Cognitive-behavioral Treatment For Depression Research Articles

Cognitive variables in alcohol dependent patients with elevated depressive symptoms: Changes and predictive utility as a function of treatment modality

The aim of the current study was to examine, through posthoc analyses, changes in and predictive utility of mood‐related cognitive variables as a function of treatment modality in a group of alcohol dependent patients with elevated depressive symptoms. In addition to the background partial hospital treatment for alcoholism which lasted a mean of 21.2 days, study patients (n = 35) received cognitive‐behavioral treatment for depression (CBT‐D) or a control treatment consisting of relaxation training (RTC). While both groups showed improvement on dysfunctional attitudes during treatment, only the CBT‐D group improved on measures of alcohol‐related expectancies. Changes in cognitive variables during treatment predicted drinking outcomes, and the predictors of drinking outcomes varied across the two treatments. Among the RTC patients, changes in positive alcohol‐related expectancies were negatively correlated with drinking frequency and quantity at follow‐up. However, for the CBT‐D patients, changes in self‐efficacy concerning negative mood situations and negative alcohol‐related expectancies were negatively correlated with drinking at longer‐term follow‐up. The results of this study provide evidence concerning the mechanisms by which the treatment modalities examined may affect patient outcome. Although these results are preliminary in nature, they do suggest that future research might examine efforts to capitalize on these mechanisms through the facilitation of changes found to predict better drinking outcomes in this study.

Group Cognitive-Behavioral Treatment of Depression and the Interaction of Demographic Variables

Group Cognitive-Behavioral Treatment of Depression and the Interaction of Demographic Variables

The influence of comorbid risk factors on the effectiveness of cognitive-behavioral treatment of depression

Response levels of 92 depressed subjects to a standardized small-group CBT intervention were examined. Data on differing comorbid factors and clinical variables were assessed for differential treatment effects. Findings are based on combined groups wherein adults participated in 12, 2-hour skill-building sessions. Participants were assessed for levels of depression, hopelessness, anxiety, and social adjustment at pre- and posttest and 5 follow-up intervals. The intervention was effective in the treatment of unipolar depression for all groups and comorbid and clinical variables were found to have various significant functional relationships with treatment outcome.

Cognitive–behavioral treatment for depression in smoking cessation.

Cigarette smokers with past major depressive disorder (MDD) received 8 group sessions of standard, cognitive-behavioral smoking cessation treatment (ST; n = 93) or standard, cognitive-behavioral smokiig cessation treatment plus cognitive-behavioral treatment for depression (CBT-D; n = 86). Although abstinence rates were high in both conditions (ST, 24.7%; CBT-D, 32.5%, at 1 year) for these nonpharmacological treatments, no main effect of treatment was found. However, secondary analyses revealed significant interactions between treatment condition and both recurrent depression history and heavy smoking ( > or =25 cigarettes a day) at baseline. Smokers with recurrent MDD and heavy smokers who received CBT-D were significantly more likely to be abstinent than those receiving ST (odds ratios = 2.3 and 2.6, respectively). Results suggest that CBT-D provides specific benefits for some, but not all, smokers with a history of MDD.

A component analysis of cognitive-behavioral treatment for depression.

The purpose of this study was to provide an experimental test of the theory of change put forth by A. T. Beck, A. J. Rush, B. F. Shaw, and G. Emery (1979) to explain the efficacy of cognitive-behavioral therapy (CT) for depression. The comparison involved randomly assigning 150 outpatients with major depression to a treatment focused exclusively on the behavioral activation (BA) component of CT, a treatment that included both BA and the teaching of skills to modify automatic thoughts (AT), but excluding the components of CT focused on core schema, or the full CT treatment. Four experienced cognitive therapists conducted all treatments. Despite excellent adherence to treatment protocols by the therapists, a clear bias favoring CT, and the competent performance of CT, there was no evidence that the complete treatment produced better outcomes, at either the termination of acute treatment or the 6-month follow-up, than either component treatment. Furthermore, both BA and AT treatments were just as effective as CT at altering negative thinking as well as dysfunctional attributional styles. Finally, attributional style was highly predictive of both short- and long-term outcomes in the BA condition, but not in the CT condition.

A component analysis of cognitive-behavioral treatment for depression.

A component analysis of cognitive-behavioral treatment for depression.

