What is the use of Cognitive Tasks in Psychotherapy?

Currently, there are no approved uses for these tasks in psychotherapy, so the answer to this is none. But there is great potential for research and treatment. Research suggests that certain tasks are strongly correlated with symptom improvement and reduced relapse rates. (Devito et al 2018). In his book, Decoding Madness (2021), Dr. Richard Lettieri describes using a Stroop Task on a client to assess impulse control. This is very important, as I firmly believe that in forensic psychology you need to gather as much evidence as possible and assess it all together to form a complete and unbiased evaluation. We base most of our decisions in English Common Law based on evidence, whether it’s beyond a reasonable doubt, a preponderance, or more likely than not; we are never certain. We can never have enough evidence for our legal decisions. Can you make a solid legal decision with just a Stroop task? Absolutely not. Can you make a legal decision with any signal piece of evidence? Absolutely not.

These tasks need more research in predicting recidivism, but as of right now, they do not hurt your argument, as they still provide more evidence for important decisions.

These tasks could enable the quantification of psychoanalysis. I’m no expert in psychoanalysis, but I view it as a useful tool and style. I do not want to center my entire psychotherapeutic style around it (I want to take an eclectic approach so that I can keep learning new skills and be person-focused with treatment). Showing statistical or quantifiable differences that can be used for insight. If a client wants evidence for the insight you provide, these tasks may provide a route of analysis.

Should these tasks be used for diagnosis? No, not now, based on current research. Can they be used in future diagnosis? I cannot predict future research, and assuming the impact of research is antithetical to the point of research. These tasks could be used for diagnosis, or they might not be. It would be hard to determine statistical differences in diagnosis unless you’re comparing their results to their baseline before symptom onset. But that’s dumb, to do that, you’d have to run these tasks multiple times a year to determine a baseline and establish a health comparison point. I have no idea how much that would cost, how it would be implemented, or what infrastructure would be needed to do so. And again, to reiterate, we do not have the research to support this. In the words of Carl Sagan, extraordinary claims require extraordinary evidence.

However, you also have to use common sense; if psychotherapy is to be manualized and analytical, then you would miss out on building rapport, which is so important for the therapeutic relationship. If these tasks do have a use (which, based on current research, is a possibility), be smart and tactful with them. Some clients will think they are great; some will get bored and hate them.

Here is a pdf file of an essay I wrote that explores this topic.