuroticism and scores on self- and oth-
er-downing; positive correlations were found between age and scores on openness, agreeableness, conscientious-
ness, and rationality. In both inpatient groups irrational beliefs were not related to age, while openness decreased in
the function of time. In the first depressive episode group, age was related to low scores on extraversion and high
scores on conscientiousness; in the recurrent depression group age was related to high scores on agreeableness.
Conclusion: Changes across the lifespan in the personality and rational and irrational beliefs are different among the
depressed participants compared to the healthy control group. In the inpatient groups, irrational beliefs are stable
during time while openness decreases. In the healthy control group, irrational beliefs decline, as well as neuroticism,
while openness increases. These findings point to the protective role of opennes in preventing the development of
depression with age. In addition, fostering rational beliefs is also of great importance in preventing depression during
the course of aging.

Keywords
irrational beliefs, personality, aging, depression

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PS60 Aid Representatives’ Perception of the Issue of Sexual Violence Among

Palestinian Female Youth in Israel
‫דלאו›ח חלאס ובא ןאנע‬
Ono Academic College, Israel

Abstract
Sexual violence is a global and historical problem that affects all levels of society, including the Palestinian community
in Israel. Studies have shown that cultural, ethnic, religious, racial, and gender differences impact the rates of sexu-
al violence and the reporting of such crimes. Rates of this issue among ethnic minority groups compared to other
groups are influenced by social and ethnic factors. Sexual violence tends to be more common among communities
with indigenous minority groups compared to non-indigenous communities.
Researchers have highlighted the common challenges that many victims, including those from ethnic minority
groups, face in accessing the criminal justice system. These challenges arise from the fear of stigma, the fear of being
wrongly accused, reluctance to accuse and involve a community member in the legal process, prevailing stereotypes
and accusatory environments, lack of cultural sensitivity in intervention strategies, and the absence of specialized
professional training.
Palestinian society in Israel is considered an indigenous minority. The issue of sexual violence is influenced by social,
cultural, and political factors. These factors contribute to the silencing of victims, concealment of the problem, resolv-
ing issues within the family, and the low social status of the victims in the family hierarchy. The political situation and
discrimination faced by the Palestinian population in Israel are evident in the lack of resources, societal oppression,
victims’ lack of trust in formal systems, and the incompatibility of services with the cultural characteristics of Palestin-
ian society.
The article will illustrate four forms of oppression experienced by Palestinian victims: their national Palestinian af-
filiation, being part of a native minority that suffers from oppression and institutional discrimination; women who
face discrimination that attributes superiority to men; and the control of cultural values that prioritize solving family
problems within the family in an informal way.

Keywords
Sexual abuse; Indigenous; Palestinian Female Youth

PS61 The mediating role of self-compassion in the relationship between

perfectionism and rumination
Anamarija Bolvanac
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Katarina Ristić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Tijana Lajić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Marija Davidoski
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Miljana Stojanović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia

Abstract
Introduction
Self-compassion, perfectionism and rumination, which belong to individual cognitive category, are important factors
related to depression and anxiety among students. According to the diathesis-stress model for students with high
perfectionism, external and internal sources of anxiety and stress during studies can be even more distressing, as the
exceedingly high expectations for themselves and others are unlikely to be met. Perfectionism is considered to ex-
plain increasing levels of negative repetitive thinking, such as worry and rumination. In the recent studies, rumination
has been studied extensively as a transdiagnostic variable in depression and anxiety. The aim of this study is to exam-
ine the perfectionism-rumination relationship and mediating role of self-compassion within university students, as
a potential target for future interventions, aimed at reducing perfectionism-driven rumination, as well as depression
and anxiety symptoms consequently.

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Method
The methodology was based on quantitative analysis of students’ responses to the online questionnaire. The ques-
tionnaire consisted of Frost Multidimensional Perfectionism Scale (FMPS), Ruminative Response Scale (RRS) and
Self-Compassion Scale (SCS). The study was performed with a total of 180 university students in Serbia, with the mean
age of 22.5 years and the majority being women (82.8%). The data was statistically analyzed using Pearson correlation
method in SPSS and mediation analysis in PROCESS macros for SPSS.
Results
The correlation analysis of the main variables in the research show that there is a statistically significant positive cor-
relation between Perfectionism and Rumination (r=0.540, p<0.01.), as well as a negative correlation between Self-com-
passion on the one hand and Perfectionism (r=-0.503, p<0.01.) and Rumination (r=-0.471, p<0.01.), on the other. Thus,
it has been shown that people with more expressed perfectionism are more prone to a ruminative reaction style, and
that people with more compassion towards themselves are less prone to rumination and have less intensive perfec-
tionist tendencies. The data, furthermore, confirm that self-compassion partially mediates the relationship between
perfectionism and the ruminative reaction style. It has been shown that people who are prone to perfectionism are
less prone to rumination, the more self-compassion is expressed. The study also examines the relationship of Concern
over mistakes as maladaptive perfectionism in relation to rumination, self-compassion and its subscales.
Discussion
The findings of our study show that perfectionists tend to have low self-compassion, as well as that perfectionism
and self-compassion are positively and negatively associated with ruminative response style, respectively. What is
more, perfectionism positively correlates with rumination via low self-compassion. In other words, the latter acts as
a partial mediator in that relationship, suggesting it may have a protective role in preventing ruminative response
style in highly perfectionist students. However, it is important to note that larger and more diverse sample would
better support the generalization of the study findings. The findings underline self-compassion’s relevance in perfec-
tionism-driven rumination prevention and management, supporting its use as an intervention target in depression
and anxiety treatment. Future studies should also focus on investigating the efficacy of those interventions in CBT
practice.

Keywords
self-compassion, perfectionism, rumination

PS62 A study on the relations of religiosity and tendencies towards rational/

irrational thinking in the general population
Lucija Gojković
Serbia
Jovanka Hrvačević
Military medical center Karaburma, Serbia
Žarko Milojević
Private practice, Serbia

Abstract
In this research, the degree of religiosity and tendency towards irrational and rational thinking were examined on
a suitable sample from the general population. The primary goal of the research was to examine the relationship
between the degree of religiosity and, the aforementioned concepts derived from the theoretical framework of REBT
psychotherapy, for which Albert Ellis hypothesised to exist in such a way that a high degree of religiosity is signifi-
cantlly correlated with emotional disturbance and irrational thinking. Method: Sample - The results were collected on
a sample of 171 respondents from the general population, of which 70.2% were women, 29.8% were men. The largest
part of respondents in our sample are respondents with university degree (74.3%), followed by respondents with the
high-school degree (14.6%). Age range of respondents was from 20 to 67, AS=36.2. More than half of the sample con-
sists of respondents who declare themselves to be religious (59.6%), while there are slightly less non-religious 40.4%.
Instruments - The Centrality of Religiosity Scale (CRS) questionnaire was used to examine the degree of religiosity,
while the Attitudes and Belief Scale 2-Abbreviated Version (ABS-2-AV) questionnaire was used to examine various
rational and irrational beliefs. Results: The results gathered from 171 participants show that the level of irrational
thinking measured by ABS-2-AV, is moderate (M=2.35, SD=.78), and level of rational thinking is more saturated in the
sample (M=4.01, SD=.6). Religiosity level of participants was moderate (M=2.52, SD=.9). Linear regression analysis, in
which predictor was religiosity, and criterium was irrational thinking, did not show a significant contribution (F=.99,
p>.05, R²=.001), neither did the linear regression, in which criterium was rational thinking (F=.482, p>.05, R²=-.003).

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This research contributed to understanding of a very specific and sensitive topic, in terms of showing that people with
different religiosity levels do not differ when it comes to rational or irrational thinking. This finding can reduce both
positive and negative biases in practitioners who are in psychotherapy process with people who define themselves
as religious. Possible limitation of the results is biased sample in terms of education level and this could moderate the
overall result.

Keywords
REBT; religiosity; rational and irrational beliefs and attitudes

PS63 Child’s Therapeutic Alliance in a Cognitive Behavioural Therapy for

Anxiety Disorders: Does exposure make a difference?
Ana Pereira
CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Portugal
Mónica Duarte
Faculdade de Psicologia, Universidade de Lisboa, Portugal
Margarida Perdigão
CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Portugal
Ana Maria Pereira
CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Portugal
Bruna Paulino
CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Portugal
Mariana Saraiva
Faculdade de Psicologia, Universidade de Lisboa, Portugal
Daniela Cordeiro
Faculdade de Psicologia, Universidade de Lisboa, Portugal
Helena Moreira
University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC),
Coimbra, Portugal, Portugal

Abstract
This study examines the differences in Observed and Perceived Therapeutic Alliance between the first sessions and
exposure sessions in a Cognitive Behavioural Intervention for Anxiety Disorders. The sample is composed of 43 chil-
dren (Mage=9,44, DP =1,52 44% boys) with a primary diagnosis of anxiety disorder participating in a group interven-
tion (Coping Cat; Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders in Children). Therapeutic
Alliance was measured session by session using the Therapy Process Observational Coding System - Alliance Scale
(TPOCS-A). The Therapeutic Alliance Scale for Children - Revised (TASC-r) was administered to the children in the 6th
and 13th sessions. When comparing the sessions of the first segment of the intervention with the exposure segment,
results show no significant differences in Perceived Therapeutic Alliance but a significant difference in Observed Ther-
apeutic Alliance. Children show a higher therapeutic alliance in the exposure sessions. These results indicate that
exposure does not negatively impact a child’s Therapeutic Alliance.

Keywords
Children; Therapeutic Alliance; Cognitive Behavioural Therapy ; Exposure

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PS64: The Effect of Chronotype and Social Jetlag on Checking Behaviors

Ellaey Hass
Bar Ilan University, Ramat Gan, Israel
Omer Linkovski
Bar Ilan University, Ramat Gan, Israel

Abstract
Recent studies link between late chronotype (i.e., eveningness) and increased prevalence and severity of obses-
sive-compulsive disorder. However, the underlying mechanisms driving this link remain unclear. This ongoing study
investigates whether social jetlag (SJL), the misalignment between one’s biological clock and social obligations, me-
diates the link between chronotype and clinically relevant behaviors, specifically repetitive checking behaviors.
A sample of 70 healthy undergraduate students from Bar-Ilan University performs a delayed matching-to-sample
task on two mornings – at the end of a workweek and at the beginning of the next one. The task allows unrestricted
repetitive checking behavior. Chronotype and SJL are assessed using the Munich ChronoType questionnaire and daily
sleep logs. We hypothesize that individuals with a late chronotype will engage in fewer checking behaviors at the start
of the workweek, when the adverse effects of circadian misalignment are at least partially recovered, compared to the
end of the workweek. This difference in checking behavior is not expected in individuals with an early chronotype due
to their circadian alignment with social time obligations.
Results supporting our hypothesis would indicate a strong association between chronotype and SJL, with the latter
accounting for more of the variance in the checking behavior difference between the start and end of the workweek.
Such results would highlight the effect of SJL on checking behaviors and shed light on the role of everyday envi-
ronmental factors in the relationship between chronic disturbances of biological circadian processes and clinically
relevant behaviors.

Keywords
OCD, Sleep, Chronotype, Social Jetlag

PS65 Attitudes Of Psychology Students Towards Cognitive-Behavioral,

Psychodynamic and Humanistic Therapy
Aleksandra Mikić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Isidora Gudalović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Kristina Pavlović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Emilija Kostić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Miljana Pena
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Aleksandra Kostić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia
Milena Knežević
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia

Abstract
This research examines the perceptions of therapeutic approaches among psychology students in Serbia, focusing
on Cognitive-Behavioral Therapy (CBT), Psychodynamic Therapy, and Humanistic Therapy. The main objectives are
to determine the popularity of each therapeutic approach among students and to assess their beliefs regarding the
effectiveness of these approaches in treating mental disorders, self-development, addressing underlying issues, and
understanding client personalities. A questionnaire was created for this purpose, consisting of 21 items, with seven
different items repeated for each psychotherapeutic approach. The questionnaire was split into three sections, each
dedicated to a different approach, and each section began with a short description of the respective psychothera-
peutic approach. Using a diverse sample of psychology students at undergraduate, master’s, and doctoral levels, data
were collected through surveys distributed on social media and via email. The data were analyzed using the SPSS 23
package, and in addition to descriptive statistics, ANOVA for repeated measures was used as a method of analysis.

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While this is an ongoing research, preliminary results on 61 participants indicate that different psychotherapeutic
approaches have varying impacts on different aspects of personality development. The findings indicate that there
are significant differences between certain pairs of therapeutic approaches in the measurement of “growth and de-
velopment,” but not between all pairs. Specifically, CBT and Humanistic Therapy are recognized as better for personal
growth and development in comparison to Psychodynamic Therapy. However, there is no significant difference be-
tween CBT and Humanistic Therapy. Results also indicate a significant difference in psychotherapeutic approaches
when it comes to the “deeper understanding of personality” and “practicality and goal setting”. CBT is particularly
practical and effective in goal-setting, while Humanistic Therapy is more practical and effective in goal-setting com-
pared to Psychodynamic Therapy. On the other hand, Psychodynamic Therapy is perceived as most interested in a
deeper understanding of personality, while CBT is considered poor in this domain, according to our participants.
In these preliminary results, there were no significant differences in the general attitude of students towards the
different psychotherapeutic approaches. This suggests that while students recognize the varied impacts of each ap-
proach, their perceptions and acceptance of these therapies are consistent.
This research provides a deeper understanding of students’ perspectives, highlighting their beliefs about the effec-
tiveness of each approach in different therapeutic domains. Furthermore, the research explores nuanced factors such
as educational background that may influence students’ perspectives. By focusing on psychology students in Ser-
bia, this research provides valuable insights into the preferences and perceptions of therapeutic approaches with-
in a specific educational context, offering implications for education, training, and clinical practice in psychology.
The conclusion is that important differences between these approaches in psychotherapy remain and it highlights
the importance of individualized psychotherapeutic approaches that are tailored to specific needs. This can help us
understand and contribute to improvements in training, education, and clinical practice in psychotherapy. Further
research is needed to verify these findings and explore the mechanisms that drive these effects.

Keywords
Psychotherapeutic approaches , Cognitive-Behavioral Therapy, Psychodynamic Therapy, Humanistic Therapy

PS66 ICD-11 Personality Domains, Trait Mindfulness, and Quality of Life in the
Context of an 8 Week Mindfulness-Based Stress Reduction Program
Lina Bagdonaviciene
Laboratory of Behavioural Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania
Julius Neverauskas
Laboratory of Behavioural Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania
Dan J. Stein
SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, Uni-
versity of Cape Town, South Africa
Narseta Mickuviene
Laboratory of Behavioural Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania
Julija Gecaite Stonciene
Laboratory of Behavioural Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania

Abstract
Background. Mindfulness-based interventions, such as the 8-week Mindfulness-Based Stress Reduction Program
(MBSR), are among the most effective evidence-based interventions for improving quality of life (Grensman et al.,
2018), while mindfulness tools are often implemented in the treatment of personality disorders (Sng, 2016). Although
the scientific literature includes studies on personality traits and their association with mindfulness related charac-
teristics (Tang & Braver, 2020) to our knowledge, there is no published research on the newly developed ICD-11 per-
sonality domains (Gecaite-Stonciene et al., 2021) and their links with trait mindfulness. Therefore, in the current study
we aimed to (1) assess changes in quality of life before and after the 8-week online MBSR, and (2) to investigate the
relationship between trait mindfulness, ICD-11 personality domains and quality of life.
Methods. The current study included 301 adult participants (94.6% women, 42±9 years), who attended a remote
MBSR group during 2021-2024 in Lithuania. The certified mindfulness teachers invited group participants to com-
plete the anonymous online survey before and after MBSR. The questionnaire included: (1) informed consent
and socio-demographic questions (i.e., age, gender, education, marital status, professional activity, chosen for-
mal practice and its duration, etc.); (2) the Five-Factor Personality Inventory for ICD-11 (PiCD) to assess personality
domains such as anankastia, detachment, dissociality, negative affectivity, and disinhibition; (3) the World Health

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Organization Quality of Life Questionnaire Brief Version (WHOQOL-BREF) to assess physical health, psycholog-
ical health, social relationships, and environment; and (4) the Five Facet Mindfulness Questionnaire (FFMQ), mea-
suring trait mindfulness characteristics including observing, describing, acting with awareness, non-judging, and
non-reactivity. Correlational analyses and comparisons within groups (series of t-test analyses) were performed.
Results. In the study participants that completed the questionnaire the second time (n=51), we found a positive
change in all areas of quality of life after the MBSR group (p<0.02). Furthermore, after analyzing the responses com-
pleted before the MBSR (n=301), we found that trait mindfulness and almost all its characteristics were negatively
associated with the ICD-11 personality domains negative affectivity (r = [-0.305 to -0.585], p<0.001), disinhibition (r =
[-0.207 to -0.375], p<0.001), and detachment (r = [-0.225 to -0.469], p<0.001). Also, all quality of life areas were posi-
tively linked with trait mindfulness (r = [0.291 to 0.550], p<0.001).
Conclusion. The findings indicate a significant positive change in quality of life after the MBSR program in Lithuania.
However, the major limitation was limited sample size, thus further study with larger samples is warranted. Further-
more, trait mindfulness was negatively linked with ICD-11 personality domains, such as negative affectivity, disinhi-
bition, and detachment, which are known to be problematic in many personality disorders. These results may under-
score the importance of studying ICD-11 personality domains and their interplay with mindfulness related aspects.

