An Investigation of Sequencing Effects in Combining Cognitive Questioning and Mindful Acceptance

  • Rosita BorlimiEmail author
  • Gerhard Benetka
  • Gianni Brighetti
  • Gabriele Caselli
  • Elisabetta Caletti
  • Carolina A. Redaelli
  • Giovanni M. Ruggiero
  • Diego Sarracino
  • Sandra Sassaroli


Cognitive-behavioral treatments assume that the mechanisms of change depend on the assessment and questioning of biased beliefs. In contrast, recent developments have emphasized mindful acceptance interventions, in which clients allow thoughts to come and go without questioning them. In order to discuss therapeutic efficacy difference in emotional disorders, we explored the possible normalizing effects of cognitive questioning and mindful acceptance on sympathetic reactivity aroused by recall tasks. We compared the effects of different sequencing of cognitive questioning and mindful acceptance on emotional distress in two groups in which questioning either preceded (group 1) or followed (group 2) acceptance. Thirty-five non-clinical individuals (21 males, 14 females) randomly allocated to either group 1 or 2 participated in the experimental tasks (unpleasant recall, cognitive questioning, and metacognitive acceptance). Sympathetic reactivity levels were measured using galvanic skin response. Results showed that acceptance reduced sympathetic reactivity when compared to questioning. The best sequence was that in which questioning preceded acceptance. By interpreting sympathetic reactivity as a measure of emotional distress and experimental tasks as models for therapeutic approaches, this experiment suggests that acceptance is better than questioning in reducing emotional distress especially when cognitive questioning is followed by mindful acceptance.


Acceptance Cognitive therapy Metacognition Questioning Sympathetic reactivity 



This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

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

Authors and Affiliations

  • Rosita Borlimi
    • 1
    • 2
    Email author
  • Gerhard Benetka
    • 3
  • Gianni Brighetti
    • 1
    • 2
  • Gabriele Caselli
    • 1
    • 4
  • Elisabetta Caletti
    • 5
  • Carolina A. Redaelli
    • 4
  • Giovanni M. Ruggiero
    • 1
    • 6
  • Diego Sarracino
    • 7
  • Sandra Sassaroli
    • 1
    • 4
  1. 1.Sigmund Freud UniversityMilanItaly
  2. 2.Department of PsychologyUniversity of BolognaBolognaItaly
  3. 3.Faculty of PsychologySigmund Freud UniversityViennaAustria
  4. 4.Post Graduate Cognitive Psychotherapy SchoolStudi CognitiviMilanItaly
  5. 5.Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore PoliclinicoUniversity of MilanMilanItaly
  6. 6.Psicoterapia Cognitiva e RicercaPost Graduate Cognitive Psychotherapy SchoolMilanItaly
  7. 7.Department of PsychologyMilano Bicocca UniversityMilanItaly

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