Cognitive-Behavioral Treatment of Depression, Part VIII. Developing and Utilizing the Therapeutic Relationship

A good therapeutic relationship is essential for the successful implementation of any form of therapy. The present manuscript provides recommendations for developing and utilizing the therapeutic relationship in the cognitive-behavioral treatment of depression. Throughout therapy, the therapist should attempt to: (1) establish an atmosphere of openness and trust, (2) instill hope in the client's potential for change, (3) display empathic concern for the client's distress, (4) stay calm and objective even when the client is upset, (5) emphasize the collaborative nature of therapy, (6) remain flexible and spontaneous in the treatment plan, and (7) apply the work in sessions to the client' everyday life experiences. These strategies help develop a strong therapeutic relationship as a foundation on which to build, and maximize the efficacy of other components of cognitive-behavioral treatment of depression.

Cognitive-Behavioral Treatment of Depression, Part X: Reducing the Risk of Relapse

Cognitive-behavioral therapy has been found effective for the treatment of depression. Nonetheless, many clients who respond to treatment are still vulnerable to relapse during the months following remission. It is important for therapists to be aware of the temporal patterns often seen in patients following recovery from depression so they can use strategies designed to reduce the risk of relapse or recurrence. Relapse prevention strategies focus on helping clients: 1) identify high risk situations, 2) develop specific coping strategies to deal with emotional distress, 3) deliberately seek and confront difficult situations, 4) cope with feeling overwhelmed, 5) expand and refine their coping skills, 6) enhance their feelings of self-confidence, and 7) anticipate and prepare for a lapse. These strategies provide much help in maintaining the gains that had been obtained through the earlier treatment efforts.

Cognitive-Behavioral Treatment of Depression, Part IX: Confronting Predisposing Factors

Cognitive-behavioral therapy can help many depressed clients learn more effective ways of coping with problems in their lives. However, for many clients with chronic or recurrent depression, it can be helpful to examine the biological, psychological, and social/cultural factors that may predispose a person toward depressive episodes. In order to address possible biological predispositions, it is important to assess for a positive family history of depression, evaluate family members' response to previous treatments, and refer for medications when needed. In order to address possible psychological predispositions, it is useful to evaluate long-standing personality styles, identify negative events from childhood, examine the client's relationship with his or her parents, evaluate the history of abuse, and identify early loss experiences. Cultural factors may play an influential role in the etiology of depression, and can be useful to incorporate into a broad treatment plan. However, cultural factors are difficult to modify through individual psychotherapy. Hence, they are unlikely to play a central role in cognitive-behavioral therapy for depression. Overall, therapists working with depressed clients should be prepared to confront a broad range of biological, psychological, and environmental factors that can create or perpetuate a client's risk for depression.

Cognitive-behavioral treatment of depression, part VII: Coping with precipitating events

Cognitive-behavioral treatments are effective for many clients suffering from depression. These treatments include strategies designed to improve social functioning, reduce cognitive biases, enhance problem-solving skills, and improve self-control skills. The present manuscript describes cognitive-behavioral strategies designed to enhance the client's ability to cope with stressful life events. Several unproductive coping responses are described and should be discouraged. A range of productive coping responses are described and have been found effective in dealing with stressful life events. A conceptual model is presented to help understand the way in which stressful life events may precipitate depressive reactions and can be addressed in treatment.

Cognitive-behavioral treatment of depression, part VI: Integrating the use of antidepressant medications

Cognitive-behavioral therapy has been found effective in the treatment of depression. However, many clinicians and researchers view cognitive-behavioral therapy and antidepressant medications as independent forms of intervention. The present manuscript discusses the use of antidepressant medications as an effective complement to cognitive-behavioral therapy. Guidelines are presented for the assessment of depressive subtypes related to different types of psychotropic medications. Also, the risks and benefits of psychotropic medications are discussed. Therapists working with depressed clients are encouraged to follow a comprehensive evaluation and treatment plan using interdisciplinary resources to help clients overcome their depression.