Keywords
ICD-11 Personality domains, trait mindfulness, MBSR, quality of life

PS67 Low-Intensity Cognitive Behavioral Therapy Interventions by Well-

Being Advisors in Lithuania: Reducing Depressive and Anxiety Symptoms and
Improving Subjective Well Being
Julija Gecaite Stonciene
Laboratory of Behavioural Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania
Julius Neverauskas
Laboratory of Behavioural Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania
Lina Bagdonaviciene
Laboratory of Behavioural Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania
Narseta Mickuviene
Laboratory of Behavioural Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania

Abstract
Background. Mental and behavioral disorders are increasing, with one of the world’s highest suicide rates linked main-
ly to depression in Lithuania (Gailienė, 2022). Improving the mental health situation in the country relies on robust
health and social systems, ensuring timely, evidence-based support for those with psychological problems. However,
scarce and expensive mental healthcare resources hinder the recruitment of specialists, especially in rural areas. To
combat resource shortages and overmedication, some countries (Knapstad et al., 2020) train specialists in related
fields to provide efficient, evidence-based consultations within a low-intensity Cognitive Behavioral Therapy (CBT)
framework for early-stage depression and anxiety. Lithuania sought to adapt the good practices (Knapstad et al.,
2020) by expanding mental health providers to include nurses, social workers, and public health specialists, aligning
with the Europe 2020 strategy to reduce disparities in healthcare across regions. As a result, we aimed to develop and
implement the new well-being advisor model and test its preliminary efficacy. Therefore, for this study, the goal was
to evaluate the change in subjective well-being as well as depressive and anxiety symptoms after short-term low-in-
tensity CBT interventions by well-being advisors in Lithuania.
Methods. The current study included data from 4221 clients (67.4% women, age 42.39±14.44) who were consulted
by 28 well-being advisors from 14 municipalities in Lithuania. All well-being advisors were trained and worked within
the project during the period from July 2022 to April 2024. In addition to sociodemographic information, we collected
data on subjective well-being using the WHO-5 Well-Being Index (WHO-5) (Topp et al., 2015), while depressive and
anxiety symptoms were evaluated with the Patient Health Questionnaire-9 (PHQ-9) (Kroenke & Spitzer, 2002) and the
Generalized Anxiety Disorder Questionnaire-7 (GAD-7) (Spitzer et al., 2006). All data were collected before and after
the consultations.
Results. The average number of consultations was 4.53±2.32 for one client. We found a significant difference regard-
ing subjective well-being before(WHO-5 scores: 48,68±17,55) and after (WHO-5 mean scores: 67,77±16,95) the ses-
sions ( t = -59.81, p < 0.001). Further, there was also significant change in depressive (PHQ-9 mean scores 8,97±4,58
vs. 4,39±2,98) as well as anxiety symptoms (GAD-7 mean scores 8,96±4,51 vs. 4,30±2,93) after the low intensity CBT
interventions provided by well-being advisors (t = 63.57, p < 0.001 and t = 65.87, p < 0.001, respectively).

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Conclusion. The current study suggests significant changes in subjective well-being, as well as depressive and anxiety
symptoms, after an average of 4.5 low-intensity CBT interventions delivered by well-being advisors in Lithuania. These
results highlight the applicability and utility of low-intensity CBT interventions delivered by specialists in related fields
with a relatively short amount of training.

Keywords
Depression, anxiety, CBT, well-being advisors, prompt mental health care

PS68 The effectiveness of mindfulness on depression, anxiety, and distress in

cancer patients: A meta-analysis.
Ema Štánerová
Faculty of Arts, Comenius University in Bratislava, Slovakia
Veronika Zelenayová
Faculty of Arts, Comenius University in Bratislava, Slovakia
Jakub Rajčáni
Faculty of Arts, Comenius University in Bratislava, Slovakia

Abstract
Background: Cognitive behavioral therapy or mindfulness can be used as supporting treatment in patients with can-
cer. These psychological interventions aim to reduce patients’ stress and support their healthy emotion regulation
and coping. This study aimed to evaluate the effects of mindfulness-based interventions on subjectively experienced
distress, depression, and anxiety in the published literature. Methods: To conduct the meta-analysis, we searched
PubMed, Scopus, PsycINFO, and Web of Science for clinical trials that used mindfulness or biofeedback in cancer
patients published up to July 25, 2023. Eligible studies provided results on at least one of the studied outcome vari-
ables, applied the intervention to adult cancer patients during regular treatment, and had a control group with reg-
ular treatment only. Two researchers independently reviewed abstracts and full texts, extracted data, and assessed
the risk of bias in Covidence. The meta-analysis was done using RevMan and CMA software. The study protocol was
preregistered via PROSPERO (CRD42023450211). Results: The meta-analysis included 28 studies (2265 participants).
Mindfulness interventions significantly reduced patients’ distress, depression, and anxiety when compared to con-
trols with effects at 1.9 SD or larger. Subgroup analyses indicated that interventions with standard protocols, those us-
ing a randomized design, and studies with women-only samples showed larger effect sizes. For anxiety reduction, the
geographic region was also significant. The overall certainty of the evidence (GRADE) is limited due to considerable
heterogeneity and a risk of bias in most studies. Conclusions: Mindfulness-based interventions seem to be effective
in reducing distress, depression, and anxiety in cancer patients. Further randomized controlled studies are needed, as
there is considerable heterogeneity in the present literature. More detailed subgroup analyses based on the diagnosis
and disease stage would allow these interventions to be more optimized for patients with cancer.

Keywords
Mindfulness, cancer, depression, anxiety, distress

PS69 The Serbian Validation of the Co-Rumination Questionnaire

Milica Arnautović
University of Belgrade, Faculty of Philosophy, LIRA Lab, Serbia
Matija Gvozden
University of Belgrade, Faculty of Philosophy, LIRA Lab, Serbia
Tatjana Vukosavljević-Gvozden
University of Belgrade, Faculty of Philosophy, Serbia
Sanda Stanković
University of Belgrade, Faculty of Philosophy, LIRA Lab, Serbia, sanda.stankovic@f.bg.ac.rs

Abstract
Co-rumination is an interpersonal construct that refers to extensive and repetitive discussion of problems within close
relationships, with a focus on negative feelings. Previous studies show that co-rumination is positively related to anx-
iety, depression, and rumination (small to moderate effect sizes), but also to higher friendship quality, indicating that
co-rumination may have both maladaptive and adaptive aspects. It has been predominantly studied in children and

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adolescent friendships, but student samples and other relationships are also researched. The most frequently used
measure is the Co-Rumination Questionnaire (CRQ, Rose, 2002). However, to date, there have been scarce and incon-
clusive findings regarding the factor structure of the CRQ instrument. Both the one-factor and hierarchical three-fac-
tor structure of the instrument have been reported. This study aimed to determine the factor structure, convergent
and discriminant validity of the Serbian translation of the CRQ on an adult sample. Data was collected by convenience
sampling of psychology students and the general adult population (N=304, Mage=31,5, women=86,8%). Subjects
were asked to fill in the CRQ having in mind one of their best friends, a measure of friendship quality (MFQ-FF), coping
strategies (CISS-21), emotion dysregulation (DERS), depression, anxiety, and stress symptoms (DASS-21), and rumina-
tive thought style (RTSQ). Confirmatory factor analysis did not provide support neither for one-factor nor three-factor
hierarchical solution. Exploratory factor analysis with Maximum likelihood extraction and Promax rotation method
suggested a two-factor solution. The first factor is best described as Core co-rumination, containing items that refer
to the co-ruminative way of talking about problems: repetitiveness, focusing on details and negative aspects. The
second factor could be described as Prioritising problem talk - it contained items referring to prioritising and encour-
aging talking about problems. The two factors had different associations with other variables. The core co-rumination
factor was significantly and positively related to difficulties in emotion regulation (r = .27, p < .01), anxiety (r = .25,
p<.01), and depression (r = .27, p <.01), while prioritising problem talk was not. Core co-rumination also had higher
positive correlations with emotion-oriented coping strategies (core co-rumination: r =.40, p <.01; prioritising problem
talk: r = .16, p <.01) and ruminative thought style (core co-rumination: r = .39, p < .01; prioritising problem talk: r = .20,
p <.01). On the other hand, prioritising problem talk was more strongly related to higher friendship quality (problem
talk: r = .47, p < .01; core co-rumination: r = .28, p < .01). To summarize, core co-rumination factor seems to reflect
the maladaptive aspect of co-rumination - it is related to difficulties in emotion regulation, internalizing symptoms
and poorer coping strategies. Conversely, prioritising problem talk is more strongly associated with higher friendship
quality and is not related to anxiety or depression, nor difficulties in emotion regulation. These results go in line with
the notion of co-rumination being related to both positive and negative outcomes. Further research on the factor
structure of the instrument is needed, employing different cultural and age samples, and also types of relationships.

Keywords
co-rumination, friendship quality, difficulties in emotion regulation, coping strategies, anxiety, depression

PS70 Virtual reality supporting the process of dialectical-behavioral therapy

Anna Englert-Bator
University of Rzeszow, Poland

Abstract
Dialectical-Behavioral Therapy (DBT), developed by Marsha Linehan is a cognitive-behavioral treatment initially de-
signed for individuals with borderline personality disorder (BPD). Over the years, it has been adapted for various
other mental health conditions such as depression, anxiety, substance abuse, eating disorders and post-traumatic
stress disorder (PTSD). DBT emphasizes the psychosocial aspects of treatment, focusing on skills training in areas like
emotional regulation, interpersonal effectiveness, distress tolerance, and mindfulness. Despite its efficacy, traditional
DBT can be challenging for some patients due to the need for significant self-motivation, the abstract nature of some
skills, and difficulties in real-world application. The main goal of this research was to explore the integration of Virtual
Reality (VR) into DBT, proposing that VR can enhance the therapeutic process by providing immersive, controlled, and
replicable environments for skills practice and exposure therapy. VR technology offers an immersive experience that
can simulate real-life scenarios, allowing patients to practice DBT skills in a safe and controlled setting.
In the context of emotional regulation, VR can simulate stress-inducing environments, providing a platform for pa-
tients to practice mindfulness and distress tolerance skills. By experiencing and managing simulated stressful situa-
tions, patients can learn to apply these skills in real-world contexts, potentially reducing the intensity and frequency
of emotional outbursts. Additionally, VR can be used to practice and reinforce mindfulness techniques by offering
virtual environments conducive to meditation and relaxation, such as serene nature scenes or calming guided vi-
sualizations. Exposure therapy, a critical component of DBT for treating anxiety and PTSD, can also be significantly
enhanced through VR.
The incorporation of Virtual Reality into Dialectical-Behavioral Therapy holds significant promise for enhancing the
therapeutic process. By providing immersive, controlled environments for skills practice, exposure therapy, and data
collection, VR can help bridge the gap between theoretical skills training and real-world application. This innovative
approach not only supports the efficacy of DBT but also enhances its accessibility, offering a promising avenue for
improving mental health treatment outcomes.

Keywords
DBT, dialectical-behavioral therapies, virtual reality, third waves therapies

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PS71 Underreported Addiction and Irrational Beliefs Associated with Lying

Ivana Peruničić-Mladenović
University of Belgrade, Faculty of Philosophy, Department of Psychology, Serbia
Snežana Filipović
Institute of Mental Health, Belgrade, Serbia
Ivica Mladenović
Institute of Mental Health, Belgrade, Serbia
Elena Stevanović
Institute of Mental Health, Belgrade, Serbia

Abstract
Objective: Despite their adverse consequences, addictive behaviors encompass repetitive actions such as manipu-
lating, cheating and lying as substantial tendencies. Regardless of their frequency, both literature and clinical prac-
tice have established that those suffering from addiction tend to also underreport their addictive behavior. Rational
Emotive Behavior Therapy (REBT), known for its integrative approach has been shown to be particularly effective in
addressing addictive tendencies due to its ability to elucidate the role of irrational beliefs in addictive behaviors. Giv-
en this background, the aim of this study is to investigate whether underreported gambling behavior operationalizes
irrational beliefs associated with the tendency to lie.
Method: The sample consists of 95 inpatients who underwent addiction treatment at the Clinic for Substance Disor-
ders of the Institute of Mental Health, Belgrade, Serbia. They were administered the self-report version of the South
Oaks Gambling Screen (SOGS) as well as the General Ability and Belief Scale (GABS). The attending clinicians evaluat-
ed their SOGS, which included additional information obtained from their family members, treatment cosponsors as
well as blood and urine tests. An objective measure of lying was obtained from the differential scores of self-report
and the clinicians’ ratings (SOGS clinicians – SOGS self-report).
While the results indicate the clinicians’ reports to be less socially-desirable than self-reports, the inpatients tend to
underreport their gambling tendencies. The regression analyses show the GABS had significant impact in accounting
for the differential scores. Those who scored higher on the tendency to lie also had a significantly higher demand
for achievement and were more generally irrational. Their demand for comfort was only expressed weakly, thereby
demonstrating that lying is linked to tendencies to take risks, cheat and manipulate. Moreover, it was found that those
who prefer to not undergo stress, seek to ease their distress and remain in their comfort zone were also more honest.
Conclusions: Our findings reveal that individuals who tend to minimize their gambling problems have lower scores
on rationality, a greater need for achievement and a lower demand for comfort. Given these results, it might be con-
cluded that a narcissistic tendency to seek achievement may also hinder any truthful presentation they undertake.
General irrationality and the absence of the demand for comfort may therefore provoke dishonest relations.

Keywords
lying, underreporting addiction, irrational beliefs

PS72 Decreased oxygen saturation during sleep in an 8-week app-based

mindfulness intervention: A smart-watch randomized controlled trial.
Kohki Kaji
The University of Tokyo, Japan
Riko Uwagawa
The University of Tokyo, Japan
Koichiro Adachi
The University of Tokyo, Japan
Mai Sugie
The University of Tokyo, Japan
Yukari Kimura
The University of Tokyo, Japan
Mariko Shimoda
The University of Tokyo, Japan
Ryu Takizawa
The University of Tokyo, Japan

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Abstract
Objectives: In working women, the stress of the dual role of balancing family and work has a negative impact on their
physical and mental health (Poms et al., 2016). Although they should get care service, general face-to-face interven-
tion programs are too burdensome for healthy workers to implement for mental health prevention. Therefore, we
adopted low-intensity intervention with a smartphone application to enhance accessibility.
Mindfulness-based Intervention (MBI) have recently been increasingly used clinical settings, and research regarding
their effects on health has grown. With regard to the research aspect, the physiological effects of MBI evaluated from
biological markers such as heart rate variability, heart rate, and respiratory rate have been studied (Rådmark et al,
2019). Whereas, few studies have addressed the effects on arterial and tissue oxygenations (Bernardi et al., 2017), and
evaluated it from the perspective of sleep quality. Although, Bernardi et al. (2017), who have conducted one-time
intervention in laboratory, have adopted a pulse oximetry to measure arterial oxygenation, they have not evaluated
oxygen saturation during sleep. The current study aims to the continuous effect of our app-based MBI on oxygen
saturation during sleep with a smart-watch among working women .
Methods: 47 healthy working women (mean age ± SD 36.9 ± 10.8) fulfilling the conditions were included in the study.
Each participant was provided a smart watch (Fitbit sense 2Ⓒ), which was linked to their mobile using the Fitbit appⒸ.
The data of oxygen saturation during sleep was collected from the devise in the 8-week period. Participants were
randomly assigned to either a mindfulness condition (n = 22) or a waitlist condition (n = 25). The study was approved
by the Life Science Research Ethics and Safety, the University of Tokyo (reference number: 23-144, 23-227, 24-020) and
registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN000051796).
Results: The 26 participants who were provided with the smart-watch and cooperated in data collection were includ-
ed in the multilevel analysis (the intervention condition: n = 10; the control condition: n = 16). The multilevel model
was adopted the method of Maximum Likelihood and linear mixed model. The interaction effect between the 56
days (longitudinal data) and intervention condition variable was significant (p < .01). When linear mixed model was
conducted for each group, there was a significant decrease in the intervention group (p = .04), but no change in the
control group (p = .48).
Conclusion: This smart-watch RCT trial revealed that the 8-week app-based mindfulness intervention reduced oxygen
saturation during sleep in Japanese healthy working women. The present finding is novel with regard to decreased
oxygen saturation during sleep, and almost consistent with the intervention study of Bernardi et al. (2017), which
reported that the meditation significantly decreased oxygen saturation compared to baseline meditation. Future re-
search should replicate these findings and mechanism of the continuous effect why decrease the oxygen saturation,
and what contribute to mental health prevention for working women (This study was supported by JP19K03278,
22H01091, 22K18582, AL150003).

Keywords
App-based mindfulness, randomized controlled trial (RCT), digital biological marker (Smart-watch)

PS73 Overgeneral Future-Oriented Thinking in Swiss refugees

Grazia Ceschi
University of Geneva, Switzerland

Abstract
Introduction - Projecting specific and vivid future thoughts is crucial for emotional regulation, goal setting, strategy
development, and forming future identities. Impairments in the specificity of prospective autobiographical memo-
ries (PAMs), often seen in individuals with depression or PTSD, are linked to overgeneral memory effects. This study
explores the relationship between trauma exposure and the ability to generate specific PAMs in refugees arriving in
Europe post-2015 migration crisis, a group exposed to severe and repeated traumatic events.
Method - This study compared the specificity of PAMs in 17 refugees with 16 Swiss non-French speakers matched by
age and gender. Trauma exposure and PTSD symptoms was measured with traumatic events inventory, and post-trau-
matic symptoms self-report scales. Prospective memory specificity and fluency scores were obtained using the Future
oriented version of the Autobiographical Memory Test and of the Verbal Fluency Test.
Results - Refugees shows higher levels of trauma exposure and post-traumatic symptoms than Swiss nationals and
demonstrated significantly lower specificity and fluency in PAMs. No significant correlation was found between trau-
ma exposure and PAM scores.
Discussion - Trauma experienced before, during, and after migration seems to be associated to a reduction in speci-
ficity and fluency of PAMs in refugees, potentially affecting emotional regulation and future goal-setting abilities. Fur-
ther research with larger populations is necessary to replicate these findings and guide the development of effective
memory specificity training that may aid refugee’s resettlement process.

