Cognitive bias modification, attention-bias modification

Domain II · Behavioural & cognitive · Colin MacLeod, Andrew Mathews · 2000 · Western Australia; Cambridge, UK

What it is

Cognitive bias modification (CBM) is a family of computerised training procedures, not a talking therapy. It comes out of experimental psychopathology; the work of Colin MacLeod (Western Australia) and Andrew Mathews (Cambridge, UK) around 2000 is usually cited as its origin. The tasks first…

Format

• CBM has no therapeutic phases in the usual sense. The protocols do share a sequence, set out below. The session counts are those of the protocols opened; any criterion not stated in a protocol is marked.
• ABM face dot-probe: 160 trials a session, 8 sessions, twice weekly for 4 weeks. Najmi and Amir describe about 20 minutes a session, twice a week, for 8 to 10 sessions.

Who practises it, and how they are trained or regulated

• Phase B: Orientation (part of the first training contact).
• Phase C: Training block (the "dose"). Protocol doses by paradigm:
• Version followed: there is no single treatment manual. This guide follows the paradigms as written in published trial protocols: attention-bias modification (ABM) as the 8-session, twice-weekly face dot-probe protocol (Amir lineage, as specified in ClinicalTrials.gov NCT03932032); interpretation-bias modification (CBM-I) in two forms, Mathews and Mackintosh ambiguous-scenario training as run on the University of…

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?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• 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

• use different scenarios for assessment and training.
• clients who expect CBM to replace therapy (see Section 5).
• a pattern of drop-off after discharge or after the novelty wears off.
• the client crediting the app and dropping homework, or the reverse. Keep both going.
• use only versions that come with published software and parameters. Do not build your own.

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.