Predicting the effect of cognitive therapy for depression: A study of unique and common factors.

Abstract

The ability of several process variables to predict therapy outcome was tested with 30 depressed clients who received cognitive therapy with or without medication. Two types of process variables were studied: 1 variable that is unique to cognitive therapy and 2 variables that this approach is assumed to share with other forms of treatment. The client's improvement was found to be predicted by the 2 common factors measured: the therapeutic alliance and the client's emotional involvement (experiencing). The results also indicated, however, that a unique aspect of cognitive therapy (i.e., therapist's focus on the impact of distorted cognitions on depressive symptoms) correlated negatively with outcome at the end of treatment. Descriptive analyses that were conducted to understand this negative correlation suggest that therapists sometimes increased their adherence to cognitive rationales and techniques to correct problems in the therapeutic alliance. Such increased focus, however, seems to worsen alliance strains, thereby interfering with therapeutic change.

Cites (6)

1. An inventory for measuring depression
   BECK, A. T. · 1961 · Archives of General Psychiatry
2. A rating scale for depression
   Hamilton, M. · 1960 · Journal of Neurology, Neurosurgery & Psychiatry
3. The generalizability of the psychoanalytic concept of the working alliance.
   Bordin, Edward S. · 1979 · Psychotherapy: Theory, Research & Practice
4. The Global Assessment Scale: A Procedure for Measuring Overall Severity of Psychiatric Disturbance
   Endicott, Jean · 1976 · Archives of General Psychiatry
5. Cognitive Therapy and Pharmacotherapy for Depression: Singly and in Combination
   Hollon, Steven D. · 1992 · Archives of General Psychiatry
6. Determinants of change in cognitive therapy for depression
   DeRubeis, Robert J., Feeley, Michael · 1990 · Cognitive Therapy and Research

Show all 6 references

Cited by (70)

1. Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review
   Martin, Daniel J., Garske, John P., Davis, M. Katherine · 2000 · Journal of Consulting and Clinical Psychology
2. Evidence-based practice in psychology.
   American Psychological Association · 2006 · American Psychologist
3. Empirically supported psychological interventions: Controversies and evidence
   Chambless, Dianne L., Ollendick, Thomas H. · 2001 · Annual Review of Psychology
4. Research summary on the therapeutic relationship and psychotherapy outcome.
   Lambert, Michael J., Barley, Dean E. · 2001 · Psychotherapy: Theory, Research, Practice, Training
5. The efficacy of psychodynamic psychotherapy
   Shedler, Jonathan · 2010 · American Psychologist

See all 718