Keywords
Prospective memory, Future thinking, Refugees

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PS74 The Impact of Cognitive Flexibility on Post-Traumatic Growth in Women

Diagnosed with Breast Cancer
Hüseyin Savran
Psychiatry Clinics, Kocaeli City Hospital, Kocaeli, Turkey
Melek Coşar Yakar
Eskisehir Osmangazi University, Turkey
Bülent Yıldız
Eskisehir Osmangazi University, Turkey
Ercan Altınöz
Eskisehir Osmangazi University, Department of Psychiatry, Turkey

Abstract
Background and Aim: Receiving a cancer diagnosis can be traumatic due to its association with death, slow progres-
sion, unclear cause, and stigma. Breast cancer, the most common cancer among women, impacts femininity and
sexuality. Following such trauma, individuals may experience negative consequences like depression and PTSD, but
also positive changes known as post-traumatic growth (PTG). PTG involves positive changes in beliefs about oneself,
interpersonal relationships, and worldview. Cognitive flexibility is the ability to think about alternative solutions in
problematic situations. This study aims to determine PTG levels in female breast cancer patients and examine the
relationship between PTG and cognitive flexibility.
Methods: The study included 115 female patients who applied to the Medical Oncology and Radiation Oncology
outpatient clinics between 01.12.2019 and 01.09.2021. Inclusion criteria were ages 18-65, at least six months since
diagnosis, completed or not received chemotherapy and radiotherapy, and no brain metastasis. Participants complet-
ed a sociodemographic data form, PTGI, MSPSS, BDI, and BAI. Cognitive functions were assessed using the CANTAB.
Results: The mean age was 46.78 (±7.90) years. 53.5% had low PTG levels. A significant difference was found between
the occupational status of patients with low and high PTG levels (p=0.008), with a higher rate of working among
patients with high PTG levels. Higher PTG levels were also found in patients who developed lymphedema (p=0.004).
MSPSS total scores were higher in those with high PTG levels (p<0.001). Cognitive flexibility scores were significantly
higher in patients with high PTG levels (p=0.005), while error rates were higher in those with low PTG levels (p=0.028).
A one-point decrease in MSPSS total scores caused a 1.353-fold decrease in PTG levels (p<0.001), and a one-point
decrease in cognitive flexibility scores caused a 1.016-fold decrease in PTG levels (p=0.021).
Conclusion: This study is the first to reveal the relationship between PTG levels and cognitive flexibility in breast
cancer patients using computer-based cognitive tests. High PTG levels were found in 46.5% of patients. The higher
rate of working among patients with high PTG levels may be related to more social support resources in their work
environment. Regression analysis indicated that perceived social support is the most significant variable affecting
PTG. Patients with high PTG levels had significantly higher cognitive flexibility, suggesting they can find alternative
solutions more efficiently and act more flexibly in the face of traumatic changes. These findings highlight the impor-
tance of interventions and support programs aimed at enhancing cognitive flexibility.
Funding: This study was supported by the Eskişehir Osmangazi University Scientific Research Projects with the project
number 202011A217.

Keywords
Breast cancer, post-traumatic growth, cognitive flexibility.

PS76 An integrated software platform for the automation of Cognitive

Behavioral Therapy Sessions with real-time psychophysiological assessment
Slobodan Radovanović
BITWORK DOO, Serbia
Emil Jovanov
The University of Alabama in Huntsville, United States
Mladen Milošević
N/A, United States

Abstract
Software support for Cognitive and Behavior Therapies (CBT) can significantly improve the effectiveness, efficiency,
and accessibility of mental health care and provide big data for personalization, monitoring of longitudinal trends,
research and exploration of using artificial intelligence for improving CBT. We present an integrated software system

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UbqExp designed for automation of clinical studies and support of real-time therapy sessions. UbqExp is the first
system that provides support for real-time psychophysiological assessment of users during remote therapy sessions
in person, two way live video chat sessions, or self-administered therapy sessions. Therapists define their own cus-
tomized protocols that can be selected at the beginning of the session, customized questionnaires, and an active set
of wearable physiological monitors during the session. All data, including physiological signals, real-time event anno-
tations, notes, and session instructions are saved on the secure cloud server for postprocessing and development of
Artificial intelligence analysis tools.
UbqExp has already been used for conducting studies at the University of Alabama in Birmingham with real-time
physiological monitoring and supervised video sessions. The system was also applied to develop guided breathing
therapies for stress reduction and improvement of the heart rate variability of users. By leveraging technology, the
future enhancements of the system will provide automation and AI facilitated analysis for therapists and provide
personalized, engaging, and cost-effective solutions that empower users to manage their mental health more proac-
tively and effectively.

Keywords
Physiological monitoring, Telemedicine, Automation, Software platform, Artificial intelligence

PS79 Effect of Parents‘ Sleep Habits and Their Children’s Behavioral

Characteristics on Parents’ Mental Health: Focusing on Differences by Child
Developmental Stage
Naoko Ayabe
Akita University, Japan
Michitaka Yoshimura
Aichi Toho University, Japan

Abstract
This study aims to determine the extent of parents’ own sleep problems and sleep hygiene practices and the impact
of their children’s emotions and behaviors on the mental health of parents of school-aged children. An online survey
was conducted with parents of children in elementary and junior high schools (ages 6–15) in Japan.
The survey items included demographic characteristics, sleep problems (Pittsburgh Sleep Quality Index; PSQI), child
adjustment and mental health (Strength and Difficulties Questionnaire; SDQ), degree of sleep hygiene practices
(Sleep Hygiene Practices Scale (SHPS)), and mental health issues, such as depression and anxiety (6-item Kessler Psy-
chological Distress Scale; K6). A hierarchical multiple regression analysis was conducted with three groups of parents
according to their children’s grades (lower elementary, upper elementary, and junior high school), with K6 score as
the objective variable and PSQI total score (Step 1), SHPS domain score (Step 2), and SDQ subscale score (Step 3) as
explanatory variables. This study was approved by the Research Ethics Review Committee of Akita University.
The analysis showed that the model including the SDQ was significant for parents of children in lower (n = 421) and
upper elementary grades (n = 418) (lower grades: adjusted R2 = .31, ΔR2 = .03, p < .001; upper elementary grades:
adjusted R2= .35, ΔR2 = .03, p < .001). The PSQI total scores and arousal-related behaviors (a SHPS domain), as well as
the SDQ subscales hyperactivity/inattention (β = .14, p = .005) and peer relationship problems (β = .10, p = .04), were
positively associated with K6 scores among parents of lower elementary school children. In addition, the PSQI total
scores and arousal-related behaviors, as well as the SDQ subscale emotional symptoms (β = .10, p = .08), were posi-
tively associated with K6 scores among parents of upper elementary school children. Conversely, SDQ scores did not
show a significant change among parents of junior high school students (n = 430).
Thus, in addition to parents’ own sleep problems and sleep hygiene practices, the younger the child’s age, the more
their behavioral characteristics impacted parents’ mental health. Therefore, support that considers children’s emo-
tional and behavioral problems according to their developmental stage, as well as assessment of their sleep habits, is
necessary to improve their parents’ mental health.

Keywords
Sleep Habit, Parents’ Mental Health

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PS80 A Study on Developing a Scale of Thought Patterns in Depression in

Children and Adolescents
Gizem Yıldız
Koc University, Turkey
Tevfik Bedirhan Üstün
Koc University, Turkey
Tuba Mutluer
Koc University, Turkey

Abstract
Adaptation of the Thought Patterns in Depression Scale for Children and Adolescents
This study aims to adapt the Hacettepe Depression Thought Patterns Scale (HDDKÖ) for the child and adolescent
population. Depression in childhood can lead to emotional, social, and psychological regressions, laying the founda-
tion for future difficulties. Therefore, it is crucial to measure depression in children accurately and reliably, and to take
necessary precautions. While research to determine depression levels in adolescents and adults is common in our
country, studies focusing on children and adolescents are insufficient. This gap hinders the application of cognitive
behavioral therapies. This study aims to develop a thought patterns scale for depression in children and adolescents.
The study sample consists of participants aged 8-18. Data were collected via the digital data collection platform Koç
Qualtrics, with parental consent obtained online. Data collection tools included a demographic information form,
ICD-10 Scale, Automatic Thoughts Questionnaire, and the Hacettepe Depression Thought Patterns Scale for Children
and Adolescents (ÇE-HDDKÖ).
The study comprises four stages. In the first stage, experts evaluated the ÇE-HDDKÖ, resulting in the removal of 13
items. In the second stage, a pilot study was conducted with 164 participants using the revised 50-item scale, and the
internal consistency coefficient was calculated as 0.958. In the third stage, an exploratory factor analysis led to the
removal of 10 items, continuing with a 40-item form. The KMO value of the scale was found to be 0.957. In the final
stage, the scale was administered to 1022 participants, and after excluding incomplete and erroneous data, analyses
were conducted on a dataset of 540 participants. The internal consistency coefficient was 0.949.
The explanatory factor analysis of the final 31-item form revealed a five-factor structure explaining 61.288% of the
total variance: “Self-Blame,” “Pessimism,” “Negative Interpersonal Relationship I,” “Perfectionism,” and “Negative Inter-
personal Relationship II.” The confirmatory factor analysis showed good fit indices (χ2/df = 1.159, RMSEA = 0.017, NFI
= 0.987, CFI = 0.998, SRMR = 0.045, GFI = 0.991, AGFI = 0.989). The ÇE-HDDKÖ was determined to be a reliable mea-
surement tool.
The study found that depression is prevalent among children and adolescents and is influenced by various factors.
Depression significantly affects the thought patterns of participants. The effects of depression vary by gender and
age, with boys and adolescents exhibiting more severe symptoms and negative thought patterns. Children diag-
nosed with depression had more negative thought patterns compared to the control group. As the severity of depres-
sion increased, more negative changes in thought patterns were observed. These findings highlight the importance
of cognitive therapies and psychological support methods in the treatment of depression.

Keywords
Depression, Negative Beliefs, Thought Patterns, Child, Adolescent

PS81 Effects of Attention Training Technique in Patients with Schizophrenia

with Auditory Hallucinations
Joachim Kowalski
Institute of Psychology, Polish Academy of Sciences, Poland
Małgorzata Dąbkowska
Institute of Psychology, Polish Academy of Sciences, Poland
Adrianna Aleksandrowicz
Institute of Psychology, Polish Academy of Sciences, Poland
Michał Jarkiewicz
Institute of Psychiatry and Neurology in Warsaw, Poland
Frank Larøi
University of Oslo, Norway

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Łukasz Gawęda
Institute of Psychology, Polish Academy of Sciences, Poland

Abstract
Background: Attention Training Technique (ATT) is utilised in Metacognitive Therapy. Up to date, it has been researched
primarily as a brief, separate intervention for various clinical populations. Additionally, studies in non-clinical popu-
lations explored potential mechanisms of this technique. At this point, there are evident effects of ATT on various
outcome variables like anxiety, depression, stress levels, and repetitive negative thinking (RNT, i.e. worry, rumination,
intrusive thoughts). There is also tentative evidence pointing to the utility of ATT in patients with experience of psy-
chosis and persistent auditory hallucinations. Several case studies show the beneficial effects of ATT on hallucinations
in patients diagnosed with schizophrenia. This study aims to test the effects of ATT on various outcome variables in
schizophrenia patients and a matched control group.
Methods: The study was conducted as a double-blind, randomised controlled trial. Sixty-five patients with schizo-
phrenia and current auditory hallucinations (SH), 70 patients without current auditory hallucinations (SN) and 70
demographically matched healthy controls (HC) were randomised to either receive eight sessions of ATT or sham
ATT (placebo control condition) throughout a week. Measurements were conducted before the first and after the last
session of ATT. The primary outcomes were measures of RNT (strategies subscale of Cognitive-Attentional Syndrome
questionnaire, CAS-1), hallucinations (Revised Hallucinations Scale, RHS) and general psychopathology (Symptoms
Checklist 27plus, SCL-27plus). Secondary, mechanistic outcomes were self-focused attention (Self-Consciousness
Scale, SCS), metacognitive beliefs (Interpretation of Voices Inventory, IVI, Metacognitions Questionnaire, MCQ-30 and
negative metacognitive beliefs subscale from CAS-1), attentional functioning, both self-description (Attention Con-
trol Scale, ACS) and auditory attention performance (dichotic listening). Analyses were performed with an ANCOVA,
where post-pre differences served as outcome variables and pre-intervention (baseline) measures served as covari-
ates. We analysed the main effects of intervention (ATT vs placebo) in three groups combined and performed planned
analyses of the effects of intervention in subgroups.
Results: The analyses are underway, but preliminary results show that participation in ATT, compared to placebo, sig-
nificantly reduces the severity of auditory hallucinations (RHS scores) and the severity of RNT in the SH group.
Discussion: Preliminary results of our study suggest that ATT has beneficial effects for schizophrenia patients, main-
ly those who currently experience auditory hallucinations, in levels of RNT and severity of auditory hallucinations.
The observed outcomes are in line with previous studies showing the effects of ATT in patients with schizophrenia.
Analyses are currently in progress, and the results described above are preliminary, with comprehensive results to be
presented at the conference.

Keywords
metacognitivie therapy, psychosis, hallucinations

PS82 Tourettism: A Contemporary Account.

Dipesh Patel
University College London, United Kingdom
Himanshu Tyagi
University College London, United Kingdom

Abstract
Objective: We report an adult single-subject study of a patient referred to an outpatient neuropsychiatry clinic due to
a tic disorder resembling Gilles de la Tourette Syndrome (GTS).
Background: Acquired Tourettism, or Tourettism, clinical terms adopted to avoid confusion with the more common id-
iopathic GTS, is characterised by tics, both motor and vocal, yet almost always having its onset in adulthood and being
secondary to other underlying organic issues. Despite valiant attempts to understand the underlying features of this
disorder in contrast to GTS, significant uncertainty remains. It is in this context that this abstract is based. That is, taken
as a starting point is the premise that there remain features of tourettism that are distinct from GTS of which can lead
to important advances in the field of explaining the clinical phenomenon and guiding treatment decision making.
Method: A sixty-two-year-old male with a symptom onset at fifty-three-years-old presented to a tertiary-care neuro-
psychiatry outpatient clinic. He presented with intermittent motor tics such as a head scratch like movement and a
right foot stomp and phonic tics resembling vocalizations (a high pitched prolonged “ah”) and coprolalia. Although
not in a constant combination or sequence, all tics lasted several seconds and increased with attention in intensity
and frequency. At the end of a bout of vocal tics, the patient often appeared mortified and apologized for the occur-
rence. During intake assessment, attempts to distract the patient during a series of tics could interrupt a sequence of

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vocalizations. Equally, temporarily (up to thirty seconds) and with significant restlessness, purposeful suppressibility
of both the motor tics and the vocal tics was achievable. However, an inner tension of discomfort built up which was
relieved only by a consistent and repetitive bout of the tics. Similar to other tic disorders, the frequency and intensity
of his tics waxed and waned. At intake, a range of standardized instruments were administered. Administration of
the Clinical Outcome in Routine Evaluation–Outcome Measure revealed a moderate score (i.e., 57) for psychological
distress which covered four dimensions (i.e., subjective well-being, problems/symptoms, life functioning, and risk/
harm). Further routine examinations (i.e., the Autism Spectrum Quotient-10 and the Attention Deficit Hyperactivity
Disorder Self-Report Scale) were unremarkable. Administration of the Frost Multidimensional Perfectionism Scale
revealed a high-range score of 91. Through subjective assessment, inconsistent clinical signs and symptoms (lack
of premonitory sensations, lack of rebound phenomena, and ‘just right’ phenomenon) were identified. The patient’s
history was unremarkable with respect to pre, peri-, and postnatal development. There was no family history of tics
nor any other movement disorder.
Conclusion: Notwithstanding the limitations of a single-subject study design, the patient in question presents with a
complex mixture of clinical signs of tourettism, supported by a variety of findings, but at the same time not warrant-
ing referral for a behavioural intervention (i.e., habit-reversal training) for the management of both his motor and vo-
cal tics. We propose that future research should continue to document late-onset motor and/or vocal tics resembling
GTS features whilst also studying the efficacy of potential interventions.

Keywords
Tic Disorder, Tourette Syndrome, Tourettism, Movement Disorder

PS84 Considering the Importance of Continuous Development in RE&CBT

Education: Strategies for Maintaining Motivation and Engagement of
Trainees at the Final Level of education, and the Impact on Personal
Development
Tijana Stanković Milić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)
Iva Miljić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)
Nevena Ćirić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)
Anika Tabas
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)

Abstract
Continuous development and engagement of trainees during RE&CBT (Rational Emotive and Cognitive Behavioral
Therapy) education are key pillars in the early stages of building a therapeutic practice. Through regular enhancement
of knowledge and skills, as well as through personal therapy, trainees become more competent in psychotherapy.
Interestingly, a very limited amount of research addresses this topic.
To modestly contribute to this field, this research focuses on final-level trainees (psychotherapists under supervision),
examining their perception of competence during education, their motivation, and the efforts they make toward
their professional development, as well as the challenges they face. Additionally, the study explores the application of
RE&CBT in everyday life and the impact of RE&CBT education on personal development.
This research aims to identify the strategies and techniques used by trainees for their professional development and
to analyze the impact of RE&CBT education and theory on their personal and professional growth. Special attention
is given to understanding the link between continuous improvement of knowledge and skills on one hand, and their
perception of competence, confidence, and overall growth in the field of RE&CBT on the other.
The research focuses on the individual experiences and perspectives of participants, providing them an opportunity
to share their views, with particular emphasis on motivation, difficulties, and strategies they use to overcome these
challenges. The chosen approach for analyzing the participants’ narratives is Interpretative Phenomenological Analy-
sis (IPA). This research is exploratory, thus no hypotheses were predefined.
The analysis revealed that trainees’ perception of competence varies depending on their understanding of the issues
clients present and the feedback they receive, primarily from supervisors but also from their peers. Most participants
reported feeling more competent when following the steps and structure of the theory, while they encountered
problems when clients required a more flexible approach.

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One of the conclusions of this study is that there is a need for more informal education based on sharing experiences
of seasoned therapists. As main resources for professional development, trainees cited reading literature, peer super-
vision with colleagues, and foreign “single-session therapy” formats.
Furthermore, although trainees frequently reported a positive impact of RE&CBT education on their personal lives
and the application of RE&CBT philosophy in daily life, it appears that dedication to personal therapy could further
enhance their professional development. This is supported by reports from the majority of participants who are un-
dergoing personal therapy and believe it significantly aids their work with clients.
Finally, according to the results of this research, future efforts and improvements should be directed towards creating
more informal educational approaches (e.g., single-session therapy with volunteer clients, webinars for trainees fo-
cused on specific topics) where trainees could learn from experienced colleagues and share their doubts with them.
This could likely impact their perception of competence and the development of their personal therapeutic practice.
Trainees could also gain knowledge on how to approach clients who require a more flexible approach and do not
accept a clear structure, which is where trainees feel most comfortable at the beginning.

