A component analysis of cognitive-behavioral treatment for depression.

Abstract

The purpose of this study was to provide an experimental test of the theory of change put forth by A. T. Beck, A. J. Rush, B. F. Shaw, and G. Emery (1979) to explain the efficacy of cognitive-behavioral therapy (CT) for depression. The comparison involved randomly assigning 150 outpatients with major depression to a treatment focused exclusively on the behavioral activation (BA) component of CT, a treatment that included both BA and the teaching of skills to modify automatic thoughts (AT), but excluding the components of CT focused on core schema, or the full CT treatment. Four experienced cognitive therapists conducted all treatments. Despite excellent adherence to treatment protocols by the therapists, a clear bias favoring CT, and the competent performance of CT, there was no evidence that the complete treatment produced better outcomes, at either the termination of acute treatment or the 6-month follow-up, than either component treatment. Furthermore, both BA and AT treatments were just as effective as CT at altering negative thinking as well as dysfunctional attributional styles. Finally, attributional style was highly predictive of both short- and long-term outcomes in the BA condition, but not in the CT condition.

Effects of Affective and Anxiety Disorders on Outcome in Problem Gamblers Attending Routine Cognitive–Behavioural Treatment in South Australia

“…Empirical evidence for these core techniques in gambling addiction is at a nascent stage but reputable in anxiety disorders, depression, and other addictions. Exposure alone for example has been found to be as effective as cognitive or combined CBT for anxiety disorders (Marks, Lovell, Noshirvani, Livanou, & Thrasher, 1998) and cognitive therapy has been found to be as efficacious as behavioural activation for depression (Jacobson et al, 1996). Traditional CBT approaches have also been successful in treating co-occurring depression and substance use disorders (Hides, Samet, & Lubman, 2010).…”

Effects of psychotherapy for depression in children and adolescents: A meta-analysis.

“…However, research on adult depression treatment (e.g., Hollon, 2000;Jacobson et al, 1996;Jacobson, Martell, & Dimidjian, 2001) has raised questions about whether a cognitive emphasis is needed to generate improvement and even whether cognitive intervention adds significantly to such noncognitive approaches as behavioral activation. Promising results of some recent youth depression trials that used treatments without a cognitive emphasis suggest that this Burlingame, & Hoag, 1998); and study characteristics (study attrition rates, whether studies were peer-reviewed, and whether outcomes were assessed via youth self-report vs. parent report; see, e.g., Hammen & Rudolph, 1996).…”

“…Indeed, 33 of the 44 treatments in our study set emphasized cognitive change (i.e., through CBT or other cognitive approaches). This broad approach is also popular in adult depression treatment; however, some of the most provocative adult research (see, e.g., Hollon, 2000;Jacobson et al, 1996Jacobson et al, , 2001) has highlighted the potential of noncognitive behavioral-activation strategies, providing evidence that the impact of such strategies is not improved on by treatment with a cognitive focus. Our analyses of youth treatment evidence indicated, similarly, that noncognitive treatments demonstrated effects that were easily as robust as the cognitive treatments, suggesting that beneficial treatment for youth depression may not require altering cognitions.…”

Experimental test of the affect‐regulation theory of bulimic symptoms and substance use: A randomized trial

“…[29][30][31] The resulting intervention briefly introduces the cognitivebehavioral model of depression, helps participants identify negative cognitions and precipitating circumstances, and teaches them to generate positive thoughts that can be used to replace negative cognitions. Furthermore, because treatments that focus on instigating active participation in reinforcing activities have been found to be efficacious for alleviating depression in adult samples, [32][33] our intervention also encourages participants to reengage in activities that used to give them pleasure (e.g., playing a favorite sport) and to partake in a wider variety of pleasurable activities to improve mood.…”