Cognitive-behavioral treatment of depression, part V: Enhancing self-esteem and self-control

Cognitive-behavioral treatments for depression have included attempts to improve social functioning, reduce cognitive biases, and improve interpersonal problem-solving skills. However, many depressed clients report problems caused by low self-esteem. The present manuscript describes a cognitive-behavioral approach to improving self-esteem in depressed clients. Psychosocial exploration can be used to gather detailed information about the client's view of self, and help both therapist and client understand the various components of self-esteem. Then, adaptive change can be structured around four general issues: (1) expanding the client's perspective to include a more balanced view of both positive and negative events, (2) increasing the frequency of self-reinforcement by praising areas of success, (3) modifying the client's coping strategies so as to maximize the likelihood of successful performance, and (4) revising the client's goals and standards that underlie the self-evaluation process. Using a combination of these approaches, the therapist may be able to help clients improve their self-esteem and reduce the likelihood of depression.

Cognitive-behavioral treatment of depression, part IV: Improving problem-solving skills

Cognitive-behavioral treatment of depression has been found effective for helping a wide range of clients. However, current approaches to treatment emphasize the integration of a variety of treatment elements. The present manuscript describes the use of problem-solving therapy as incorporated into a broader cognitive-behavioral treatment model. Problem-solving approaches to therapy typically involve helping clients develop skill in five interrelated areas: (1) Develop an adaptive orientation to life's problems, (2) Define problems in terms of specific and realistic goals, (3) Generate a variety of response alternatives, (4) Help clients make rational decisions, and (5) Implement the plan and evaluate its effectiveness. These strategies can help many clients cope with the stressful life events that occur, and therefore can help reduce the intensity or prevent the onset of depressive symptoms. Furthermore, these strategies can be incorporated into a broader treatment plan that includes elements for monitoring depression severity, improving social functioning, and reducing cognitive biases.

Cognitive-behavioral treatment of depression, part II: Techniques for improving social functioning

Cognitive-behavioral approaches have been found effective in the treatment of depression. In order to maximize the efficiency and flexibility of cognitive-behavioral treatment, the therapist can use of a series of interrelated therapy modules focused on different aspects of treatment. The present manuscript describes the module for improving social functioning in depressed clients. Suggestions are provided for guiding therapy to help clients increase their social activity, reduce the interpersonal conflict in their lives, and learn to adjust to loss and change resulting from stressful life events. Therapy of depression may be facilitated when the present module is used in combination with other modules focused on the assessment of depression severity and suicide risk (see Part I in this Journal), reducing cognitive biases in depressed clients, and enhancing problem-solving skills in clients.

Cognitive-behavioral treatment of depression, part I: Assessment of depression and suicide risk

Cognitive-behavioral therapy has been found effective in the treatment of depression. However, most guides to conducting cognitive-behavioral therapy focus on a session-by-session description of treatment issues. The present manuscript describes the first in a series of interrelated therapy modules to help guide the treatment of depression. The use of modules helps the therapist adapt the therapy to the unique needs of each individual client, emphasizing some elements while omitting others. Also, the use of modules can maximize the short-term application of psychotherapy, allowing therapists to select certain elements to be omitted or repeated as needed for a specific client. Procedures are described for assessing the severity of depression, evaluating the need for medications, and determining when hospitalization is needed. Also, recommendations are provided for monitoring suicide risk factors and preventing self-injury in depressed and suicidal clients.

Beating the blues: Cognitive-behavioral treatment for depression in child-maltreating young mothers

Young mothers are at risk for depression. The article first reviews research on social and cognitive risk factors for depression and then considers the relationship between depression and child maltreatment. Cognitive-behavioral casework techniques that may improve social integration and self-management—mitigators of depression—are detailed. Finally, a case study demonstrates the use of these techniques with a depressed and maltreating mother.

A Comparison of Secular and Religious Versions of Cognitive Therapy with Depressed Christian College Students

This study was designed to answer two related questions: (a) Could Beck's cognitive-behavioral treatment of depression be efficaciously employed in a religious population, and (b) would the efficacy of Beck's cognitive-behavioral treatment of depression be enhanced if it was integrated with the subjects’ religious beliefs? A multiple cutoff procedure was utilized in the selection of subjects for a secular cognitive behavior modification group, a religious cognitive behavior modification group, and a waiting list control group. The results indicated that the secular and the religious cognitive behavior modification groups were significantly more effective than the waiting list control group in alleviating depression. No significant differences were found between secular and the religious cognitive behavior modification groups. The reductions in depression were maintained at a one-month follow-up. The results relevant to Beck's cognitive-behavioral therapy of depression and to the treatment of religious patients are discussed.