Cognitive group psychotherapy of depression: the close-ended group

One of the most important recent contributions to the understanding and treatment of depression is that of the cognitive theory and cognitive-behavior therapy developed by A. T. Beck. This paper describes the rationale and the technique of a short-term group psychotherapy based on Beck's Cognitive Therapy. The therapy was conducted with small closed-membership groups of patients with major depressive illness who were participating in a treatment-outcome study. Details of the role induction, session structure, roles of therapist and cotherapist, phases of group treatment course, and possible effectiveness are discussed. The technique presented here includes two individual cognitive sessions for purposes of role induction and establishing a therapeutic relationship before the first group session. We make use of flipcharts and a blackboard to illustrate various cognitive techniques, highly structured sessions with specific individualized agendas, defined therapist and cotherapist roles. The usual phases in a 15-session group course are described and our present experience of the techniques effectiveness are discussed.