Attribution therapy

Domain II · Behavioural & cognitive · Försterling, Perry · 1985

What it is

Attribution therapy is not a single branded therapy. It is a family of procedures that change the causal explanations people give for their successes, failures, symptoms and life events. It grew from Heider's and Kelley's attribution theory, Weiner's attributional theory of motivation and emotion,…

Format

• Format: interview, plus a standard measure if wanted (see 4.2) and a one- to two-week attribution diary.
• Goals: give the client a credible alternative explanation through information, persuasion, consensus data and modelling. In Perry's version this follows soon after a real setback (e.g. first test feedback) so the message lands while it matters.

Who practises it, and how they are trained or regulated

• AR has no single phase manual. The phases below combine Perry's college protocol (pre-treatment, induction, consolidation, follow-up), Försterling's clinical sequence (diagnose attributions, check whether they are realistic, change them, test them in action) and the three-step structure of school reattribution training: diagnosis (questionnaires for groups; interview or working hypotheses for individuals),…
• Format: educational and health AR is brief. In the Perry/Chipperfield version for older adults the whole induction was one 18-minute video of two older adults, watched once, with no consolidation task or booster. College versions add a consolidation exercise after a handout or video (see 4.11, 4.12). Clinical group AR (ARGT) spreads the work over eight weekly two-hour sessions. Dweck's classic child study used about…
• Typical overall dose. Educational/health AR: a single induction (e.g. one 18-minute video) up to about three sessions. Clinical group AR: the ARGT pilot ran 8 weekly 2-hour sessions with outpatient groups mixed by diagnosis (major depression, generalised anxiety, OCD), one lead therapist (a registered clinical psychologist), a co-therapist who recorded whether each planned step happened and reviewed this with the…

Evidence status, as the guide reports it

• Goals: identify the outcomes that matter (exam failure, rejection, symptoms, inactivity, a traumatic event); collect the client's spontaneous causal explanations; rate them on locus, stability, controllability and globality; link them to the emotion and behaviour that follow (giving up, avoidance,…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Rote copying of the handout. Ask for personal detail. It is working when the writing contains specific, controllable causes linked to concrete plans.
• Composite scores hide domain differences; pair them with the interview. A shift in the bad-event composite between baseline and end is one marker of change.
• Models who are too polished; "they're not like me" reactions. It is working when the client identifies with the model and names their own equivalent switch.
• Dominant members; collusion in hopelessness; peers offering unrealistic reassurance. It is working when members challenge each other's stable explanations with evidence.
• Only use true information; if the client's difficulty is genuinely atypical, say so and switch to 4.5/4.9. Working when hopelessness and avoidance fall and engagement continues.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.