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A component analysis of cognitive-behavioral treatment for depression
N S Jacobson1, K S Dobson, P A Truax
1Department of Psychology, University of Washington, Seattle 98105-4631, USA.
Journal of Consulting and Clinical Psychology
|April 1, 1996
Summary
Cognitive-behavioral therapy (CT) for depression showed no superior outcomes compared to its individual components, behavioral activation (BA) and automatic thoughts (AT) skills training. Attributional style predicted outcomes in BA but not full CT.
Area of Science:
- Psychology
- Clinical Psychology
- Psychotherapy Research
Background:
- Cognitive-behavioral therapy (CT) is a leading treatment for depression.
- Its efficacy is theoretically explained by Beck et al.'s (1979) theory of change.
- Key components include behavioral activation (BA) and modifying automatic thoughts (AT).
Purpose of the Study:
- To experimentally test the theory of change for CT in depression.
- To compare the efficacy of full CT against its core components: BA and AT skills training.
Main Methods:
- 150 outpatients with major depression were randomly assigned to three conditions: BA only, BA + AT skills, or full CT.
- Treatments were delivered by experienced cognitive therapists adhering to protocols.
- Outcomes were assessed at treatment termination and 6-month follow-up.
Main Results:
- Full CT did not yield better outcomes than BA or BA + AT treatments at termination or follow-up.
- Both BA and AT treatments were equally effective as CT in altering negative thinking and attributional styles.
- Attributional style predicted outcomes in the BA condition, but not in the full CT condition.
Conclusions:
- The study challenges the necessity of full CT for depression, suggesting component treatments may be sufficient.
- BA and AT modification appear to be critical active ingredients in CT for depression.
- Understanding attributional style may be important for predicting treatment response, particularly in BA-focused interventions.