Cognitive models have contributed significantly to the understanding of unipolar depression and its psychological treatment. Our research group has been working on the notion of cognitive conflict viewed as personal dilemmas according to personal construct theory. We use a novel method for identifying those conflicts using the repertory grid technique (RGT). This study aims to empirically test the hypothesis that an intervention focused on the dilemma(s) specifically detected for each patient will enhance the efficacy of cognitive behavioral therapy (CBT) for depression. We expect that adding a dilemma-focused intervention to CBT will increase the efficacy of one of the more prestigious therapies for depression, thus resulting in a significant contribution to the psychological treatment of depression. Relevance: This article describes the protocol of a controlled study aimed at testing the efficacy of dilemma-focused therapy (DFT) as an intervention in the treatment of depression. DFT is a constructivist-oriented intervention targeting the cognitive conflicts that block the pathway to change. Constructivist epistemology has shown its potential for creation and innovation across a variety of psychotherapy approaches. Personal construct therapy is one of these approaches, and DFT arises from it as a structured, but still flexible, intervention aimed at making explicit and fostering resolution of the specific dilemma(s) found for that particular patient in the initial repertory grid assessment.

This study explores the cognitive structures, understood as construct systems, of patients suffering from bulimia nervosa (BN). Previous studies investigated the construct systems of disordered eaters suggesting that they had a higher distance between their construction of the self and the “ideal self,” and also more rigidity. In addition to these aspects, this study explored the presence of implicative dilemmas (ID). In BN patients it was more common (71.9%) to find IDs than in controls (18.8%). They also showed higher polarization and higher self-ideal discrepancies (even more for those with a long history of BN). The measures provided by the Repertory Grid Technique can be useful for the assessment of self-construction and cognitive conflicts in BN patients and to appreciate their role in this disorder. It could also be helpful for clinicians to explore the patient’s constructs system, and especially to identify IDs that could be maintaining the symptoms or hindering change in order to focus on them to facilitate improvement

This article studies the levels of psychological symptoms, problem-solving skills and self-construction in 28 freshmen, as assessed at the beginning and end of their first year at university. The repertory grid technique was used to assess self-ideal discrepancy, cognitive differentiation, and existence of implicative dilemmas. Results showed an improvement in psychological symptoms and self-ideal discrepancy, an increase in differentiation, but no significant differences in problem-solving skills. One or more implicative dilemmas were found in over half of the sample at the initial assessment and only in one-third at the final one, although this difference was not significant. Psychological symptoms at the end of the first year were predicted only by the initial reported symptoms. However, problem-solving skills at the end were predicted by a model including both initial skills and implicative dilemmas at the beginning of the year.