Keywords
RE&CBT training

PS85 Is there a role for Early Maladaptive Schema in sexual distress related
to sexual function? Preliminary results of an exploratory study with a cross-
sectional sample of adults in an exclusive dyadic relationship.
Patrícia M. Pascoal
Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Lisbon, Portugal, Portugal
Catarina Raposo
Center for Psychology at the University of Porto, Faculty of Psychology and Educational Sciences of the University of
Porto, Portugal
Andreia A. Manão
Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Lisbon, Portugal, Portugal

Abstract
Introduction: Early maladaptive schemas (EMS) comprise patterns in how we see ourselves and our relationships with
others and work as a framework that guides our interpretation of our experiences. They stem from our childhood
and adolescence experiences and are central to understanding emotional and personality disorders. Therefore, they
are a key component of schema therapy. Despite the theoretical and clinical relevance of ST in different emotional
problems, EMS has been scarcely studied in relation to sexual problems, namely to the cross-diagnostic feature of
all sexual dysfunctions: sexual distress related to sexual activity. In the present work, we aim to answer the following
research question: Considering the 18 EMS, which are the best predictors of sexual distress related to sexual function
after controlling for relationship satisfaction? Method: After receiving deontological approval, we launched an online
cross-sectional study using the following measures: socio-demographic questionnaire (e.g., age); the Global Mea-
sure of Relationship satisfaction; the 18 EMS as assessed by the Young Schema Questionnaire Version 3 – Short Form
(YSQ-S3) as independent variables; and the Problem distress subscale of the Sexual Function Evaluation Question-
naire (SFEQ) as a dependent variable. A total of 469 sexually active people in an exclusive dyadic relationship with a
mean age of 38 years (SD = 11.6; Min- Max= 18-75) answered. All measures showed good internal consistency as mea-
sured by Cronbach’s alpha. We used multiple hierarchical multiple regression analysis, Enter method to establish the
significant predictors. Results: We assessed the ability of 18 EMS to predict levels of sexual distress related to sexual
function after controlling for relationship satisfaction. We conducted preliminary analyses and ensured no violation of
normality, linearity, multicollinearity and homoscedasticity assumptions. At step 1, we entered relationship satisfac-
tion, which explained 7% of the variance. In the final model, with a total of 20% of the variance explained [F (19, 450)
= 6,07, p< 0,001], only the control measure and the abandonment, vulnerability to harm/illness and subjugation EMS
were statistically significant, with relationship satisfaction (beta = –.24, p < .001) and the subjugation EMS (beta = .20,
p < .001) and vulnerability to harm/illness (beta = .17, p < .001) recording a higher beta value than the abandonment
EMS (beta = .13, p < .001). Discussion: The preliminary results from our exploratory study suggest EMS should be
considered in the assessment and, eventually, treatment of sexual distress related to sexual function. The preliminary
final model includes relationship satisfaction, which suggests an integrative approach that considers the interaction
of EMS and explores the current interpersonal intimate context and correlates of relationship satisfaction is needed.

Keywords
Sexual Distress; Early Maldaptive Schemas

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PS86 Socioeconomic status as moderator of the association between mothers’

emotion regulation and depressive symptoms during the COVID-19 pandemic
Cristina Ardelean
University of British Columbia, Canada
Katerina Rnic
University of British Columbia, Canada
Joelle LeMoult
University of British Columbia, Canada
Ashley Battaglini
University of British Columbia, Canada
Ellen Jopling
University of British Columbia, Canada

Abstract
Background: The COVID-19 pandemic drastically altered the daily lives of families worldwide. Mothers, in particular,
experienced significant distress, depressive symptoms, negative mood, and lower sleep quality during the pandemic.
Depression among mothers may have been exacerbated by increased caregiving burden and household responsibili-
ties, pandemic-related pregnancy stress, increased risk for domestic violence, and unemployment. Research suggests
that emotion regulation (ER) is critical for determining how well individuals adapt to stressful conditions, including
whether they develop depressive symptoms. Empirical evidence indicates it is adaptive for individuals to engage
in the ER strategy of cognitive reappraisal to mitigate the risk of depression when they experience uncontrollable
stressors. Cognitive reappraisal is an adaptive ER strategy that involves reframing negative situations more positively.
Moreover, studies suggest that cognitive reappraisal might be especially crucial for alleviating depression in mothers
with a lower socioeconomic status (SES). This result may reflect evidence that the challenges individuals face depend
on their SES. Those from lower-SES backgrounds often encounter greater unpredictability (employment instability,
housing insecurity, food insecurity) and have less control over resources to alter their surroundings than do individu-
als from higher-SES backgrounds; they, therefore, would benefit the most from engaging in cognitive reappraisal. It is,
however, unclear whether the cognitive reappraisal was associated with mothers' depressive symptoms when facing
COVID-19-related stressors and whether their SES moderated this association.
Objective: The purpose of the study was to investigate the moderating effect of SES on how mothers' tendency to use
cognitive reappraisal influenced their mental health during the COVID-19 pandemic, as measured via their symptoms
of depression.
Methods: Participants were recruited online from across North America to participate in this study. Data were gath-
ered at the start of the COVID-19 pandemic in the spring/summer of 2020. Mothers with children less than 18 years
old completed the Emotion Regulation Questionnaire (ERQ) to assess their tendency to engage in cognitive reap-
praisal, as well as the Beck Depression Inventory-II (BDI-II) to assess depressive symptoms.
Results: Linear regression analysis established that mothers’ greater tendency to engage in cognitive reappraisal was
associated with lower levels of depressive symptoms. On the other hand, mothers' SES did not moderate the associa-
tion between cognitive reappraisal and depression.
Conclusions: Our results suggest that cognitive reappraisal is an adaptive emotion regulation strategy regardless of
SES. In other words, even though individuals from lower SES might face more challenges, adaptive emotion regula-
tion strategies continue to be helpful. Elucidating the associations between ER strategies and depressive symptoms
during the pandemic highlights the critical role of cognitive reappraisal in shaping mothers' depression during peri-
ods of high stress. This research is essential as it may inform mental health interventions focusing on the adaptive use
of ER strategies to mitigate adverse mental health effects among mothers from various SES backgrounds.

Keywords
emotion regulation, cognitive reappraisal, depression, mothers, COVID-19

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PS87 Parents’ experiences of change during parent training delivered after a

report of child abuse
Livia van Leuven
Karolinska Institutet, Sweden

Abstract
Objectives: Parenting programs based on social learning theory have been shown effective to prevent child abuse.
However, low motivation to participate is a common challenge. There is also little knowledge about what specific
improvements parents experience from taking part in such programs and a need to improve program effectiveness.
The aim of this study was to gain knowledge about parents’ experiences of participating in Safer Kids, a CBT-based
parenting program delivered to parents reported for child abuse. Interviews were conducted with parents participat-
ing in a randomized controlled trial (RCT) evaluating the effectiveness of Safer Kids.
Method: Interviews were conducted with 15 parents who participated in the Safer Kids RCT. Participants were re-
cruited from the social services in Swedish municipalities. Parents had been reported for physical or emotional abuse
of a child 2-12 years old. A semi-structured interview guide was used and data was analyzed with reflexive thematic
analysis.
Results: Analyses generated themes relating to parents’ experiences of why they took part in the program, change
processes, and improvements: Mindful parenting – Improved presence when being with their child and an increased
ability to take the child’s perspective; Confidence to face challenges – Improved ability to regulate one’s own and the
child’s emotions; Enjoying the relationship – A stronger parent-child relationship characterized by more joyful inter-
actions; The desire to improve parenting strategies – Wanting to improve parenting competence was both a reason
to participate and developed during the course of the program.
Conclusions: Parents reported satisfactory experiences from the program and that the content was useful for them in
their daily life. Several improvements were described. An ability to direct attention to the present moment seemed
crucial for improving emotion regulation and parent-child relationship quality, which could be important to reduce
harsh parenting. A general desire to improve as a parent seemed to be the main reason to participate.
Recommendations or takeaway points:
• Parents seem to be satisfied with Safer Kids and experiencing meaningful improvements.
• Parents describe improvements in their ability to regulate both positive and negative affect, and to be present in
daily life.
• To describe parent training as a way to generally improve parenting competence could be helpful to motivate abu-
sive parents to participate.
• The results can generate hypotheses for future quantitative studies on potential mechanisms of change.

Keywords
Abuse; parent training; child abuse; child protection

PS88 Psychotherapy by video versus at the office: The Covideo study

Einar Heiervang
Innlandet Hospital Trust, Norway
Jo Magne Ingul
Norwegian University of Science and Techonology, Norway
David Clark
University of Oxford, United Kingdom
Eleanor Leigh
University of Oxford, United Kingdom
Marianne Aalberg
Akershus University Hospital, Norway
Jon Fauskanger Bjaastad
Division of psychiatry, Stavanger University Hospital, Norway
Gro Wergeland
University of Bergen, Norway

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Abstract
Introduction
The Covideo study is a randomized nationwide multicenter study with non-inferiority design of psychotherapy for
social anxiety disorder in youth, delivered online by video or at the clinicians office.
Background
At the start of the Covid pandemic clinicians were locked out from offices, having to learn video systems to reach
clients.
In a survey one month later, 73% were quite or very satisfied with video, but there is little empirical evidence for its
use.
Aims
The study aims to provide empirical support for the use of psychotherapy by video for youth in three work packages:
WP1. Effectiveness: Is video therapy non-inferior to office therapy?
WP2. Attractiveness: Is video attractive to youth and therapists?
WP3. Sustainability: Are emissions and costs lower for video?
Sample
Two hundred youth, with a primary diagnosis of social anxiety disorder, 14-18 years, are recruited from clinics or
schools. Exclusion criteria are autism, learning disability, severe depression, psychosis and more than 20% absence
form school.
Therapists
Twentyfour clinicians are recruited from primary and secondary mental health services at four centers across Nor-
way.
In a pilot stage of the study they receive training and supervision for one patient treated by video and one at the
office.
Intervention
The CT-SAD-A has 14 weekly individual 90-minutes sessions and a booster session six months later.
Outcomes
WP1: Response and remission. WP2: Qualitative interviews. WP3: Client reports and registers.
Assessments
WP1: Pre/post and after 2 and 4 years.
Inclusion period
2023 - 2025.
Funding
The national Klinbeforsk program.

Keywords
cognitive, screen, video, effectiveness, acceptability, sustainability, RCT, youth

PS89 Social Anxiety and sensitivity to loss of belongingness and status

Eva Gilboa-Schechtman
Bar Ilan University, Ramat Gan, Israel
Dan Hay
Bar-Ilan University, Israel
Noa Perets
Bar-Ilan University, Israel
Roy Azoulay
Bar Ilan University, Ramat Gan, Israel
Zohar Klein
Bar Ilan University, Ramat Gan, Israel

Abstract
Evolutionary models suggest that social anxiety (SA) is associated with sensitivity to status loss (humiliation) and af-
filiation loss (exclusion). These models make several additional predictions concerning the strength and specificity of
the association between post-event distress (PED) following these losses and SA. First, the strength of this association
is postulated to be uniquely related to SA. Second, for status-loss events, the strength of the association is postulated
to be enhanced in men, especially following status losses inflicted by other men. We examined these predictions in
six online samples: four concerning humiliation (total N = 1123) and two concerning exclusion (total N= 522). In all
studies, participants recalled social loss events and rated the emotional and distressing impact of these experiences.

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Our findings were consistent with evolutionary predictions. SA was associated with PED following social status-loss
events and affiliation-loss (exclusion) events above and beyond the association with other relevant psychopathol-
ogies (depression, generalized anxiety). The PED-SA association following status loss events was stronger in men
than in women. Moreover, the SA-PED association following status loss was especially enhanced following intra-male,
compared to intra-female and inter-gender status losses. These relationships were not observed with respect to ex-
clusion events. Our data highlights the significant impact of socially stressful events and delineates the scarring sig-
nature of such events in SA.

Keywords
social anxiety, social stress, post-traumatic distress, evolutionary theory

PS90 Control Beliefs and The Sense of Social Agency in Depression: Dysphoric
Individuals Fail to Benefit from Social-Control Beliefs
Sun Bleicher
Bar-Ilan Univesity, Israel
Eva Gilboa-Schechtman
Bar Ilan University, Ramat Gan, Israel, Israel

Abstract
The capacity to experience ourselves as initiators and masters of our actions and their consequences – the sense of
agency (SoA) – is inherent to the human condition and appears to be closely tied to the more global and multilevel
cognitive construct of control. Both SoA and control were documented as reduced in depression, according to some
contemporary findings for SoA and the decades-long literature for control. So far, studies examining both the agen-
tic experience and control beliefs in depression were mostly based on explicit judgments and self-reports, drawing
heavily on the participants’ inner-models and perceptions, rather than on their unbiased and ecological experiences.
Moreover, the few studies addressing SoA and depression have mainly focused on non-social settings, even though
depression is theorized as a phenomenon strongly-rooted in social and social-evolutionary factors.
Given the inherently social nature of the depressive experience - examining agency and control beliefs in social set-
tings is likely to activate and realize a context particularly vital to the depressive experience. To that end, we aimed to
evoke vicarious SoA (sense of agency through another) for the social experimental condition, comparing its interac-
tion with depression to the effect of the non-social condition. Depressive symptoms were measured with the BDI-II
questionnaire, dividing the sample to a non-dysphoric group (BDI <= 9) and a dysphoric group (BDI >= 13).
We conducted an online experimental study (n = 202 for the final sample; all BIU students participating for credit)
assessing the agentic experience in a social, as well as non-social, context, using a novel version of an intentional bind-
ing task. For the social-context condition, our task utilizes a social manipulation leading participants to believe they
are interacting with a conspecific and leading their actions, while the non-social version was essentially similar - only
without the manipulation creating the impression of another individual that follows the participants' lead. We found
a main effect for context/condition showing that intentional binding (i.e., SoA intensity) was significantly stronger in
the social context compared to the non-social one (p < 0.000), and that this socially-enhanced agency was confirmed
only for non-dysphoric individuals – so the expected interaction effect was seen in the results as well (p < 0.05). Unlike
a few other recent studies examining SoA and depression, no main effect for depressive symptoms.
These findings support the notion that individuals with higher depressive-symptoms experience difficulties to ben-
efit from social-power and social-agency aspects, as well as control beliefs. Although the social (vicarious) agency
manipulation realized higher SoA for the dysphoric compared to dysphoric SoA in the non-social condition -- this was
non-significant in post-hoc tests. Therefor, these findings join the long line of research regarding depressed individu-
als' difficulties in benefiting from social factors that non-depressed easily "pick the fruits" of, while bringing about a
novel finding -- the difficulty of experiencing enhanced social sense of agency evoked by control-belief manipulation.
Implications for the understanding of control beliefs and SoA in depression are discussed, as well as implications for
future research and clinical thinking.

Keywords
Sense of Agency, Control Beliefs, Depression, Social Psychology, Cognitive Psychology

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PS91 Practice of European CBT psychotherapists with LGBT clients

Marija Knežević
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Serbia, marijaknezevic05@gmail.com
Ivana Peruničić Mladenović
University of Belgrade, Faculty of Philosophy, Serbia
Sanda Stanković
University of Belgrade, Faculty of Philosophy, LIRA Lab, Serbia
Nikola Petrović
University of Belgrade, Faculty of Philosophy, Serbia

Abstract
The aim of this study was to see how well are CBT psychotherapists informed about issues of LGBT population and
to investigate if they feel comfortable treating these clients. The second aim was to examine attitudes towards this
population and how they are affecting psychotherapy practice. We also gave respondents 4 vignettes to determine if
the therapist was doing something wrong in hypothetical cases when working with LGBT clients. The four issues were
assuming heterosexuality of the client, assuming sexual orientation was the cause of client’s depression, assuming
that a bisexual person is actually gay and spending multiple sessions in which the client educates the therapist about
transgender issues. Research was done on a sample of 101 therapists and psychotherapy trainees (83% of which
identify as heterosexual). Results show that 63% of respondents have experience in working with this population and
that 98% would accept working with these clients. The respondents seem interested in problems of LGBT clients but
a third of them say that in reality they are little informed about their issues. The biggest hurdles they see in this work
are anxiety about saying the wrong thing, inexperience and overcoming unintended micro-prejudice. For all of the
vignettes the participants mostly agreed that the therapists made a mistake.

Keywords
LGBT, CBT therapists, attitudes, vignettes

PS92 The role of irrational beliefs (REBT) in intentional nonadherence to

medical recommendations
Sanda Stanković
University of Belgrade, Faculty of Philosophy, LIRA Lab, Serbia, sanda.stankovic@f.bg.ac.rs
Danka Purić
University of Belgrade, Faculty of Philosophy, LIRA Lab, Serbia
Ljiljana B. Lazarević
University of Belgrade, Faculty of Philosophy, LIRA Lab and Institute of Psychology, Serbia
Goran Knežević
University of Belgrade, Faculty of Philosophy, LIRA Lab, Serbia
Iris Žeželj
University of Belgrade, Faculty of Philosophy, LIRA Lab, Serbia

Abstract
Irrational beliefs are the main theoretical construct of rational-emotive and behavioral therapy (REBT), referring to
beliefs that are rigid, extreme, inconsistent with reality, illogical, and maladaptive for the person endorsing them.
Though endorsing irrational beliefs leads to various maladaptive behaviors (e.g. procrastination or avoidance), there
is scarce data on their role in unhealthy behaviors. Intentional nonadherence is a new construct (Purić et al., 2023 )
that refers to a general tendency to not adhere to official medical recommendations, among the general population.
It comprises self-medicating, avoiding medical appointments, and rejecting or changing the prescribed therapy. This
behavior can have serious health consequences for the individual and the society - we know that antimicrobial re-
sistance is one of the top 10 global public health threats according to WHO. In a wider project on health behaviors
(REASON4HEALTH), we found that intentional nonadherence is widespread. In this paper, we investigated the role of
irrational beliefs broadly defined, in predicting intentional non-adherence. Therefore, besides REBT irrational beliefs,
we included conspiracist beliefs, magical health beliefs, superstition, and extrasensory perception. These beliefs refer
to socially developed and shared ideas that lack an evidence base or contradict established scientific principles. We
report data from three samples (a community sample from Bosnia and Herzegovina, N 1 = 530; a quota sample from
Serbia N 2 = 265; and a representative sample from Serbia, N 3 = 1003). REBT irrational beliefs were correlated with in-
tentional nonadherence in all three samples (from .08, p < .05 to .22, p < .001). We conducted hierarchical regressions

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to investigate whether irrational beliefs predict intentional nonadherence above sociodemographic variables and
self-perceived health status entered in the first block and experiences with and/or trust in the medical system entered
in the second block. REBT-derived irrational beliefs were entered into a block alongside other irrational beliefs. The
latter refers to socially developed and shared ideas that lack an evidence base or contradict established scientific
principles. Due to the large scale of the project, REBT irrational beliefs were measured with a very short 6-item scale
(Owings et al, 2013). In samples 1 and 2 the irrational beliefs block made a significant incremental change, and specifi-
cally, REBT-derived irrational beliefs were a significant predictor of intentional nonadherent behavior (βs were .12, p <
.01 in sample 1 and .17, p <.01 in sample 2). Our data offers preliminary evidence for the role of REBT irrational beliefs
in nonadherent behavior, suggesting the possibility of preventive medical programs. Future studies should include
the long version of the measure of irrational beliefs, and seek to refine the evidence for specific irrational beliefs (e.g.
frustration intolerance).

