Cognitive Therapy and Research

, Volume 42, Issue 6, pp 844–855 | Cite as

Comparing Cognitive Defusion and Cognitive Restructuring Delivered Through a Mobile App for Individuals High in Self-Criticism

  • Michael E. LevinEmail author
  • Jack Haeger
  • Woolee An
  • Michael P. Twohig
Original Article


There are ongoing questions regarding the similarities and differences in the clinical impact and processes of change for cognitive restructuring and cognitive defusion. This clinical component test compared 87 adults high in self-criticism randomized to a cognitive defusion mobile app, restructuring app, or waitlist condition for 2 weeks. Equivalent improvements were found from the defusion and restructuring apps relative to the waitlist on self-criticism and distress as well as decentering, self-compassion, and dysfunctional attitudes. However, the defusion condition had a more consistent pattern of improvements relative to waitlist. Improvements in cognitive decentering, self-compassion, and dysfunctional attitudes mediated effects for cognitive defusion relative to waitlist. These mediators were inconsistent for cognitive restructuring. Improvements in self-compassion and cognitive decentering correlated with improvements in outcomes in the defusion condition, but not the restructuring condition. Overall, these results suggest mobile apps providing cognitive defusion and cognitive restructuring strategies are equally effective, but work through distinct processes of change.


mHealth Acceptance and commitment therapy Cognitive therapy Mindfulness Component analysis 


Compliance with Ethical Standards

Conflict of Interest

Dr. Levin is a research associate with Contextual Change LLC, a business focused on developing online acceptance and mindfulness programs for student mental health. Dr. Twohig, Mr. Haeger, and Ms. An declare they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Animal Rights

This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Michael E. Levin
    • 1
    Email author
  • Jack Haeger
    • 1
  • Woolee An
    • 1
  • Michael P. Twohig
    • 1
  1. 1.Department of PsychologyUtah State UniversityLoganUSA

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