The role of nonspecific factors in cognitive-behavior therapy for depression.

Ilardi, Stephen S.; Craighead, W. Edward

doi:10.1111/j.1468-2850.1994.tb00016.x

Cited by 501Psychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychological Treatments and Assessments

The role of nonspecific factors in cognitive-behavior therapy for depression.

Ilardi, Stephen S., Craighead, W. Edward·1994·Clinical Psychology: Science and Practice

DOI 10.1111/j.1468-2850.1994.tb00016.x

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Abstract

This article reviews the role of nonspecific treatment factors in cognitive-behavior therapy (CBT) for depression. An analysis of relevant studies reveals that the majority of symptomatic improvement in CBT occurs prior to the formal introduction of cognitive restructuring techniques. This suggests that other, likely nonspecific, treatment factors play a large role in mediating clinical improvement. Nonspecific factors are hypothesized to ameliorate patients’ feelings of hopelessness at the beginning of treatment, a process that catalyzes improvement across other depressive symptoms. Reviewed evidence supports a mediation role for the hopelessness construct in CBT. Two nonspecific factors, the treatment rationale and the assignment of homework, appear integral to early symptomatic improvement. The role of cognitive techniques is discussed in light of these findings.

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There was unexplained response to CBT protocols in early sessions, before putatively critical elements within the model were presented.
“the unexplained response to CBT protocols in early sessions, before putatively critical elements within the model were presented 33”
From “Third-wave” cognitive and behavioral therapies and the emergence of a process-based approach to intervention in psychiatry (2021) · cites this paper as [33]
Large component analysis studies of CBT found that cognitive components were not key to outcomes.
“the unexpected results from large component analysis studies of CBT 31,32 in which cognitive components were not found to be key to outcomes”
From “Third-wave” cognitive and behavioral therapies and the emergence of a process-based approach to intervention in psychiatry (2021) · cites this paper as [32]
Eliciting hope and positive expectations about the effect of the treatment is a crucial factor in many psychotherapies.
“Evidence suggests that eliciting hope and positive expectations about the effect of the treatment is a crucial factor in many psychotherapies [93–96].”
From An Internet-based Acceptance and Commitment Therapy intervention for older adults with anxiety complaints: study protocol for a cluster randomized controlled trial. (2018) · cites this paper as [94]
Several studies have shown the impact of client expectancies on treatment effect.
“Several studies have shown the impact of client expectancies on treatment effect.”
From An Internet-based Acceptance and Commitment Therapy intervention for older adults with anxiety complaints: study protocol for a cluster randomized controlled trial. (2018) · cites this paper as [94]
Response to traditional cognitive therapy often occurs before cognitive change techniques have been implemented.
“The response to traditional cognitive therapy often occurs before cognitive change techniques have been implemented”
From Acceptance and commitment therapy: model, processes and outcomes (2006) · cites this paper as Ilardi & Craighead, 1994

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Authors: Ilardi, S. S., & Craighead, W. E.
Affiliations: Duke Medical Center (US)
ORCID: Craighead, W. Edward
Venue: Clinical Psychology: Science and Practice
Publisher: American Psychological Association (APA)
Published: 1994
Volume: 1
Issue: 2
Pages: 138-156
ISSN: 0969-5893 (ISSN-L)
1468-2850
DOI: 10.1111/j.1468-2850.1994.tb00016.x
OpenAlex: W2019208430
Cited by: 501
References: 77
Citations by year: 2026: 2 · 2025: 3 · 2024: 4 · 2023: 9 · 2022: 13 · 2021: 11 · 2020: 18 · 2019: 19 · 2018: 20 · 2017: 24 · 2016: 18 · 2015: 20 · 2014: 27 · 2013: 23 · 2012: 23
FWCI: 5.10
Type: journal article
Language: en
Open access: closed
Licence: doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 7913 d)
Locations: Clinical Psychology Science and Practice (publishedVersion)
Funders: National Institutes of Health
National Institute of Mental Health
Topics: Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
Keywords: cognitive behavioral therapy, depression, hopelessness, cognitive restructuring, treatment rationale, homework

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The role of nonspecific factors in cognitive-behavior therapy for depression.

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