Patient constructive learning behavior in cognitive therapy: A pathway for improving patient memory for treatment?

Patient memory for treatment is poor and associated with worse outcome. The Memory Support Intervention was designed to improve outcome by enhancing patient memory for treatment. Half of the strategies comprising the Memory Support Intervention (termed constructive memory support strategies) involve therapists inviting patients to construct new ideas, inferences, or connections related to treatment material that go beyond information already presented by therapists. This study investigated the relationship between patient responses to therapist use of constructive memory support strategies and patient recall of treatment contents. Therapist uses of constructive memory support strategies were coded from sessions recorded during a pilot trial of the Memory Support Intervention in the context of cognitive therapy for depression (n = 44 patients). Patients who successfully constructed new ideas, inferences, or connections (termed patient constructive learning behavior) in response to therapist use of constructive memory support strategies showed greater recall of treatment contents. Mediation analyses provided some evidence that patient constructive learning behavior may be a mechanism through which the Memory Support Intervention results in enhanced patient memory. Results highlight patient constructive learning behavior as a potential pathway for improving patient memory for treatment.