Skip to main content

SMART Lab (Study of Maladaptive to Adaptive Repetitive Thought)

SMART Lab (Study of Maladaptive to Adaptive Repetitive Thought) is focused on the understanding of the mechanisms of worry and rumination, identified as mechanisms common across multiple disorders, the translation of this understanding into better interventions to treat and prevent disorders characterized by repetitive negative thought such as depression and anxiety, and the increased access and dissemination of these interventions.

Key strands

  1. Experimental research into the processing styles that can be adaptive or maladaptive depending on context.
  2. Investigating the development and change of healthy versus unhealthy habits and the application of functional analysis.
  3. Research into the development, evaluation, mechanisms, and wide-scale implementation of rumination-focused CBT (RFCBT; Watkins, 2015) as a face-to-face individual, group, internet, and guided self-help intervention.

There is good evidence for RFCBT treating chronic treatment-refractory depression (Watkins et al., 2011) and for preventing depression and anxiety (Topper et al., submitted). RFCBT is currently being investigated as a means to prevent anxiety and depression in at risk UK undergraduates, as a treatment for severe adult depression in Denmark, as an intervention to prevent depression and anxiety in Swedish and US adolescents, and as a community wide prevention intervention in Hong Kong.

The treatment manual for rumination-focused CBT is published by Guilford Press in spring 2016.

Rumination is a central vulnerability and maintaining factor for depression, and yet has proven to be resistant to change and hard to treat. From a leading clinician-researcher, this manual presents an empirically tested approach for helping clients with severe and chronic depression by directly tackling negative rumination. Rumination-focused cognitive-behavioral therapy (RFCBT) combines carefully adapted elements of CBT with imagery, visualization, and compassion-based techniques. Filled with vivid case material and insightful clinical guidance, the book provides everything needed to implement this innovative 12-session treatment.

The book opens by examining the nature of maladaptive rumination and why it makes sense to target it in treatment. Key components and principles of RFCBT are explained. Subsequent chapters spell out the therapy step by step, beginning with assessment, goal setting, and functional analysis. In rich detail, the author describes interventions designed to shift clients away from unhelpful to more helpful processing styles, with particular emphasis on becoming more concrete, increasing absorption and “flow” in activities, and increasing self-compassion. Extensive sample dialogues and a chapter-length case example illustrate particular techniques and clinical issues. Also addressed are ways to adapt RFCBT for use with groups. Special features include reflections and learning exercises for therapists and 10 reproducible client handouts. Purchasers get access to a Web page where they can download and print the reproducible materials in a convenient 8 1/2" x 11" size.

Synthesizing many years of experimental research and clinical experience into a simple, effective, and powerful approach, this book will be read with interest by anyone who treats patients with depression, including clinical psychologists, psychiatrists, clinical social workers, mental health and pastoral counselors, and psychiatric nurses.