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Symptom prescription and reframing: Should they be combined?

Abstract

The present study evaluated the initial effects of two types of paradoxical directives. Socially anxious males were randomly assigned to three groups: symptom prescription without reframing, symptom prescription with reframing, and a wait-list control condition. The assessment of outcome consisted of various measures administered pretreatment, posttreatment, and at 1-month followup, as well as daily self-ratings that were obtained throughout the course of the study. Subjects who were exposed to symptom prescription with reframing showed significantly greater improvement than the subjects in the other groups, both at posttreatment and at followup. In contrast, the subjects who were exposed to symptom prescription alone manifested only limited improvement and were not significantly less socially anxious after treatment than the subjects in the wait-list control group. The findings support the view that paradoxical treatments are clinically useful when their effects include changes in the meaning clients attribute to their symptoms.

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Correspondence to Emmanuel Akillas.

Additional information

This article is based in part on a doctoral dissertation completed by the senior author. Alan L. Sockloff provided statistical advice, and Bret Boyer, Chris Combs, Amy Glascott, Alan Lipman, Leslie Parkes, Michael Penn, Lydia Santiago, and Fran Sessa served as therapists.

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Akillas, E., Efran, J.S. Symptom prescription and reframing: Should they be combined?. Cogn Ther Res 19, 263–279 (1995). https://doi.org/10.1007/BF02230400

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Key words

  • symptom prescription
  • social phobia
  • reframing
  • paradoxical treatments