Keywords
irrational beliefs, REBT, intentional nonadherence to medical recommendations (iNAR), health behaviors

PS93 4P Model of an adolescent with sexual orientation

obsessions: a case report
Sena Ciminli
İstanbul Medeniyet University, Turkey
Alperen Bıkmazer
İstanbul Medeniyet University, Turkey

Abstract
INTRODUCTION
Obsessive-compulsive disorder (OCD) is a disabling condition estimated to affect 1% to 3% of individuals throughout
their lifetime. This psychiatric disorder is characterized by obsessions and compulsions, which consume a significant
amount of time and lead to notable distress and impairment. Obsessions refer to intrusive and repetitive thoughts,
urges, or mental images that are challenging to control. With the intensified public awareness and media coverage of
issues concerning gender identity and gender incongruence, distinguishing true gender dysphoria or incongruence
from the sexual obsessions of OCD is especially important.
CASE
A 17-year-old male patient without any history of psychopathology was admitted to our outpatient clinic with com-
plaints of severe anger crises triggered by seeing his father or even just hearing his voice, accompanied by feelings of
malaise and emptiness and suicidal thoughts. When the history was elaborated, it was learned that he had thoughts
that his sexual orientation had changed in the last few weeks and that he had recurrent disturbing thoughts that his
father’s looking or touching him indicated that this situation would never be the same again. These thoughts had
been haunting him for most of his daily life and to test these thoughts, the patient had been checking whether he
was aroused by looking at certain images and checking himself in the same way when he was with his girlfriend. It
was learned that the patient self-harmed himself by cutting his hand with a knife after an argument with his father.
As a result of the history taken from the patient and his mother and mental status assessment, the patient was di-
agnosed with OCD and CBT and concurrent medical treatment was started. Sertraline 50mg and Risperidone 0.5mg
was started and increased to Sertraline 200mg and Risperidone 1mg. Although his depressive mood and self-harm
thoughts regressed significantly, his obsessive thoughts did not respond adequately to medical treatment. During
the follow-up period, his thoughts and expressions of anger changed from his father towards his brother, his friends
and even his employers. Although he could not get rid of his obsessive thoughts, his avoidance behaviors such as
smoking, alcohol use, pornography addiction and anger expressions improved.
The patient was exposed to many challenging life experiences such as witnessing the death of a childhood friend,
migration to another country, peer bullying and domestic violence. The patient’s grandmother had a history of con-
tamination OCD, suggesting a genetic predisposition. The patient has an unstable school and worklife which makes
it difficult for the patient to establish a healthy life routine and fight against OCD and other addictions. On the other
hand, the patient’s compliance to therapy and his insight are factors that affect the patient’s prognosis well.
DISCUSSION
With this case, we wanted to present an example of sexual orientation OCD, which is a rare form of OCD. We tried to
address the factors affecting the emergence and course of the disease. More studies are needed to differentiate sex-
ual orientation OCD from gender dysphoria and to intervene with the right approach.

Keywords
obsessive-compulsive disorder, sexual orientation, formulation

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PS94 Culturally adapted cognitive-behavioral group therapy plus problem

solving training for mental disorders in refugees:
a multicenter randomized-controlled trial
Ulrich Stangier
Institut für Psychologie der Goethe-Universität Frankfurt, Germany, Germany

Abstract
Introduction
Since a high proportion of refugees in Germany suffer from a broad range of mental disorders, transdiagnostic treat-
ments are needed that target a broad range of symptoms. There is much evidence for the efficacy of culturally adapt-
ed cognitive-behavioral therapy (CA-CBT). Based on the promising results of CA-CBT in pilot studies, the combination
with problem solving training (CA-CBT+) represents a novel approach that potentially improves the refugees’ ability
to cope actively with psychosocial problems. A randomized-controlled multicenter trial was conducted evaluating
the efficacy of CA-CBT+ compared with treatment as usual (TAU) in a sample of refugees suffering from at least one
DSM-5 disorder.
Methods
130 adult refugees with at least one primary DSM-5 diagnosis were allocated to CA-CBT+ or TAU. Refugees came from
Afghanistan (59%), Iran (20%), Syria (9 %), Iraq (4%) and other, mainly African countries (8%). CA-CBT+ consisted of 12
weekly group sessions providing psychoeducation, techniques of emotional regulation, stretching and problem solv-
ing training. Primary outcome was treatment response as defined by a clinically significant change in General Health
Questionnaire score at post-treatment. intervention. Secondary outcomes comprised changes in psychopathological
symptoms, somatic symptoms and quality of life. Follow-ups have been scheduled for 3 and 9 months after treatment.
Results and conclusion
After treatment, there was a significant superiority of CA-CBT+ as compared to TAU (63,3 vs. 40%). Furthermore, signif-
icant and substantial effects were observed in psychopathological distress, depression, symptoms of PTBS and quality
of life. Furthermore, there was a significant interaction with gender, indicating that male refugees showed very strong
effects in CA-CBT+ vs. TAU, whereas women did not differ between both conditions. The results support the important
role of CA-CBT+ in the implementation as a stepped care component in mental health care for refugees in Germany.

Keywords
Refugees, cultural adaptation, CBT, trauma, depression

PS95 Process-based therapy: a new approach to personalized

assessment and treatment
Ulrich Stangier
Institut für Psychologie der Goethe-Universität Frankfurt, Germany, Germany

Abstract
The process-based approach offers a new conceptualization of personalized assessment and treatment planning. A
key element of this concept is the view that the cause of mental health problems cannot be explained by the latent
disease model but should be conceptualized as dynamic networks of individual psychological processes.
One of the innovative components of process-based therapy is that the hypothetical model of the disorder, derived
collaboratively by therapist and patient in the initial treatment sessions, is tested empirically. This is achieved using
ecological momentary assessment in the real-life context of the patient, based on a smartphone app allowing for
personalized items. To reduce the burden of daily EMA, assessment is restricted to a limited number of variables.
Patients are instructed to enter ratings of these variables several times a day in relevant situations related to their
individual problems. Furthermore, to avoid an exclusive focus on psychopathology and increase the variance of vari-
ables, ratings are given not only on negative aspects but also on the positive pole of the dimension (e.g., avoidance
vs. approach behavior, dysfunctional cognitions vs. adaptive appraisal, etc.). After collecting a sufficient number of
negative and positive ratings, data are analyzed using dynamic network analyses, and central factors (“nodes”) main-
taining maladaptive networks are identified. These “nodes” serve as targets for the implementation of interventions.
In addition, treatment planning is refined by matching interventions to the central node of the individual patient
based on the active ingredients rather than considering the global efficacy of treatment packages (e.g., cognitive
reappraisal vs. cognitive therapy, behavioral activation vs. CBT). The empirical basis for evaluating the effective com-
ponents of an intervention is provided by research on mediators. If there is evidence that a specific mediator explains

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the effectiveness of a certain intervention, then the intervention will have a strong effect on the central nodes of the
pathological network. Additionally, to assess change processes, daily measurements of the central node are conduct-
ed.
Clinical case descriptions are presented to demonstrate the feasibility of process-based therapy, including dynamic
network models and algorithms for treatment decisions. Furthermore, future applications of using artificial intelli-
gence and big data to improve the prediction of network changes are discussed.

Keywords
process-based therapy; ecological momentary assessment; dynamic network analysis; active ingredients

PS96 The Role of Irrational Beliefs in Diabetes Distress

Smiljana Cvjetkovic
Faculty of Medicine, University of Belgrade, Serbia
Kristina Vrtic
Tratamento AG, Switzerland
Milica Todorovic
Udruženje za kognitivne i bihejvioralne terapije Srbije, Serbia
Ognjen Krcmar
University of Belgrade - Faculty of Medicine, Serbia
Slavisa Kovac
Association Rainbow, Serbia
Aleksandar Prica
Association Rainbow, Serbia
Vida Jeremic Stojkovic
Faculty of Medicine University of Belgrade, Serbia

Abstract
Background: Empirical and clinical evidence indicate that negative emotions associated with diabetes can signifi-
cantly impair the quality of life for those affected. Emotional challenges that arise from managing the demands of
living with the disease has been recognized as diabetes distress, where distress about stigma, healthcare provider and
interpersonal issues have been identified as some of the most important aspects. Distress about stigma refers to the
disease related shame and feeling that it needs to stay hidden from others. Distress about healthcare provider encom-
pass the perception of lack of the authentic caring human relationship with their doctor. Distress about interpersonal
issues involves the perception of lack of care and understanding from one’s own family and friends.
The Aim: The aim of the study was to determine irrational beliefs related to distress about stigma, distress about
healthcare provider and distress about interpersonal issues in patients with type 2 diabetes.
Methods: Total of 313 respondents with type 2 diabetes aged 30-83 years from Serbia participated in the study. A
cross-sectional design was applied using an online questionnaire and convenience sampling procedure. Irrational
beliefs were measured using the Shortened General Attitude and Belief Scale (SGABS) and perception of relationships
with healthcare professionals and friends and family and shame related to the disease were assessed by Type 2 Diabe-
tes Distress Assessment Tool (T2DDAT-Sources). Multivariate regression analysis was employed.
Results: People who experienced more stigma due to their condition (β=.52, p<.001) and felt they lack support and
understanding from their healthcare professional (β=.33, p<.001) were more prone to self-downing. Respondents
who believed they lack support and understanding from their friends and family had more pronounced need for
approval (β=.22, p<.05) and were more inclined to others-downing (β=.18, p<.05).
Conclusion: Understanding the relationship of self-downing, others-downing and need for approval with the aspects
of diabetes distress can inform interventions aimed at reducing suffering and improving overall well-being in individ-
uals with diabetes. Strategies focused on unconditional acceptance may help mitigate diabetes distress and improve
quality of life of people suffering the disease. In addition, our findings indicate the need for certain public health
interventions such as inclusion of health psychologists in diabetes counselling centre activities and provision of com-
munication skills training for endocrinologists and diabetologists.

Keywords
Irrational beliefs, Diabetes distress, Type 2 diabetes

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PS97 Brief CBT for eating disorders (CBT-T) is a case of protocol adaptation for
anorexia nervosa in a teenager with low weight
and in combination with SSRIs.
Elena Okonishnikova
Peoples’ Friendship University of Russia named after Patrice Lumumba. Assosiation for Cognitive and Behavioural
Psychotherapy., Russian Federation

Abstract
Introduction
Brief CBT for eating disorders (CBT-T), authors Waller, G. et al. is designed for adult patients without body weight defi-
ciency. There is no special selection of patients, cases of bulimia nervosa and anorexia nervosa, binge eating disorder,
and other specific eating disorders can be included.
The exclusion criteria are the absence of active forms of suicidality or serious self–harm. Adherence is about 90% and
is well received by patients, as it is more flexible and much cheaper [Hoskins et al. 2019]. Also effective as 20 sessions
of classic CBT-E [Signorini et al. 2018; Turner et al. 2015]. However, the demand for therapy for eating disorders ex-
ceeds available resources and patients, including those with a body weight deficit, have to wait for long time, and
weight continues to decrease. This may justify the use of CBT-T for patients with, but subject to additional conditions.
Materials and methods
A male teenager, 14 years old. Diagnosis: F50 Anorexia nervosa. Complaints: low mood, increased anxiety; obsessive
thoughts about the calorie content of food, about body weight, about losing weight; considers himself “fat” — he
does not like cheeks, stomach, buttocks.
From anamnesis: during the pandemic, due to the quarantine of the school and gym, he stopped exercising and spent
more time at home at the computer, it began to seem that he “got fatter”; height / weight at that time 172 cm / 59
kg, BMI 19.9; began to limit the amount of food and its calorie content to 800 kcal. per day due to carbohydrates and
fats, ate three times a day, counted calories in all foods, weighed himself daily; lost 13 kg of weight in six months, at
the time of therapy height / weight 172 cm / 46 kg, BMI 15.5 kg; the level of motivation for treatment and recovery is
high, looking for help.
Used: Clinical Interview (ICD10); EAT26 and ED-15 tests; Nutrition diaries; Weight chart.
Result
Therapeutic interventions:
Psychopharmacotherapy — Sertraline 100 mg per day.
Phase 1. Early nutritional changes and exposure, sessions 1-4.
Phase 2. Behavioral experiments and cognitive restructuring, sessions 3-7.
Phase 3. Working with emotional triggers, sessions 5-7.
Phase 4. Working with body image, sessions 5-9
Phase 5. Prevention of relapses, sessions 9-10
Follow-up consultations in 1 month and 3 months.
At the end of therapy: eats five times a day, tries not to fix on portions and calorie of food, focuses on hunger and
satiety; weighs himself once a week (so as not to go into weight deficit again); height / weight 173 cm / 56.4 kg, BMI
18.85— weight gain 10.4 kg by week 9-10 of therapy;
Conclusion
This case showed the effectiveness of the use of Brief CBT for eating disorders for a teenager with a weight deficit and
high motivation for treatment and recovery and in combination with SSRIs. This justifies the further study of the ef-
fectiveness of this protocol on a wider sample of adolescent patients with weight deficiency, provided they are highly
motivated and possibly in combination with SSRIs.

Keywords
Eating disorders. Anorexia nervosa and bulimia nervosa. Adolescents with body weight deficit. Brief CBT for eating
disorders (CBT-T).

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PS98 Preliminary Psychometric Analysis of the Emotional Needs Scale

Bruno Faustino
Lusófona University, HEI Lab: Digital Human Environment Interaction Labs, Lisbon, Portugal
Catarina Raposo
Center for Psychology at the University of Porto, Faculty of Psychology and Educational Sciences of the University of
Porto, Portugal

Abstract
Attending to universal human needs is an integral compound of psychotherapy. According to the biopsychosocial
and contextual pressures model, several emotional needs require modulation for individuals to achieve adequate lev-
els of psychosocial functioning and mental health. However, a coherent assessment measure is lacking to assess these
needs. Therefore, this poster describes the preliminary Emotional Needs Scale (ENS) developed, Exploratory Factor
Analysis (EFA) and correlational analysis. Standard procedures were used for item development. Individuals (N=327)
answered several questionnaires in a cross-sectional design. Nine emotional needs emerged through EFA: stability
and nurturance, development and autonomy, acceptance and emotional fulfillment, expression and spontaneity,
worth and self-coherence, internal limits and modulation, social pleasure and compassion, reciprocal fairness and
justice, cognition and meaning. Almost all emotional needs correlated negatively with psychopathological symptoms
measured with the Brief Symptom Inventory (BSI-53). Results suggest that the ENS may become an accurate instru-
ment for emotional needs assessment. Nevertheless, more research is required to explore scale features with similar
constructs in other samples.

Keywords
emotional needs scale; exploratory analysis; correlational analsysis

PS99 Assessing the Integration of Cognitive Behavioral Therapy Education in

Turkish Undergraduate Psychology Programs
Uzay Peser
Yeditepe University, Turkey
SILA YOLCU
Yeditepe University, Turkey
Nuray Nabizade
Yeditepe University, Turkey
Ezgi Uzun
Medicana Ataköy Hastanesi, Turkey
SENA ECE ILGIN
Marmara University Research & Training Hospital, Turkey

Abstract
Cognitive Behavioral Therapy (CBT) is globally used for addressing maladaptive thought patterns and behaviors as-
sisting individuals who experience psychological distress. It is a significant component of psychology education and
practice in Turkey, comparable to how it’s applied globally. University programs, clinical training, psychotherapy, spe-
cialized training and supervision are examples of how CBT is applied into the field of psychology, both in education
and professional contexts in Turkey.
This study aims to assess the prevalence of CBT education in Turkish undergraduate psychology programs and adhere
to which extent the CBT courses meet international standards. Specifically, by analyzing the ratio of how many Turkish
universities offer CBT integrated programs, where universities are spread out geographically, and how closely the
course curriculums align to international criteria. The study will explicitly focus on 18 universities, which are accred-
ited by the Turkish Psychological Association (n=18). This ensures that the examined universities have a baseline of
professional licensure and recognition of educational quality.
Universities in Turkey which integrate CBT into their curriculum ensure that students receive evidence-based meth-
ods. Turkish universities can promote cultural sensitivity in therapy for mental health issues by teaching psychologists
CBT in a Turkish context. Trained CBT practitioners can effectively address prevalent problems like anxiety, depression,
and trauma. The structured CBT education meets certification and licensing requirements of professional organiza-
tions such as the TPD and TACBT. Turkish universities are investing in society’s mental health by emphasizing CBT in
their curricula.

