Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-20T06:21:11.148Z Has data issue: false hasContentIssue false

Cognitive-Behaviour Therapy for Depression: Empirical Findings and Methodological Issues in the Evaluation of Outcome

Published online by Cambridge University Press:  06 October 2014

Peter H. Wilson*
Affiliation:
University of Sydney
*
Department of Psychology, University of Sydney, NSW 2006
Get access

Abstract

The aim of this paper is to examine the treatment-outcome literature related to cognitive-behaviour therapy for depression in adults. Evidence for the effectiveness of cognitive-behaviour therapy is obtained from comparisons with waiting-list controls, non-specific controls, and other treatments, including pharmacotherapy. Short term effects are superior to those obtained with waitinglist controls, but are at least equivalent to pharmacotherapy. Longer term effects are difficult to evaluate due to methodological problems in such studies, particularly the lack of maintenance medication comparison groups. Nevertheless, the long term effects appear to be promising. Issues and data concerning the prediction and prevention of relapse are discussed. It is recommended that future research should focus on broader assessment goals and include cost-benefit analyses.

Type
Research Article
Copyright
Copyright © The Author(s) 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Baker, A.L. & Wilson, P.H. (1985). Cognitive-behavior therapy for depression: The effects of booster sessions on relapse. Behavior Therapy, 16, 335344.Google Scholar
Beach, S.R.H. & O'Leary, K.D. (1986). The treatment of depression occurring in the context of marital discord. Behavior Therapy, 17, 4349.Google Scholar
Beck, A.T., Hollon, S.D., Young, J.E., Bedrosian, R.C. & Bundez, D. (1985). Treatment of depression with cognitive therapy and amitriptyline. Archives of General Psychiatry, 42, 142148.Google Scholar
Beck, A.T., Rush, A.J.Shaw, B.F. & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.Google Scholar
Beck, A.T., Ward, C.H., Mendelson, M., Mock, J. & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561571.Google Scholar
Beutler, L.E., Scogin, F., Kirkish, P., Schretlen, D., Corbishley, A., Hamblin, D., Meredith, K., Potter, R., Bamford, C.R. & Levenson, A.I. (1987). Group cognitive therapy and Aprazolam in the treatment of depressed older adults. Journal of Consulting and Clinical Psychology, 55, 550556.Google Scholar
Blackburn, I.M. & Bishop, S. (1983). Changes in cognition with pharmacotherapy and cognitive therapy. British Journal of Psychiatry, 143, 609617.Google Scholar
Blackburn, I.M., Bishop, S., Glen, A.I.M., Whalley, L.J. & Christie, J.E. (1981). The efficacy of cognitive therapy in depression: A treatment trial using cognitive therapy and pharmacotherapy, each alone and in combination. British Journal of Psychiatry, 139, 181189.Google Scholar
Blackburn, I.M., Eunson, K.M. & Bishop, S. (1986). A two-year naturalistic follow-up of depressed patients treated with cognitive therapy, pharmacotherapy and a combination of both. Journal of Affective Disorders, 10, 6775.Google Scholar
Brown, R.A. & Lewinsohn, P.M. (1984). A psychoeducational approach to the treatment of depression: Comparison of group, individual, and minimal contact procedures. Journal of Consulting and Clinical Psychology, 52, 774783.Google Scholar
Comas-Diaz, L. (1981). Effects of cognitive and behavioral group treatment on the depressive symptomatology of Puerto Rican women. Journal of Consulting and Clinical Psychology, 49, 627632.Google Scholar
Covi, L. & Lipman, R.S. (1987). Cognitive behavioral group psychotherapy combined with Imipramine in major depression: A pilot study. Psychopharmacology Bulletin, 23, 173176.Google Scholar
de Jong, R., Treiber, R. & Henrich, G. (1986). Effectiveness of two psychological treatments for inpatients with severe and chronic depression. Cognitive Therapy and Research, 10, 645663.Google Scholar
