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Changes in Perspective-Taking During Cognitive Behavioral Therapy in a Partial Hospital Setting

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Abstract

Objective

Perspective-taking deficits are thought to perpetuate interpersonal dysfunction across different forms of mental illness. Although psychotherapeutic treatments are thought to target perspective-taking deficits, there is a dearth of research supporting this claim. In the current naturalistic study, we investigated whether perspective-taking frequency changed over the course of a two-week cognitive behavioral therapy (CBT) partial hospital treatment program.

Method

Participants were 421 adults with severe and complex mental illness that included mood, anxiety, and psychotic-spectrum disorders. Perspective-taking was assessed at admission and discharge using the 7-item Interpersonal Reactivity Index subscale.

Results

Results indicated improvements in perspective-taking from admission to discharge that did not vary as a function of participants diagnostic status or symptom severity. More severe autism spectrum disorder and borderline personality disorder symptoms were associated with less frequent perspective-taking across both time points.

Conclusions

These findings provide preliminary evidence to suggest that CBT may promote perspective-taking. Future research is needed to determine whether changes in perspective-taking are causally related to CBT, and if so, whether perspective-taking is a mechanism of change in psychotherapy.

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Notes

  1. Individuals with borderline personality disorder have also been theorized to “hypermentalize”, defined as the tendency to overattribute extreme mental states to other (Sharp & Vanwoerden, 2015). Further, hypermentalization has recently been proposed as a transdiagnostic feature of psychopathology (McLaren et al., 2022). Importantly, individuals can have both a reduced tendency to engage in perspective-taking and demonstrate a pattern of hypermentalization when they engage in perspective-taking.

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Acknowledgements

We thank the staff and patients of McLean Hospital’s Behavioral Health Partial Hospital Program for making this study possible. This project was supported by the McLean Hospital Pope-Hintz Fellowship and the Canadian Institute of Health Research Postdoctoral Fellowship.

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Authors and Affiliations

  1. McLean Hospital, 115 Mill Street, 02478, Belmont, MA, USA

    Chloe C. Hudson, Emily M. Bowers, Thröstur Björgvinsson & Courtney Beard

  2. Harvard Medical School, Boston, USA

    Chloe C. Hudson, Thröstur Björgvinsson & Courtney Beard

  3. Virginia Polytechnic Institute and State University, Blacksburg, USA

    Chloe C. Hudson

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Hudson, C.C., Bowers, E.M., Björgvinsson, T. et al. Changes in Perspective-Taking During Cognitive Behavioral Therapy in a Partial Hospital Setting. Cogn Ther Res 47, 909–918 (2023). https://doi.org/10.1007/s10608-023-10422-4

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