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Yet, there is still a lack of information on the incorporation of Cognitive Behavioral Therapy (CBT) in psychology pro-
grams at universities in Turkey. This research will address this gap by examining the curricula of undergraduate psy-
chology programs at 18 universities accredited by the Turkish Psychological Association (TPD) to assess the preva-
lence, content, and emphasis on CBT-related courses.
Results indicate that only three universities offer specific courses on CBT, while others mention CBT in broader courses
like Selected Topics in Clinical Psychology and Family Therapies.
Challenges were encountered in obtaining detailed curriculum information from some universities. This analysis aims
to provide insight into the current status and significance of CBT education in Turkish psychology programs.
In order to understand how Cognitive Behavioral Therapy (CBT) is integrated into undergraduate psychology educa-
tion in Turkey, this study examines the following inquiries:
• The presence of CBT-specific courses in accredited Turkish undergraduate psychology programs.
• The emphasis on theoretical understanding, practical application, or an integrated approach to CBT in these
programs.
• The alignment of CBT curricula in Turkish universities with international standards for CBT education.
• The challenges in implementing comprehensive CBT training across diverse regions in Turkey.
The study sheds light on the current status of CBT education in Turkey, revealing that only a few universities offer ded-
icated CBT courses, while many incorporate CBT into broader therapeutic courses. This highlights a potential gap in
focused CBT training. Addressing these shortcomings is crucial for bringing Turkish psychology programs in line with
global standards and improving mental health services.

Keywords
psychology, syllabus, cbt

PS100 Case Report: OCD In A Homosexual Adolescent

Gunay Budagova
Department of Child and Adolescent Psychiatry Biruni University Faculty Of Medicine, Turkey

Abstract
Abstract: Obsessive-Compulsive Disorder (OCD) is a psychiatric disorder included in the DSM-5 Obsessive-Compul-
sive Spectrum Disorders. The main OCD symptoms include intrusive thoughts (obsessions), and ritualistic behav-
ior (compulsions). Obsessions are unwanted, intrusive, recurrent thoughts or impulses associated with significant
distress. Compulsions are excessive or unrealistic repetitive behaviors reinforced by escape from obsession-related
distress . Obsessions in OCD are typically ego-dystonic, i.e., inconsistent with an individual’s self-image, values, and
beliefs. Sexual orientation-based OCD has become a well-investigated form of OCD doubt, and is characterized by
repetitive, intrusive, ego-dystonic thoughts about sexual orientation, often accompanied by reassurance seeking, and
ritualistic verification of a patient’s sexuality.
Case: Mr. F. is a 17-year-old biological male, a high school senior. 4 years ago, during the Covid-19 pandemic, he re-
ceived psychopharmacological treatment for a year due to his obsession with cleanliness and contamination. The
reason for applying to our clinic was that he had obsessions about his sexual orientation. The young man, who stated
that he was a homosexual, stated that he had been disturbed by doubts and compelling thoughts about being a
pedophile for about 3 months. He expressed that if he sees a child somewhere or hears a child’s voice, he wants to
cover his ears and get away from the environment. He stated that since the Child Psychiatry outpatient clinic in our
clinic is located within the Children’s Clinic, he always had to listen to music in the background with his headphones
during the interview. He stated that he tried to get rid of doubts about his sexual orientation by going to girls’ gyms
from time to time to test whether he liked the opposite sex, and that when the female students in his class touched
him, he thought about whether he liked them or not, and that he was disturbed by these thoughts. Mr. F. completed
the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) checklist in clinic, score was 21. It was revealed that he had reli-
gious obsessions as well as sexual orientation obsessions (he stated that he was an atheist, but at times he had doubts
about his belief ). CBT and psychopharmacological treatment were planned for the patient.
Discussion: Sexual orientation-related obsessions might serve as a “template” for understanding how transgender
identity can also be a topic of OCD-related doubt. Obsessions about sexual orientation are often “classified” as un-
acceptable or taboo obsessions because they load predominantly onto the corresponding factor in factor analytic
studies. Compared to patients with OCD who do not have sexual orientation-related obsessions, those with such
obsessions report significantly more distress and interference from obsessions, as well as greater proneness to avoid-
ance. In our case, responses to sexual orientation-related obsessions are observed, such as avoiding specific situations
that may trigger the obsessions and behaviors that “test” the person’s sexual orientation. Mental health professionals
play a central role in distinguishing between OCD with gender identity-related obsessions, and the questioning of

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one’s gender identity that is based on the deeply felt incongruence between assigned gender and the gender that
the person identifies with.

Keywords
obsession, compulsion, gender identity, sexual orientation

PS102 Self-care as a tool for preventing mental illness

Anabela Pereira
University of Aveiro, Portugal
Isabel Souto
University of Aveiro, Portugal
Elisabeth Brito
University of Aveiro, Portugal
Ines Direito
University of Aveiro, Portugal

Abstract
Background: This paper explores the relationship between self-care and the well-being of teachers in the context of
Portuguese higher education (HE), focusing on self-care as a tool for preventing mental illness and promoting indi-
vidual and organizational health.
Method: The sample consisted of 401 higher education teachers, whose data was collected using the Self-Care Ac-
tivities Screening Scale (SASS-14), Brief Resilient Coping Scale (BRCS), Kessler Psychological Distress Scale (K10), Fear
and Anxiety of Covid-19 Scale (FAS-19), Copenhagen Psychosocial Questionnaire(COPSOQ III), and Sociodemographic
Questionnaire.
Results: Self-care is moderately practiced by (HE) teachers. Of the self-care factors considered, inter- and intrapersonal
coping strategies are the least used. Sleep quality improves with age, while nutrition and physical activity are more
frequent in polytechnics. Self-care is negatively related to work-family conflict, especially during the COVID-19 pan-
demic, when teleworking and caring for dependents increased this conflict. The relation of selfcare with satisfaction
with lifestyle during the pandemic reinforces the role of self-care as a response to daily and work stress. In addition,
self-care acts as a predictor of well-being, evidencing itself as protective against adverse effects on the individual and
organizational health.
Conclusion: Psychology can provide resources and support to facilitate self-care practices for mental illness preven-
tion, which arise from the negative impacts of daily and work-related stress, as well as impacting resilience, emotional
regulation and stress management. Promoting self-care in organizational policies and practices is crucial for valuing
mental health and work-life balance. Health literacy and health-consciousness are fundamental for adherence to self-
care behaviors.

Keywords
Self-care, mental wellbeing, health-consciousness, individual and organizational health

PS103 Virtual Reality as a Therapeutic Tool for Depression:

A Systematic Review
Narcis Galatanu
Babeș-Bolyai University, Department of Clinical Psychology and Psychotherapy, Romania
Daniel David
Babeș-Bolyai University, Department of Clinical Psychology and Psychotherapy, Romania

Abstract
Depression is a common disease worldwide, affecting approximately 3.8% of the population, which represents ap-
proximately 280 million people (Global Health Data Exchange, 2019). Although there are effective treatments for
mental disorders, more than 75% of people in low- and middle-income countries do not receive any treatment (Ev-
ans-Lacko et al., 2018). Barriers to providing effective treatment include lack of resources, lack of qualified staff and
social stigma associated with mental disorders. A promising alternative to overcome these barriers could be the deliv-

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ery of therapeutic interventions through virtual reality. However, literature for treating depressive symptoms with VR
is relatively sparse, and there is no clear direction on which type of intervention to choose when treating depression
with VR. The aim of this systematic review is to analyze interventions that have used virtual reality to treat depressive
symptoms and to determine the magnitude of their effectiveness.
Methodology
Interventions aimed at reducing depressive symptomatology were included in the analysis, provided that reduction of
depressive symptomatology was the primary outcome, using interactive immersive (6DoF) or semi-immersive (3DoF)
virtual reality as a direct or adjunctive delivery method of the intervention. The samples studied were of clinical na-
ture. Search terms used in five databases included terms such as "virtual reality," "depression," "intervention," and their
derivatives. The selected studies were qualitatively assessed based on the psychological mechanism targeted, how
the intervention was delivered via virtual reality, the type of VR system used and the functionalities implemented, as
well as the cost-benefit analysis.
Results
The qualitative analysis identified eight studies eligible for review. The studies were analyzed individually and divided
into categories according to the type of intervention: behavioral activation (n=3), self-compassion (n=1), Eriksonian
psychotherapy intervention (n=1), supportive-expressive therapy (psychotherapy psychodynamic) (n=1), increased
positive affect through autobiographical memories (n=1), and psychedelic experiences in VR (n=1). In all interven-
tions, the level of depressive symptoms decreased after the intervention was completed.
Conclusions
Virtual reality is an innovative way to deliver therapeutic interventions for the treatment of depression that has the
potential to overcome some of the traditional barriers to treatment access. The reviewed studies suggest that virtual
reality interventions may be effective, but require further optimization and further research to determine the most
effective methods and practices. Indications for a more appropriate use of VR in interventions have been made, so
that the use of VR is an asset and a more effective method of delivering interventions, leading to better outcomes. The
limits of using VR in interventions were also discussed.

Keywords
Virtual Reality, Depression, Systematic Review, VR Interventions

PS104 Cultivating Resilience: The Impact of Mindfulness-Based Stress

Reduction (MBSR) on Self-Compassion And Mindfulness
Serra Kadayıfci1, Ela Oncel Arı1
1
Istanbul Medipol University, Psychology Department, Istanbul, Turkey

Correspondence:
M.A Clinical Psychology Student Serra Kadayıfci, PhD Assistant Professor Ela Oncel Ari
serrakadayifci98@gmail.com, ela.ari@medipol.edu.tr

Abstract

Aim: This study aims to improve participants’ awareness, self-compassion and resilience through a mindfulness-based
stress reduction program. Secondary aim is to improve expressivity and interpersonal emotional regulation to assess
impact of MBSR on interpersonal skills.
The aim of this study was to investigate individuals’ and interpersonal effects of a mindfulness-based stress reduction
program (MBSR). This study examines the impact of a mindfulness-based stress reduction program on participants’
in experimental group the mindfulness awareness, interpersonal emotion regulation, emotion expressivity, self-com-
passion and resilience. A sample of 20 participants, aged 18 and above, were recruited for the study. The experimental
group (n = 9) and control group (n=11) completed Mindful Attention Awareness Scale (MAAS), the Self-Compassion
Scale-Short Form (SCS-SF), Interpersonal Emotion Regulation Questionnaire (IERQ), The Brief Resilience Scale and the
Berkeley Expressivity Questionnaire (BEQ), before and after completion of MBSR course.
The foundation of this study lies in Kabat-Zinn’s pioneering development of the 8-week Mindfulness-Based Stress Re-
duction Program (MBSR) at the University of Massachusetts Medical School in 1979. Initially designed to help patients
manage chronic pain, the MBSR program altered patients’ relationship with pain rather than eradicating it. Formal and
informal mindfulness practices, including body scan, walking meditation, sitting meditation, breath awareness medi-
tation, mindful eating, and mindful communication, constitute the core components of the program. Home practices
reinforce the development of mindful skills each week. Our examination of numerous research findings highlights

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MBSR’s positive impact on psychological well-being, as evidenced by significant reductions in symptoms of anxiety
and depression (Norouzi et al., 2020). The 8-week MBSR program, developed by Jon Kabat-Zinn, was implemented,
involving formal practices such as body scan, walking meditation, sitting meditation, breath awareness meditation,
and visual meditation, as well as informal practices like mindful eating and mindful communication. Home practices
were assigned after each session to support the development of mindfulness skills. The study aimed to assess MBSR
effect on both experimental group and control group participants’ individual and interpersonal skills by comparing
pre-test and post-test scores. To determine if there was any change between the pre-test and post-test scores in both
groups, a paired-sample t-test was conducted.

According to research results, participants in experimental group reported higher mindfulness awareness scores in
the post-test compared to the pre-test (p <.05). The experimental group also showed significant improvements in
self-compassion scores (p <.01) compared to the control group. The study contributes to the existing literature by
focusing on the individual and interpersonal effect of MBSR in a sample of participants with no previous mindful-
ness training experience. Previous research has primarily examined the individual benefits of mindfulness in specific
populations, such as healthcare professionals and students. This study extends the understanding of mindfulness
interventions by demonstrating their potential impact on expressivity, self-compassion and interpersonal emotion
regulation as well as their well-being.
In conclusion, the findings show that participating in a mindfulness-based stress reduction program can enhance only
the MBSR course participants’ individual skills such as mindfulness awareness and self-compassion but no significant
difference was found according to their emotional expressivity, resilience and interpersonal emotional regulation.
These results have implications for individuals seeking to improve their well-being through mindfulness practices.
Mindfulness-based programs tailored specifically for interpersonal emotion regulation and emotional expressivity
could be developed. Our aim was to enhance these aspects through the program; however, this was not achieved.
Extending the MBSR program beyond eight weeks might alter the outcome, or it is possible that MBSR does not
sufficiently cultivate skills in these areas. Therefore, it is recommended to adapt the MBSR program with a focus on
improving interpersonal emotion regulation and expressivity skills.

Keywords
Mindfulness based stress reduction, mindfulness, self-compassion, interpersonal emotion regulation, emotional ex-
pressivity, brief resilience.

PS105 CBT via Videoconferencing for Youths in COVID Era: Outcomes on

Anxiety and Depression Symptoms
Mehmed Seyda Tepedelen
Department of Psychology, School of Humanities and Social Sciences, Ibn Haldun University, Turkey, Turkey
Burcu Uysal
Ibn Khaldun University, Turkey

Abstract
The purpose of this study was to determine how well online CBT anxiety and depression management psychoeduca-
tion programs contribute to reducing the COVID-19 pandemic’s detrimental psychological effects on Turkish children
between the ages of 14 and 20.
Method
This study evaluated the impact of online Cognitive Behavioural Therapy (CBT)-based anxiety and depression man-
agement psychoeducation programs on mental health and coping skills in youth ages 14–20 by using a within sub-
ject pretest-posttest methodology. To lower the possibility of dropout rates, a total of 4 anxiety psychoeducation and
2 depression psychoeducation groups were created. Each group was arranged based on the participants’ after-school
schedules. Out of the two depression psychoeducation groups, 15 attended the 4 sessions, while the remaining 28
attended the first session. Furthermore, of the 4 anxiety psychoeducation groups, 50 attended the initial session, and
only 17 finished all four. Every session was conducted using Zoom and lasted approximately 90 minutes. To evaluate
the effectiveness of the psychoeducational program, the Revised Child Anxiety Depression Scale, KidCope, and the
Demographic Information Form were given both before and after the program.
Results
In the anxiety psychoeducation group, adaptive coping strategies went up (T = 55.00, z = 2.87, p = .004, r = .49), avoid-
ant coping strategies went down (T = 18.00, z = −1.95, p= .050, r = −.33) and anxiety scores went down (T = 30.00,
z = −2.20, p = .028, r = −.37). The depression scores and maladaptive coping strategies did not show a significant

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difference (p > .05). The depression psychoeducation group exhibited For the depression psychoeducation group, a
significant decrease in depression scores was found (T = 25.00, z = −1.99, p = .046, r = −.36). Anxiety scores and coping
skills showed no changes (p > .05).
Conclusion and Discussion
Following the online CBT anxiety management psychoeducation program, the results show a large reduction in anx-
iety levels, a major decrease in avoiding circumstances that cause anxiety, and a significant increase in coping skills.
Participants in this psychoeducation program showed a substantial decline in depression levels. This study contrib-
utes to the body of literature suggesting that short psychoeducation programs could be more easily implemented in
a variety of contexts, such as schools, counseling centers, virtual settings, and hospitals, saving time and money. Given
the study’s limitations (e.g., no control group, high attrition), these results should be interpreted cautiously; however,
they do indicate that psychological prevention or intervention programs might be helpful for young people who are
unable to attend school due to physical limitations or who are unable to interact in person with social support net-
works. Although efforts were made to create a dynamic setting for participants, there was little opportunity for both
individual and group contact and involvement. Future research that incorporates active participation programs may
therefore be taken into consideration. Furthermore, a control group and follow-up test would strengthen the study’s
methodological design.

Keywords
psychoeducation, anxiety, depression, COVID-19, CBT

PS106 Kognitivne distorzije u crnogorskim izrekama i poslovicama

Milena Raspopović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Montenegro
Nevenka Pavličić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Montenegro
Nikola Ralević
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS), Montenegro

Abstract
Narodne izreke i poslovice, kao dio tradicije i nasleđa u Crnoj Gori, dobro su polazište za izučavanje kolektivnih vri-
jednosti života u crnogorskom društvu. Nesporan je doprinos narodnih poslovica usvajanju određenog univerzalnog
sistema vrijednosti koji veliča čast, poštenje, hrabrost, odlučnost… Ove narodne umotvorine dio su svakodnevne
komunikacije u društvu, pa iako ih ljudi često koriste, nisu u potpunosti svjesni njihovog značenja. Međutim, postavlja
se pitanje ograničenja koje opšteprihvaćeni narodni izrazi predstavljaju pred pojedinca. Kao REBT&CBT terapeuti čes-
to se u praksi susrećemo sa samoosujećujućim porukama koje proizilaze upravo iz tih izraza, a ni sami nismo sasvim
imuni na njihovo korišćenje.
U ovom radu smo identifikovali i analizirali kognitivne distorzije u nekim od najfrekventnijih crnogorskih izreka. Kao
primjer etiketiranja imamo izreku: ,,Zlo goveče, dovijeka june.’’ Primjer fokusiranja na negativno: ,,Obećanje ludom
radovanje.’’ Primjer katastrofiziranja: ,,Čovjek se vremenom izliže kao para.’’ Primjer sve ili ništa razmišljanja: ,,Dok jed-
nom ne mrkne, drugom ne svane.’’ Primjer skoka na zaključak: ,,Što je brzo, to je kuso.’’ Primjer petjerane generalizacije:
,,Ako želiš izgubiti prijatelja, pozajmi mu novac.’’ Primjer tunelske vizije: ,,Niko srećan, niko zadovoljan, niko miran, a
niko spokojan.’’
Svrha ove analize je da se ukaže na negativan uticaj pojedinih opšteprihvaćenih i uveliko upotrebljavanih narodnih
izreka i poslovica na funkcionisanje pojedinca, te da se podstakne kritičko razmišljanje o sadržaju istih.

