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Reversals of Sudden Gains Made During Cognitive Therapy with Depressed Adults: A Preliminary Investigation

Published online by Cambridge University Press:  21 April 2010

Paul Manning ,
Gillian Hardy  and
Stephen Kellett
Paul Manning
Affiliation:
Centre for Psychological Services Research, University of Sheffield, UK
Gillian Hardy
Affiliation:
Centre for Psychological Services Research, University of Sheffield, UK
Stephen Kellett*
Affiliation:
Centre for Psychological Services Research, University of Sheffield, UK
*
Reprint requests to Stephen Kellett, IAPT Programme Director, Clinical Psychology Unit, University of Sheffield, Sheffield S10 2TN, UK. E-mail: [email protected]
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Abstract

Background: This study investigated sudden reversals during cognitive therapy (CT), through the comparison of “in-session” activity and “out-of-session” life events. Method: The sample comprised 20 clients who experienced sudden gains during CT for depression: 10 who subsequently suffered a reversal of this gain and 10 matched clients who maintained progress. Measures of client resistance and therapist responses were scored by judges from session transcripts and clients completed measures of life events and depression at each session. This enabled the Reversal and Non-Reversal groups to be compared during pre-sudden gain, pre-reversal or matched sessions. Results: No differences were apparent between the Reversal and Non-reversal groups or between the pre-gain and pre-reversal sessions in terms of client or therapist “in-session” activities. In the Reversals group, 6 out of 10 clients recovered their level of symptom improvement, following the reversal. Therapists showed higher levels of reflection and self-disclosure with clients who did not recover their symptom gain following the Reversal than with clients who did recover their symptom gain following the Reversal. Conclusions: The study is discussed in terms of the manner by which reversals can be more effectively measured and researched.

Keywords

Sudden reversalssudden gainsdepressionoutcomes
Type
Brief Clinical Reports
Information
Behavioural and Cognitive Psychotherapy , Volume 38 , Issue 4 , July 2010 , pp. 491 - 495
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2010

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