The DID IT protocol

A fours-session transdiagnostic protocol targeting maladaptive thinking by helping clients decouple autonomous (Type 1) from higher reasoning processes (Type 2).

Thank you for your interest in the DID IT protocol. We’ve developed this transdiagnostic protocol based on the observation that most of our clients continuously engage in ruminative, self-critical, worrying or catastrophizing ‘stories’ and that these ‘stories’ maintain their psychopathological symptoms.

As CBT therapists, we attempt to make these ‘stories’ less believable or attractive by cognitive behavioral strategies including challenging dysfunctional beliefs, self-monitoring and behavioral experiments. However, we thought that empowering clients to make their own decisions of whether they want to engage with these ‘stories’ would be a more economic and effective way to help clients move away from these thinking patterns and become more involved in life.

This protocol is based on the following main assumptions:
(1) Engagement with maladaptive thinking patterns such as self-criticism, ruminations, worry and catastrophizing drives a wide variety of psychopathological symptoms.
(2) Maladaptive thinking patterns are higher reasoning processes (Type 2) that require significant cognitive resources to be maintained over time.
(3) Maladaptive thinking patterns maintain and reinforce not only themselves, but also autonomous cognitive processes (e.g., associative network; Type 1)
(4) The subjective experience of lacking control over maladaptive thinking patterns is the result of a conditioning process linking elements from the associative network and maladaptive thinking patterns (e.g., “mental habit”).
(5) The above mentioned conditioning process, however, can only initiate (but not maintain) maladaptive thinking patterns.

The DID IT protocol, therefore, is about

Distinguishing controllable from autonomous thinking processes
Identifying the transition point between these processes
Delaying the initiation of the client’s ‘story’ (thus breaking ‘mental habits’)

Increasing motivation for letting go of the ‘story’
Training in breaking ‘mental habits’

To help clients make the most of the protocol, clients:
– Are provided with weekly handouts
– Have weekly home tasks
– Train using the ‘thinking loops’ module of This module includes 4 weeks of daily training (3 minutes a day) to consolidate what has been discovered during each therapy session.

We also recommend including questionnaires as part of the protocol itself. This allows for better monitoring of progress and outcomes of the therapy. Questionnaires used can include symptoms assessment measures such as the PHQ-9 (Kroenke & Spitzer, 2002), GAD-7 (Spitzer, Kroenke et al., 2006), PSWQ (Molina, & Borkovec, 1994) or OCI-12 (Abramovitch et al., 2021).
The use of process questionnaires such as the Ruminative Response Scale – short form (RRS; Treynor et al., 2003), the Forms of Self-criticizing/Attacking & Self-Reassuring Scale (FSCRS; Gilbert et al., 2004) or the Self-Critical Rumination Scale (SCRS; Smart et al., 2015) are also strongly recommended.

To get a copy of the protocol or for any queries contact us

Prof. Guy Doron on [email protected]
Dr. Danny Derby on [email protected]