Keywords
narodne izreke, narodne poslovice, kognitivne distorzije, analiza sadržaja

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PS107 On the Question of Existential Anthropology as a Philosophical Level

of the Cognitive Behavioral Approach
Dmitry Dyakov
Institute of Psychology, Belarus, Belarus
A.S. Martysevich
Belarus CBT Association, Belarus

Abstract
Many leading experts have spoken about the potential for collaboration between Cognitive Behavioral Therapy (CBT)
and Existential Psychotherapy. We agree with this view, but we also propose that this integration should be carried
out not only through the use of individual ideas or techniques from Existential Psychotherapy, but also at the theo-
retical and methodological levels. In particular, we believe that the Socratic paradigm, in the broadest sense of the
term, including the teachings of Socrates himself -- The Stoics -- an Existential-phenomenological school, implicitly
took place as philosophical foundation of Cognitive Behavioral Therapy (CBT). Existential-phenomenological philos-
ophy, which reveals the fundamental existentials of human existence, offers a broader understanding of a person as
a bearer of the psyche, which is significant for a specialist engaged in cognitive behavioral therapy. Moreover, this
contextualization allows for the development of an integrated concept of needs, which is a topic widely discussed in
contemporary psychology.
Within the framework of our model of human needs, we have creatively integrated the ideas of P.V. Simonov, J. Young,
and C. S. Dwek. We also draw on the ideas of Martin Heidegger regarding the ultimate importance of meaningful
existence for humans being and E. Van Dorzen’s idea about the main existential dimensions of human existence built
on the basis of M. Heidegger’s fundamental ontology. We proceed from the existential understanding of man as
an ecstatic, transcendent being here. Generalizing and comprehending these ideas, we consider from the fact that
psychoemotional needs according to J. Young or social and zoosocial needs according to P. V. Simonov and even
basic needs according to C. S. Dweck are not ultimate for a human being, but go back to the need for transcending
existence, which makes this existence meaningful. It is essential for an individual to maintain their safety not only for
the sake of it, but also in order to live as long and fulfilling a life as possible. It is also crucial for a person to feel loved
or to develop professional competence, that is, to establish their significance for others, not just as an individual, but
also in order to contribute meaningfully to the lives of others and transcend the boundaries of individual existence.
To summarize briefly, the reorganization of Existential Anthropology and the hierarchy of psychoemotional needs
makes it possible to base the principles and techniques used in various models of Cognitive Behavioral Therapy (as
well as Existential Therapy), on a single methodological foundation. This allows for a more systematic and consistent
operationalization of these principles and techniques in therapy.

Keywords
CBT, philosophy, existentialism

PS108 Positive and Negative Impacts of Rumination in People with Mild and
Severe Depressive Symptoms
Viktoriia Denisova
National Research University Higher School of Economics, Russian Federation

Abstract
Introduction
Rumination (from Latin “ruminato” – repetition, chewing) is an obsessive type of thinking characterized by the occur-
rence and repetition of the same thoughts. In psychotherapy, rumination refers to the tendency to constantly think
about the causes, situations, and consequences of one’s own negative experiences. Rumination is one of the predic-
tors of depression and its role in occurrence and maintenance of depressive disorders are studied by M. T. Banich, K. L.
Mackiewicz, B. E. Depue, A. J. Whitmer, G. A. Miller, W. Heller, E. Watkins and others.
The hypotheses:
- The emotional and cognitive spheres influence the occurrence and maintenance of rumination in people
with depressive symptoms.
- The occurrence of rumination in people with mild symptoms of depression has a positive impact.
Methods
A total of 44 people participated in the study, 24 of them women and 20 men, the age of the subjects ranged from 22
to 45 years. The three following methods were used in the study.

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1. The Beck Depression Inventory (BDI)
Two groups of subjects were identified, namely people with severe depressive symptoms (more than 15 points) and
people with mild symptoms of depression (up to 15 points).
2. Scale of Emotional Stability-Instability (Neuroticism) by. G. Eysenck.
The subjects with severe symptoms of depression have a higher level of neuroticism than subjects with mild symp-
toms of depression.
3. Response Styles Questionnaire (RSQ)
All indicators of the group with severe symptoms of depression are higher than in the group with mild symptoms.
Results
Subjects with mild symptoms of depression are more likely to resort to reflexive rumination than those with severe
symptoms of depression. Reflexive rumination can conditionally be considered an adaptive mechanism, since this
type of rumination implies that a person scrolls through certain thoughts and situations in their head, thinking about
how they could act, what they can do with them, etc., that is, these ruminations can contribute to finding solutions
to problems.
Subjects with severe symptoms of depression have significantly higher rates of gloomy-brooding rumination and
obsessive depressive experiences, they resort to them much more often than to reflexive ones, and also much more
often than people with mild symptoms. These ruminations are expressed in scrolling unpleasant memories and
thoughts, negative scenarios, as well as thoughts about possible problems, one’s own insolvency. Thus, these types of
rumination can exacerbate the state of depression, since a person’s cognitive focus is always focused on unpleasant
and frightening experiences, which absorbs a significant mental resource, without giving any positive effect, a way
out of a difficult situation.
Discussion
I suggest that the results of the study are useful for further investigation of the best possible interventions for reduc-
ing rumination in subjects with severe symptoms and improvements of the outcomes of reflexive ruminations in
subjects with mild depressive symptoms. I propose further discussion of the applicability of mindfulness-based stress
reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) interventions for these purposes.

Keywords
rumination, depression, and reflexive rumination

PS109 Mindfulness for Nonclinical Paranoia in Virtual Reality:

A Randomised Controlled Trial
Elise Gear
Royal Holloway, University of London, United Kingdom

Abstract
Paranoid beliefs are common within the general population with prevalence estimates indicating that 27% of the
general population experience elevated levels within everyday life (Freeman et al., 2019). For university students,
however, prevalence rates are even higher, reaching up to 47% (Ellett et al., 2003; Freeman et al., 2005; Freeman et al.,
2011; Cella et al., 2011). Relatedly, the experience of paranoid thinking in students is distressing, persistent, and preoc-
cupying (Ellett et al., 2003; Allen-Crooks & Ellett, 2014; Lincoln & Keller, 2010). In combination, these factors provide an
impetus for effective interventions to reduce the distress caused by paranoia within the student population. The cur-
rent pre-registered study aimed to explore whether a mindfulness-based intervention (MBI) could attenuate self-re-
ported paranoia, potential behavioural indices of paranoia, and increase mindfulness within a nonclinical sample of
university students. This study used a single-blind mixed measures experimental design to examine the effects of a
2-week self-administered MBI, including 10 minutes of daily guided mindfulness practice (n = 40 ), versus a wait-list
control (n = 39). Measures of state paranoia, trait paranoia, mindfulness and psychological distress were administered
at baseline, post-intervention and 1-month follow-up. Eye-tracking and location data were also recorded in virtual
reality at each time point to measure between and within group differences on prospective behavioural indicators
of paranoia. Preliminary analyses have revealed a significant Time*Intervention interaction, whereby state paranoia
scores reduced for the MBI condition between baseline and post-intervention, and baseline and 1-month follow-up.
The remaining pre-registered analyses are in progress and will be completed prior to conference presentation.

Keywords
Paranoia, Mindfulness, Eye Tracking, Virtual Reality

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PS110 Multidimensional Cognitive Attention Syndrome Scale Validity and

Reliability in Turkish
Erkil Çetinel
Sağlık Bilimleri Üniversitesi, Ankara Etlik City Hospital, Department of Psychiatry, Turkey
Kadir Özdel
Sağlık Bilimleri Üniversitesi, Ankara Etlik City Hospital, Department of Psychiatry, Turkey
Ercan Altınöz
Eskisehir Osmangazi University, Department of Psychiatry, Turkey
Uğur Doğan
Muğla Sıtkı Koçman University, Turkey
Sedat Batmaz
Ankara Social Sciences University, Turkey

Abstract
Cognitive Attention Syndrome (CAS) defined as a group of strategy adopted by client who has psychological disorder.
Applying this strategy includes criticizing a thought in depth or ruminative pattern of thinking, using maladaptive be-
havioral strategies like avoidance and reassurance seeking, and maladaptive attentional focus like threat monitoring.
It is one of the core elements in Wells’ metacognitive model of psychopathology. Cognitive operations split into two
specific pattern: Worry and Rumination that have a nature of fruitless, extended, repetitive, verbal chains. As a general
feature, the focus of attention is on the issues that the person perceives as threats. All of these cognitive and attention
processes are used by the client as a coping strategy. Mental, emotional and behavioral avoidance processes are also
used as additional coping strategies within the CAS. After a while, a perception of loss of control of mental processes
occurs due to reinforcement and lack of awareness. Although the CAS is considered as a central element in meta-
cognitive model, there is no scale that measures all lower dimensions of CAS in Turkish. Multidimensional Cognitive
Attention Syndrome Scale (MCASS) evaluates the subdimensions of CAS: rumination, substance use, external fixation,
thought suppression, behavioral avoidance, internal fixation and worry.
The main purpose of this study is to adapt the MCASS, which is widely used in the field, into Turkish. It is aimed to test
the validity by examining its relation with the Depression-Anxiety Stress Scale, Psychological Symptom Screening
Test-90, Automatic Thoughts Questionnaire, Cognitive Attentional Syndrome-1 Questionnaire, Metacognitions Ques-
tionnaire-30, Ruminative Respond Scale (Short form), Multidimensional Experiential Avoidance Scale-30 by testing
internal consistency and test-retest reliability of the scales and evaluating the MCASS. The CFA results, applied to the
control group data of our study, have initial results that suggest that the MCASS is sufficient to measure the sub-di-
mensions of CAS in Turkish. The results are meaningful when evaluated together with the theorical background found
in literature (p<0.05). Standard Estimate values range between 0.24-0.96 for sub-dimensions. The results of our study
will be base on comparison of the data between client group selected from larger group consisting of people with
depression and anxiety disorder who applied to our clinic and control group selected from the larger control group
who do not currently have a psychiatric disorder. The trial is still ongoing. The results will be available before the con-
ference.

Keywords
Cognitive Attention Syndrome(CAS), subdimension, validity, reliability, scale

PS111 Confirmatory Analysis of the Outcomes of Poor Sleep Scale OOPS-S 29

Peđa Miladinovic
Faculty for business and legal studies Dr Lazar Vrkatić, Novi Sad, Union University in Belgrade; Temenos Center, Novi
Sad., Serbia
Radomir Belopavlović
Faculty of Philosophy, University of Novi Sad, Serbia
Snežana Tovilović
Faculty of Philosophy, University of Novi Sad, Serbia

Abstract
Sleep difficulties or poor sleep are defined as a person's subjective assessment that the length and quality (depth)
of sleep are not satisfactory. In previous research, an exploratory factor analysis confirmed a four-factor solution for
the Outcomes of Poor Sleep Scale. The aims of this study were to verify the four-factor solution and its correlations

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with theoretically relevant constructs. The sample consisted of participants from the general population (Total
N=1728; Nfemale=975, Mage= 31.6, SD = 14.09). By conducting a confirmatory factor analysis and while excluding
items no. 3, 27, and 28, four first-order factors were confirmed for both groups, with acceptable fit indices (online
TLI=.90; CFI=.91 and RMSEA=.06; paper & pen TLI=.91; CFI=.91 and RMSEA=.06), and acceptable to excellent re-
liability indicators of the questionnaire constructs (from α=.62 to α=.94). It was found that all factors Outcomes
of poor sleep, Poor sleep and distress, Sleepiness and fatigue, Sleep compensation, and Disrupted waking and
sleeping routine significantly correlated with theoretically relevant constructs including Neuroticism, Sleep effort,
Rumination, Anxiety, Depression, Self-criticism, Isolation, and Disrupted sleep hygiene. The Scale of Consequences
of Poor Sleep (OOPS-s 29) was shown to be an adequate questionnaire for assessing difficulties and dissatisfaction
related to poor sleep. The next important research step is to evaluate the psychometric characteristics of the ques-
tionnaire on a clinical sample.

Keywords
Poor sleep, Neuroticism, Sleep effort, Sleep hygiene

PS112 A digital psychosocial support service for Arabic-speaking refugees

living in Switzerland: preliminary findings from a three-armed RCT trial
Rilana Stöckli
Switzerland
Monia Aebersold
Swiss Red Cross, Switzerland
Viktoria Zoellner
Swiss Red Cross, Switzerland
Sebastian Burchert
Freie Universität Berlin, Germany
Jessica Wabiszczewicz
Freie Universität Berlin, Germany
Eva Heim
University of Lausanne, Switzerland
Christine Knaevelsrud
Freie Universität Berlin, Germany
Thomas Berger
Universität Bern, Switzerland

Abstract
Background: The mental health of refugees is influenced by factors at multiple levels, including structural, social,
cultural, and psychological. Quality of life serves as a comprehensive concept of well-being to holistically address the
interlinked problems and challenges that refugees face upon arrival in host countries. At present, there is insufficient
psychosocial support available to effectively improve refugees’ quality of life and address their mental health along-
side asylum-related life challenges. In addition to the limited availability of services, various other barriers such as
stigmatization, prioritization, financial resources, and language prevent refugees from accessing mental health sup-
port. Thus, there is a need for additional approaches that use scalable techniques to reach more people with a lower
threshold and at different levels of everyday life.
Aim: This study aims to investigate the efficacy of both an unguided and guided version of a newly developed mobile
application designed to improve quality of life of refugees living in Switzerland.
Methods: In a three-armed randomized controlled trial, 170 Arabic-speaking people who have recently arrived in
Switzerland were randomly assigned to either an 8-week guided or unguided app phase, or a waitlist control group
(2:2:1 allocation ratio). The app consists of nine chapters covering socio-structural Swiss-specific information, as well
as five psychological chapters comprising resource-oriented and psychoeducational explanations and exercises. The
primary outcome is quality of life, assessed with the WHOQOL-BREF, a 26-item questionnaire across four domains
(physical, psychological, social, environmental). Secondary outcomes include depressive, somatic, anxiety, and post-
traumatic symptoms, as well as self-stigma and post-migratory living difficulties.
Results: Intention-to-treat analyses using linear mixed models showed no significant Time x Group interactions in any
of the four domains of quality of life (e.g., psychological: F(1,243.79) = 0.8810, p = 0.349). Secondary analyses will be
evaluated on other outcomes and potential moderating or predicting variables.
Discussion: Contrary to hypotheses, the use of the app did not lead to improvements in quality of life. The potential
factors influencing this outcome and suggestions for future practice adjustments will be discussed. This study pro-

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vides empirical groundwork for further development of this psychosocial support service targeted to reach refugees
early after arriving in Switzerland and provide them with tools to improve their well-being.

Keywords
digital mental health; refugees; socio-structural challenges; quality of life

PS113 Integration of cognitive model and predictive coding models

Albert Murtazin
Association for Cognitive Behavioral Psychotherapy (Russia), Russian Federation
Alexander Granitsa
Kazan (Volga region) federal university, Russian Federation

Abstract
Cognitive-behavioural therapy (CBT) is a practical, goal-focused approach that helps understand the relationship be-
tween thoughts, feelings and behaviours. The aim is to identify the dysfunctional and distorted cognitions associated
with their psychological problems and to create more functional and balanced cognitive patterns that create less
emotional distress and more helpful behaviours.
Beck’s cognitive model has provided an evidence-based way to conceptualize and treat psychological disorders. CBT
theoretical models and mechanisms of change have been the most researched and are in line with the current main-
stream paradigms of human mind and behavior (e.g., information processing). When information processing provides
faulty information, other systems (e.g., affective, motivational, behavioral) no longer function in an adaptive way. Er-
rors can result in other cognitive biases (e.g., interpretation, attention, memory), excessive or inappropriate affect, and
maladaptive behavior. A negative bias will assure reactions to true danger; however, at the cost of many false alarms.
Consequently, individuals are likely to experience unwarranted anxiety in many seemingly dangerous but innocuous
situations. Similarly, a positive bias exaggerates the probability or degree of positive outcomes and consequently
increases or maintains motivation to engage in a task (Beck, Hugh, 2015). An erroneous or exaggerated interpretation
of threat, for example, will result in inappropriate or excessive anxiety and avoidance (Clark & Beck, 2011).
A biased information-processing system reflects predictive coding models. Predictive coding models of brain process-
ing propose that top-down cortical signals promote efficient neural signaling by carrying predictions about incoming
sensory information (Gilbert et al, 2022). The framework is rooted in Bayesian probability theory and the so-called
Bayesian brain hypothesis [Knill and Pouget, 2004] that conceptualizes perception as a constructive process that uses
internal or generative models to encode prior beliefs about sensory inputs and their causes. Generative models help
an individual formulate predictions about incoming sensory information that are tested against incoming sensory
inputs and produce prediction errors. Prediction errors, in turn, are used by the brain to revise its model of the world
by updating predictions in order to minimize prediction errors [Friston, 2010]
These ideas are actually used in cognitive conceptualizations of clinical cases. Distant antecedents as childhood
events can be viewed as incoming perceptual signals that may run counter to the predictive model of well-being.
And this discrepancy, accompanied by frustration of needs, forms a generalized conclusion about the causes of these
discrepancies as a basic belief. Thus, basic beliefs and cognitive schemas are part of a universal predictive model and
relate to a fairly wide range of particular situations.
Although numerous studies have extended these ideas to cognitive phenomena, their findings have not been inte-
grated with Beck’s cognitive model. This review will highlight the connections between Beck’s generic cognitive mod-
el including concepts of automatic and reflective processing and predictive coding models. The concept of predictive
coding complements the generic cognitive model well and can be used as another important theoretical basis for
training cognitive behavioral therapists and conducting psychoeducation for clients.

