Cognitive evolutionary therapy for depression: a case study

Abstract

Key Clinical MessageWe present an evolutionary-driven cognitive–behavioral intervention for a moderately depressed patient. Standard cognitive and behavioral therapy techniques focused on the patient's perfectionistic and self-downing beliefs, while novel, evolutionary-informed techniques were used to guide behavioral activation and conceptualize secondary emotional problems related to anger. The treatment reduced depressive symptomatology and increased evolutionary fitness.

Cognitive evolutionary therapy versus standard cognitive therapy for depression: A single‐blinded randomized clinical trial

“…The CT and CET therapies, consisting of individual sessions, were each delivered by four CT‐trained licensed clinical psychologists, two per condition. The two psychotherapists delivering the CET received an additional 6 weeks of training on the evolutionary components of the CET protocol (Giosan, 2020; Giosan et al, 2014).…”

“…The CET group also underwent 12 weekly 1‐h sessions of therapy. CET is based on the standard CT methods, with the important distinction that specific goals targeted at increasing an individual's subjective perception of his/her fitness were mainly targeted (Giosan, 2020; Giosan et al, 2014). Briefly, the CET intervention started with the administration of an evolutionary fitness instrument (Evolutionary Fitness Scale [EFS]; Giosan et al, 2018), which gave the CET therapists a comprehensive picture of the fitness areas that needed to be addressed in treatment.…”

“…The same set of measures, except the demographic information, was administered at posttreatment assessment and 3‐month follow‐up. Intermediary assessments at Sessions 4 and 8 were completed on a subset of measures, and the BDI‐II, CSQ‐8, and Intent‐to‐Attend Scale were administered at each session (Giosan et al, 2014).…”

“…Thus, evolutionary theories of depression raise the intriguing possibility that interventions aimed at fitness maximization could come with therapeutic benefits above and beyond the current treatments. Some researchers have already tested some evolutionary‐inspired interventions for depression, with promising preliminary results (e.g., Botanov et al, 2012; Giosan, Muresan, & Moldovan, 2014; Jacobson et al, 2007). However, although such interventions do target behaviors associated with improved fitness, to our knowledge, there have been no standardized interventions that integrate evolutionary psychology approaches to treating depression in a comprehensive, multidimensional fashion.…”

“…However, although such interventions do target behaviors associated with improved fitness, to our knowledge, there have been no standardized interventions that integrate evolutionary psychology approaches to treating depression in a comprehensive, multidimensional fashion. Toward this end, the authors of the present study used a protocol for cognitive evolutionary therapy (CET) for depression (Giosan, 2020; Giosan et al, 2014) and compared its efficacy with the widely validated Beck's cognitive therapy (CT) for depression (Beck, Rush, Shaw, & Emery, 1979; Hofmann, Asnaani, Vonk, Sawyer, & Fang, 2012). CET starts with an evaluation of a patient's subjective perception of fitness, realized with the Evolutionary Fitness Scale (Giosan, Wyka, Mogoase, Cobeanu, & Szentagotai, 2018).…”