Coping styles, homework compliance, and the effectiveness of cognitive-behavioral therapy

Factor analysis of the Self-Help Inventory (Burns, Shaw, & Crocker, 1987) in a group of 307 consecutive outpatients seeking cognitive-behavioral therapy (CBT) for affective disorders revealed 3 factors that assessed the frequency with which subjects used active coping strategies when depressed, the perceived helpfulness of these coping strategies, and their willingness to learn new coping strategies. The Frequency and Helpfulness scales did not predict patients' subsequent compliance with self-help assignments or their rate of improvement during the first 12 weeks of treatment. These findings suggest that very resourceful patients are not better candidates for CBT than other patients and that patients' expectations about the value of active coping strategies do not predict the response to CBT. In contrast, the Willingness scale was correlated with the degree of improvement during the first 12 weeks of treatment. The Willingness scale and compliance with self-help assignments made additive and separate contributions to clinical improvement. Further research on motivational factors may be indicated.