Keywords
cognitive model, predictive model, Bayesian brain hypothesis, generative models, integration

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PS114 The relationship between facets of mindfulness and attitudes

towards psychotherapy
Tamara Jovanović
Faculty Of Sciences, University Of Novi Sad, Serbia
Danica Bogatinović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)
Azra Kapetanović
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)
Jovana Nikolić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)
Neda Tasić
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)
Jovana Tizmonar
Association for Cognitive and Behavioural Therapies of Serbia (ACBTS)

Abstract
Mindfulness, a long-lasting tradition in Eastern culture and Buddhist meditation practices, was incorporated into the
“third wave” of cognitive behavior therapy as a new approach relating to inner processes (Hayes & Hofmann, 2017). It
includes an ability to bring full attention to what is happening in the present moment with complete acceptance and
no judgment. It can be described as both a state/skill and a trait (Baer et al., 2006; Brown & Ryan, 2004; Segal et al.,
2004). Mindfulness is related to openness to experience and transformative learning (Barner & Barner, 2012), however
there are no studies that explore how mindfulness as a trait shapes a person’s attitudes towards seeking psycholog-
ical help. The research was done on a sample of 331 students from three faculties in Serbia (31.1% study psychol-
ogy, 18% male, Mage=23.9). The questionnaire measured sociodemographic variables (gender, age and experience
with psychotherapy), mindfulness - Five Facet Mindfulness Questionnaire (FFMQ, Baer, 2006) and attitudes towards
psychotherapy ATSPPH-SF (Picco et al., 2016). Since FFMQ was already standardized for the Serbian population, five
facets were calculated: observing, acting with awareness, non-judging, describing and nonreactivity. For ATSPPH-
SF, Promax factor analysis revealed a two-factor solution: openness to seeking professional help (5 items, α=.646,
M=2.16) and preference to cope on one’s own (6 items, α=.780, M=3.74). Using a general multivariate regression
model, gender, experience with therapy and all mindfulness facets except acting with awareness have a significant re-
lationship with at least one dimension of attitudes towards psychotherapy. Women are more open to seeking profes-
sional help (F=10.56, p<.01) while experience with psychotherapy makes a person more willing to seek professional
help (F=14.22, p<.01) and less prone to cope on one’s own (F=7.76, p<.01). Observing (F=7.38, p<.01) and describing
(F=12.42, p<.01) make a person more open to seeking professional help. On the other hand, observing (F=6.27, p<.05)
and non-judging make a person less prone to cope on one’s own (F=6.07, p<.05) while nonreactivity (F=10.35, p<.01)
makes a person more willing to cope on one’s own with psychological problems. This study highlights the differ-
ence in gender dynamics of mental health-seeking behavior and the beneficial impact of prior experience in therapy
through willingness to further seek professional help. More importantly, examined facets of mindfulness suggest the
positive role they have on openness to therapeutic interventions, but they also underline the potential to diminish
reliance on only one’s own coping mechanisms. This implies the significance of mindfulness-based interventions in
fostering an openness towards psychotherapy, further underscoring the role of mindfulness practice in modern coun-
seling and psychotherapy.

Keywords
mindfulness, attitudes towards psychotherapy, gender, experience with psychotherapy

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PS115 The Relationship Between Self-Compassion Attachment Styles and

Emotion Regulation Difficulties in Individuals Diagnosed
with Psychosomatic Skin Disease
Mihriban Alemdar
Hasan Kalyoncu University, Turkey
Mustafa Batuhan Kurtoğlu
Hasan Kalyoncu University, Turkey

Abstract
Introduction: This study aimed to examine the relationship between self-compassion, attachment styles, and emo-
tion regulation difficulties in individuals diagnosed with psychosomatic skin. As a result of the research; Aims to ad-
dress the biopsychosocial dimension of the disease in individuals diagnosed with psychosomatic skin disease, to
discover the psychological and psychopathological processes that may cause complaints, to examine the effects of
self-compassion, attachment, and emotion regulation difficulties, and to contribute to the literature accordingly. For
this purpose; The relationship between self-compassion attachment styles and emotion regulation difficulties was
examined. Method: The sample of the study consists of individuals (N=256) between the ages of 18-65 who received
one of the diagnoses of psoriasis, alopecia areata, neurodermatitis, or dermatitis. In the study, the Sociodemographic
Information Form, Self-Compassion Scale, Attachment Styles Scale, and Emotion Regulation Difficulties Scale-Short
Form form created by the researcher was filled in by the participants via “Google Forms” in the digital environment.
In this context; Frequency, reliability, descriptive, normality, and Pearson correlation analysis tests were applied to
individuals diagnosed with psychosomatic skin disease. Results: According to the findings obtained as a result of
correlation analysis; While there was no significant relationship between self-compassion and attachment styles and
avoidant attachment styles (r=-0.03* p>0.05; r=0.06* p>0.05;), it was found to be positively correlated with secure at-
tachment (r=0.46** p<0.01) and negatively associated with anxious ambivalent attachment (r=-0.34** p<0.01). Emo-
tion regulation difficulty was found to be significantly related to all variables in general. It was observed that it was
positively related to attachment styles and anxious ambivalent attachment, while it was observed to be negatively
related to all other variables. Discussion: When the results are obtained according to the correlation variables it can
be said that as the level of self-compassion increases, secure attachment increases, and as secure attachment increas-
es, self-compassion increases Also it can be said that anxious ambivalent attachment increases as self-compassion
decreases, or self-compassion decreases as anxious ambivalent attachment decreases. Considering the finding that
self-compassion it can be said that emotion regulation difficulty increases as self-compassion increases, or self-com-
passion decreases as emotion regulation difficulty increases. According to the negative relationship between secure
attachment and emotion regulation difficulties, it can be said that emotion regulation difficulties decrease as secure
attachment increases. Considering that secure attachment is also positively related to self-compassion, it can be said
that individuals with a high level of self-compassion also have higher secure attachment rates and less emotion regu-
lation difficulties. Anxious ambivalent attachment, which was found to be negatively related to self-compassion, was
found to be positively significantly associated with emotion regulation difficulties. Considering that self-compassion
is also negatively related to emotion regulation difficulties, it can be said that self-compassion decreases and emotion
regulation difficulty increases as anxious ambivalent attachment increases.

Keywords
Attachment styles, Emotıon regulatıon dıffıcultıes, Psychosomatıc skın dısease, Self-Compassıon

PS117 Using the principles of single-session therapy and adapting PERMA

concept to pro bono Counselling
Sergei Padve
Solo practitioner, Russian Federation

Abstract
Due to the increased need for pro bono sessions in the Russian-speaking community it was decided to investigate the
effectiveness of pro bono sessions.
The majority of such counselling sessions are delivered through psychological service aggregators and are often a
single session between a client and a therapist. Taking into account that over the last 30 years single-session therapy
approach has been actively developing, it seems logical to use the SST methodology for such counselling. Very often
the therapist’s task is scientifically based “hope-building” - the solution for this can be to rely on the evidence-based
concept of PERMA from positive psychology.

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 POSTER PRESENTATIONS
So the idea is to measure the symptoms and feedback before and after a training workshop on single-session therapy
and the use of the PERMA concept. The report will describe the research design and findings.
The study began in February this year and involves a monthly training session for psychologists providing charitable
counselling services (a group of 20). In total there will be 10 such groups with a final number of 200 psychologists.
Estimated number of clients 60-80 per group and 600-800 at all.
The study is comparative in nature - a month before the training, therapists take measurements from their pro bono
clients before the session and a week after the charity session. The original questionnaire, SRS V3, Beck’s anxiety and
depression scales are used. After training, therapists use the same scales to analyze interactions with new clients. This
allows to compare changes in parameters before and after the training.
The control groups chosen are 1) CBT therapists who use the same questionnaires for the 1st sessions with their ordi-
nary clients and 2) clients who enrolled for charity sessions but did not receive help within a week of enrolment - they
are tested at the time of referral and a week later.
Should the hypothesis that the quality of charity sessions increases when using SST principles and engaging the PER-
MA concept be confirmed, further work would involve creating a sustainable robust training programme for the wide
range of professionals who currently provide free psychological care.

Keywords
Single-session therapy, pro bono, charity sessions, PERMA, positive psychology

PS118 Ispitivanje prevalencije tipa D ličnosti među psihoterapeutima - veza

sa sagorijevanjem i otpornošću
Irma Čorbo
JU OŠ Grbavica II, Bosnia and Herzegovina
Andrea Vlašić
Ministry of Internal Affairs, Bosnia and Herzegovina
Amela Bektaš
Bosnia and Herzegovina

Abstract
Tip D ličnosti je potaknuo značajan interes u zdravstvenoj psihologiji zbog svoje povezanosti s različitim nepovol-
jnim zdravstvenim ishodima. Karakterizirane kombinacijom negativne afektivnosti (NA) i socijalne inhibicije (SI), os-
obe s tipom D ličnosti sklone su doživljavanju neugodnih emocija, ali nesklone njihovom izražavanju u društvenom
okruženju. Pretpostavlja se da ova jedinstvena kombinacija stvara kronično stresno stanje, potencijalno povećavajući
osjetljivost na tjelesne i mentalne zdravstvene probleme. Ova studija istražuje prevalenciju tipa D ličnosti u skupini
psihoterapeuta, ali i vezu između ovog tipa ličnosti i sagorijevanja odnosno otpornosti na stres. Nedavna istraživanja
u Bosni i Hercegovini (Vlašić, 2021) sugeriraju da se prevalencija tipa D ličnosti u općoj nekliničkoj populaciji procjen-
juje na oko 30%. Dok brojne studije istražuju njegovu prevalenciju u različitim skupinama pacijenata i općoj populaci-
ji, trenutno postoji nedostatak istraživanja ovog konstrukta među stručnjacima za mentalno zdravlje, kao i odnosa s
otpornošću i sagorijevanjem.
Ova presječna studija provedena je u proljeće 2024. godine i uključila je 122 psihoterapeuta (87,7% žena) prosječne
dobi 40,7±9,3 godina. Radni staž ispitanika u području psihoterapije varirao je u rasponu od 0 do 50 godina (M=5,96).
U istraživanju smo primijenili tri upitnika: DS14 (Denollet, 2005) za identifikaciju ispitanika s tipom D ličnosti, Kratku
skalu otpornosti (BRS) i Oldenburški inventar sagorijevanja (OLBI). DS14 je skala za samoprocjenu od 14 stavki, od ko-
jih 7 procjenjuje negativnu afektivnost (NA), a 7 socijalnu inhibiciju (SI). Skalu su prevele i validirale Vlašić i Ivanišević
(2019). Kratka skala otpornosti (BRS; Smith i sur., 2008) sadrži 6 čestica, kojima se procjenjuje sposobnost pojedinca
da se uspješno oporavi od stresne situacije. Ima zadovoljavajuću pouzdanost tipa unutarnje konzistencije (α=0,81)
na ovom uzorku. OLBI (Demerouti i Bakker, 2008) se sastoji od 16 čestica raspoređenih u 2 subskale koje mjere is-
crpljenost i otuđivanje kao dimenzije sagorijevanja. Burić i Slišković (2018) su potvrdile dobre psihometrijske karak-
teristike hrvatske adaptacije skale.
Rezultati ovog istraživanja pokazali su da se 18,8% psihoterapeuta može klasificirati u tip D ličnosti, što je puno niži
udio u odnosu na opću nekliničku populaciju. Usporedbom psihoterapeuta klasificiranih u tip D ličnosti i ne-tip D
ličnosti t-testom, pokazalo su da psihoterapeuti s tipom D ličnosti imaju statistički značajno niže rezultate na otporno-
sti (p<0,05), ali statistički značajno više rezultate na obje dimenzije sagorijevanja – iscrpljenosti i otuđivanju (p<0,01).
Ovi rezultati imaju niz značajnih implikacija za mentalno zdravlje psihoterapeuta, dobrobit klijenata i širu profesiju:
Terapeuti tipa D ličnosti su zbog niže otpornosti na stres ranjiviji na stresne situacije, neizbježne u radu s klijentima,
što može dovesti do emocionalnog iscrpljenja, depresije i izgaranja, otežano im je suočavanje s izazovima u radu, što
može utjecati na sposobnost da učinkovito pomognu klijentima. Psihoterapeuti s tipom D ličnosti možda neće moći

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 POSTER PRESENTATIONS
pružiti istu razinu podrške i empatije, što može utjecati na ishod terapije. Nedostaju programi za podršku psihoter-
apeutima koji se bore sa sagorijevanjem. Važno je provesti dublje istraživanje o ovoj temi kako bi se dobili precizniji
zaključci o utjecaju tipa D na ličnosti psihoterapeuta. Treba se razviti i implementirati programe prevencije i inter-
vencije za podršku psihoterapeutima s tipom D ličnosti i zaštititi njihovo mentalno zdravlje.

Keywords
Psychotherapists, Type D Personality, Burnout, Resilience

PS119 Faktori koji utiču na zadovoljstvo životom kod psihoterapeuta:

Uloga negativne afektivnosti
Amela Bektaš
Bosnia and Herzegovina
Andrea Vlašić
Ministry of Internal Affairs, Bosnia and Herzegovina
Irma Čorbo
JU OŠ Grbavica II, Bosnia and Herzegovina

Abstract
Uvod: Istraživanja koja se bave faktorima koji utiču na zadovoljstvo životom psihoterapeuta su relativno ograničena.
Watson i Pennebaker (1989) su istraživali centralnu ulogu negativne afektivnosti u zdravlju, stresu i emocionalnoj
uznemirenosti. Njihovi rezultati sugerišu da negativna afektivnost ima značajan uticaj na zdravstvene tegobe, ali i
na opšte blagostanje. Zadovoljstvo životom negativno je koreliralo i sa subskalama negativne afektivnosti (NA) i so-
cijalne inhibicije (SI) (Chillicka i sur., 2020), kao i sa dimenzijama sagorijevanja kod zaposlenika univerziteta (Kord
Tamini i Kord, 2011). Sagorijevanje na poslu je predvidjelo nezadovoljstvo životom stomatologa (Hakanen i Schaufeli,
2012). "Koliko netko sebe smatra religioznim" bio je konstrukt religioznosti najznačajnije povezan sa zadovoljstvom
životom, dok je "učestalost molitve" bila najmanje povezana u istraživanju Habib, Donald i Hutchinson (2018). Za-
dovoljstvo životom raste tijekom psihoterapije (Behn i sur., 2017). Cilj istraživanja je istražiti potencijalne prediktore
zadovoljstva životom psihoterapeuta.
Metoda: U ovom presječnom istraživanju, ispitivani su faktori koji utiču na zadovoljstvo životom 122 psihoterapeuta
u dobi od 23 do 80 godina (prosječna starost 40,7 ± 9 godina). Ispitanici su ispunili online upitnike. Kao kriterijsku
varijablu u linearnoj regresijskoj analizi koristili smo jednu stavku kojom smo ispitivali opšte zadovoljstvo životom na
Likertovoj skali od 5 stepeni. Kao prediktorske varijable uključili smo negativni afekt i socijalnu inhibiciju kao dimen-
zije tipa D ličnosti (DS14, Denollet, 2005), osobnu psihoterapiju (stavka: idete li na osobnu psihoterapiju), učestalost
molitve (stavka: koliko često se molite), iscrpljenost i neangažovanost kao dimenzije sagorijevanja (Oldenburški in-
ventar izgaranja, OLBI), te otpornost na stres (Kratka skala otpornosti, BRS).
Rezultati: Korelacije između opšteg zadovoljstva životom i dimenzija sagorijevanja su niske i negativne, ali statistički
značajne. Što je viši rezultat na dimenzijama sagorijevanja, to je niže zadovoljstvo u životu. Otpornost na stres je u
značajnoj, ali niskoj i pozitivnoj korelaciji sa zadovoljstvom – što je viša psihološka otpornost na stres, to je veće i
zadovoljstvo životom. Dimenzije tipa D ličnosti (negativna afektivnost i socijalna inhibicija) su u statistički značajnoj,
niskoj i negativnoj korelaciji sa zadovoljstvom – što je viša negativna afektivnost i što je viši stepen socijalne inhibicije,
to je zadovoljstvo životom niže. Zadovoljstvo životom nije u značajnoj korelaciji sa molitvom ili osobnom psihotera-
pijom u ovom istraživanju.
Rezultati linearne regresijske analize pokazali su da model u koji smo uključili sedam prediktora može objasniti 28,3%
varijance kriterijuma, tj. zadovoljstva životom psihoterapeuta. Negativna afektivnost se pokazala kao jedini nezavisni
značajni prediktor zadovoljstva životom (β = -0,33, p < 0,001) od svih ispitivanih prediktora. Zanimljivo je da faktori
koje tradicionalno povezujemo s blagostanjem i zadovoljstvom, kao što su osobna psihoterapija, molitva, otpornost
na stres ili dimenzije sagorevanja, nisu se pokazali kao značajni prediktori zadovoljstva životom (p > 0,05) na ovom
uzorku.
Zaključak: Rezultati sugeriraju da negativna afektivnost značajno utiče na zadovoljstvo životom kod psihoterapeuta,
dok drugi faktori poput osobne psihoterapije, molitve, otpornost na stres i dimenzije sagorijevanja nisu bili značajni
prediktori. Ovi nalazi ukazuju na važnost dalje analize emocionalne osjetljivosti i njenih efekata na životno zadovol-
jstvo psihoterapeuta, kao i na potrebu za razvojem efikasnih strategija suočavanja i emocionalne regulacije, koje bi
poboljšale dobrobit i posljedičnu efikasnost psihoterapeuta.

Keywords
Psihoterapeuti, zadovoljstvo životom, sagorijevanje, otpornost na stres, negativni afekt, molitva

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Your next congress in 2025 - SAVE THE DATE!

55th Annual Congress

The European Association for Behavioural and Cognitive Therapies

Glasgow
3–6 September 2025

hosted by
British Association for Behavioural and
www.babcp.com Cognitive Psychotherapies

Next year BABCP has been given the opportunity and privilege to host the 55th Annual EABCT
Congress which we will be combining with BABCP’s annual conference. The European congress is
always a great success as it brings together and welcomes CBT friends and colleagues from all its 60
CBT Associations in 44 countries in Europe and across the world to join together.

The last time BABCP hosted the EABCT Annual Congress was in 2004 in Manchester and we look
forward to seeing you in Glasgow where you will be treated to a truly international scientific
programme matched only by the unique Scottish hospitality you will experience in Glasgow.

Co-Chairs: Congress Organising Committee

IMPORTANT DATES
Kevin Noon, Glasgow
7th September: Launch at EABCT Congress in Belgrade
Rod Holland, London
7th October: Call for papers opens
Co-Chairs: Scientific Programme 9th December: Keynotes and Pre-congress workshops
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Supported by BABCP Conference Programme Group 2025
and the European (EABCT2025) Scientific Committee 6th January: Registration opens
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Scientific Programme Administrator 31st March: Open paper and poster submissions ends
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