Fennell, M.J.V. & Teasdale, J.D. (1987). Cognitive therapy for depression: Individual differences and the process of change. Cognitive Therapy and Research, 11, 253271.Google Scholar
Fuchs, C.Z. & Rehm, L.P. (1977). A self-control behavior therapy program for depression. Journal of Consulting and Clinical Psychology, 45, 206215.CrossRefGoogle ScholarPubMed
Gonzales, L.R., Lewinsohn, P.M. & Clarke, G.N. (1985). Longitudinal follow-up of unipolar depressives: An investigation of predictors of relapse. Journal of Consulting and Clinical Psychology, 53, 461469.Google Scholar
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 5662.Google Scholar
Heiby, E.M. (1986). Social versus self-control skills deficits in four cases of depression. Behavior Therapy, 17, 158169.CrossRefGoogle Scholar
Hersen, M., Bellack, A.S., Himmelhoch, J.M. & Thase, M.E. (1984). Effects of social skill training, amitriptyline, and psychotherapy in unipolar depressed women. Behavior Therapy, 15, 2140.Google Scholar
Hollon, S.D., DeRubeis, R.J. & Evans, M.D. (1987). Causal mediation of change in treatment for depression: Discriminating between nonspecificity and noncausality. Psychological Bulletin, 102, 139149.Google Scholar
Jarrett, R.B. & Nelson, R.O. (1987). Mechanisms of change in cognitive therapy of depression. Behavior Therapy, 18, 227241.Google Scholar
Kavanagh, D.J. & Wilson, P.H. (in press). Prediction of outcome with cognitive therapy for depression. Behaviour Research and Therapy.Google Scholar
Kornblith, S.J., Rehm, L.P., O'Hara, M.W. & Lamparski, D.M. (1983). The contribution of self-reinforcement training and behavioral assignments to the efficacy of self-control therapy for depression. Cognitive Therapy and Research, 7, 499528.Google Scholar
Kovacs, M., Rush, A.J., Beck, A.T. & Hollon, S.D. (1981). Depressed outpatients treated with cognitive therapy or pharmacotherapy. Archives of General Psychiatry, 38, 3339.Google Scholar
Larcombe, N.A. & Wilson, P.H. (1984). An evaluation of cognitive-behaviour therapy for depression in patients with multiple sclerosis. British Journal of Psychiatry, 145, 366371.Google Scholar
Lewinsohn, P.M. (1975). The behavioral study and treatment of depression. In Hersen, M., Eisler, R.M. & Miller, P.M. (Eds.), Progress in behavior modification, Vol. 1. New York: Academic Press.Google Scholar
Lewinsohn, P.M., Antonuccio, D., Steinmetz, J. & Teri, L. (1984). The coping with depression course, Eugene, OR: Castalia.Google Scholar
McKnight, D.L., Nelson, R.O., Hayes, S.C. & Jarrett, R.B. (1984). Importance of treating individually assessed response classes in the amelioration of depression. Behavior Therapy, 15, 315335.Google Scholar
McLean, P.D. & Hakstian, R.A. (1979). Clinical depression: Comparative efficacy of outpatient treatments. Journal of Consulting and Clinical Psychology, 47, 818836.Google Scholar
McNamara, K. & Horan, J.J. (1986). Experimental construct validity in the evaluation of cognitive and behavioral treatments for depression. Journal of Counseling Psychology, 33, 2330.Google Scholar
Murphy, G.E., Simons, A.D., Wetzel, R.D. & Lustman, P.J. (1984). Cognitive therapy and pharmacotherapy: Singly and together in the treatment of depression. Archives of General Psychiatry, 41, 3341.Google Scholar
Nietzel, M.T., Russell, R.L., Hemmings, K.A. & Gretter, M.L. (1987). The clinical significance of psychotherapy for unipolar depression: A meta-analytic approach to social comparison. Journal of Consulting and Clinical Psychology, 55, 156161.Google Scholar
Nezu, A.M. (1986). Efficacy of a social problem-solving approach for unipolar depression. Journal of Consulting and Clinical Psychology, 54, 196202.Google Scholar
Rehm, L.P., Fuchs, C.Z., Roth, D.M., Kornblith, S.J. & Romano, J.M. (1979). A comparison of self-control and assertion skills treatments of depression. Behavior Therapy, 10, 429442.Google Scholar
