Vol.:(0123456789) Journal of Rational-Emotive & Cognitive-Behavior Therapy https://doi.org/10.1007/s10942-018-0312-8 1 3 An Investigation of Sequencing Efects in Combining Cognitive Questioning and Mindful Acceptance Rosita Borlimi 1,2  · Gerhard Benetka 3  · Gianni Brighetti 1,2  · Gabriele Caselli 1,4  · Elisabetta Caletti 5  · Carolina A. Redaelli 4  · Giovanni M. Ruggiero 1,6  · Diego Sarracino 7  · Sandra Sassaroli 1,4 © Springer Science+Business Media, LLC, part of Springer Nature 2018 Abstract Cognitive-behavioral treatments assume that the mechanisms of change depend on the assessment and questioning of biased beliefs. In contrast, recent developments have emphasized mindful acceptance interventions, in which clients allow thoughts to come and go without questioning them. In order to discuss therapeutic efcacy diference in emotional disorders, we explored the possible normalizing efects of cognitive questioning and mindful acceptance on sympathetic reactivity aroused by recall tasks. We compared the efects of diferent sequencing of cognitive question- ing and mindful acceptance on emotional distress in two groups in which question- ing either preceded (group 1) or followed (group 2) acceptance. Thirty-fve non- clinical individuals (21 males, 14 females) randomly allocated to either group 1 or 2 participated in the experimental tasks (unpleasant recall, cognitive questioning, and metacognitive acceptance). Sympathetic reactivity levels were measured using galvanic skin response. Results showed that acceptance reduced sympathetic reac- tivity when compared to questioning. The best sequence was that in which ques- tioning preceded acceptance. By interpreting sympathetic reactivity as a measure of emotional distress and experimental tasks as models for therapeutic approaches, this experiment suggests that acceptance is better than questioning in reducing emotional distress especially when cognitive questioning is followed by mindful acceptance. Keywords Acceptance · Cognitive therapy · Metacognition · Questioning · Sympathetic reactivity * Rosita Borlimi rosita.borlimi@unibo.it Extended author information available on the last page of the article