Date of Award


Degree Type


Degree Name

Doctor of Philosophy


School of Psychology and Social Science


Faculty of Computing, Health and Science

First Advisor

Professor Craig Speelman

Second Advisor

Associate Professor Lisbeth Pike


This is a presentation of the psychotherapeutic treatment modality, „Rewiring Head & Heart (Rewiring)‟ that combines cognitive therapy (“head”) with psychodynamic exercises (“heart”) into an evidence-based clinical treatment modality for use by therapists. This study extends previous research conducted by Milnes (1998). Descriptions of the origins of the treatment modality, the underpinning theoretical framework, and practical application in the Rewiring Manual are followed by an empirical investigation of its efficacy on a sample of adults with depressed mood, before discussing case studies and issues of clinical application of Rewiring. Rewiring consists of two contributing elements – Cognitive Fluency (CF) and Psychodynamic Therapy (PDT). The efficacy of each element and the combination of both were subjected to separate clinical trials. After assessment using the depression subscale of the Depression and Anxiety Stress Scales (DASS), the Beck Depression Inventory – II (BDI-II) and a clinical interview, 47 participants sharing elevated scores of depression were randomly allocated to four conditions: Cognitive Fluency (CF), Psychodynamic Therapy (PDT), Cognitive Fluency combined with Psychodynamic Therapy (CF+PDT) and a control condition. During the 4-session treatment based on Rewiring all participants were measured on Self-Ratings of Belief (SRBs). Case-studies from the efficacy trial and single subject case-studies from clinical practice were also examined. Although the n was inadequate to test the hypotheses, it did indicate a direction for treatment. It was found that both the CF and the PDT treatments were efficacious and the combined condition (CF+PDT) provided still more robust results. The empirical and case study evidence supported Rewiring as a cost-effective, short-term, psychodynamic and cognitive combination therapy that can be used in a variety of settings, and as a psychotherapeutic modality available for use by trained clinicians.

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