Rehm, L.P., Kornblith, S.J., O'Hara, M.W., Lam-parski, D.M., Romano, J.M. & Volkin, J.I. (1981). An evaluation of major components in a self-control therapy program for depression. Behavior Modification, 5, 459489.Google Scholar
Reynolds, W.M. & Coats, K.I. (1986). A comparison of cognitive-behavioral therapy and relaxation training for the treatment of depression in adolescents. Journal of Consulting and Clinical Psychology, 54, 653660.Google Scholar
Rosenbaum, M. (1980). A schedule for assessing self-control behaviors. Behavior Therapy, 11, 109121.Google Scholar
Roth, D., Bielski, R., Jones, M., Parker, W. & Osborn, G. (1982). A comparison of self-control therapy and combined self-control therapy and antidepressant medication in the treatment of depression. Behavior Therapy, 13, 133144.Google Scholar
Rush, A.J., Beck, A.T., Kovacs, M. & Hollon, S. (1977). Comparative efficacy of cognitive therapy and pharmacotherapy in the treatment of depressed outpatients. Cognitive Therapy and Research, 1, 1737.Google Scholar
Rush, A.J., Beck, A.T., Kovacs, M., Weissenberger, J. & Hollon, S.D. (1982). Comparison of the effects of cognitive therapy and pharmacotherapy on hopelessness and self-concept. American Journal of Psychiatry, 139, 862866.Google Scholar
Shaw, B.F. (1977). Comparison of cognitive therapy and behavior therapy in the treatment of depression. Journal of Consulting and Clinical Psychology, 45, 543551.Google Scholar
Simons, A.D., Garfield, S.L. & Murphy, G.E. (1984). The process of change in cognitive therapy and pharmacotherapy for depression. Archives of General Psychiatry, 41, 4551.Google Scholar
Simons, A.D., Lustman, P.J., Wetzel, R.D. & Murphy, G.E. (1985). Predicting response to cognitive therapy of depression: The role of learned resourcefulness. Cognitive Therapy and Research, 9, 7989.Google Scholar
Simons, A.D., Murphy, G.E., Levine, J.L. & Wetzel, R.D. (1986). Cognitive therapy and pharmacotherapy for depression: Sustained improvement over one year. Archives of General Psychiatry, 43, 4348.Google Scholar
Steinmetz, J.L.Lewinsohn, P.M. & Antonuccio, D.O. (1983). Client variables as predictors of outcome in a structured group treatment for depression. Journal of Consulting and Clinical Psychology, 51, 331337.Google Scholar
Steuer, J.L., Mintz, J., Hammen, C.L., Hill, M.A., Jarvik, L.F., McCarley, T., Motoike, P. & Rosen, R. (1984). Cognitive-behavioral and psychodynamic group psychotherapy in treatment of geriatric depression. Journal of Consulting and Clinical Psychology, 52, 180189.Google Scholar
Taylor, F.G. & Marshall, W.L. (1977). Experimental analysis of a cognitive-behavioral therapy for depression. Cognitive Therapy and Research, 1, 5972.Google Scholar
Teri, L. & Lewinsohn, P.M. (1986). Individual and group treatment of unipolar depression: Comparison of treatment outcome and identification of predictors of successful treatment outcome. Behavior Therapy, 17, 215228.Google Scholar
Thompson, L.W., Gallagher, D. & Breckenridge, J.S. (1987). Comparative effectiveness of psychotherapies for depressed elders. Journal of Consulting and Clinical Psychology, 55, 385390.Google Scholar
Weissman, A.N. & Beck, A.T. (1979). The Dysfunctional Attitudes Scale. Unpublished thesis, University of Pennsylvania, Philadelphia.Google Scholar
Wierzbicki, M. & Bartlett, T.S. (1987). The efficacy of group and individual cognitive therapy for mild depression. Cognitive Therapy and Research, 11, 337342.Google Scholar
Wilson, P.H. (1982). Combined pharmacological and behavioral treatment of depression. Behavior Research and Therapy, 20, 173184.Google Scholar
Wilson, P.H., Goldin, J.C. & Charbonneau-Powis, M. (1983). Comparative efficacy of behavioral and cognitive treatments of depression. Cognitive Therapy and Research, 7, 111124.Google Scholar
Zung, W.W.K. (1965). A self-rating depression scale. Archives of General Psychiatry, 12, 6370.Google Scholar