Complementarity patterns in cognitive therapy for major depressive disorder

Abstract

Background Interpersonal theories suggest that cohesion between two individuals can be described by the degree to which they communicate harmoniously or, the complementarity, of their interactions (Gurtman, 2001; Kiesler, 1996). Friendly complementarity within therapy dyads is linked to both alliance and treatment outcome (Kiesler & Watkins, 1989; von der Lippe, Monsen, Rønnestad & Eilertsen, 2008; Samstag et al., 2008; Tracey, Sherry & Albright, 1999). Aim The purpose of this study was to identify complementarity patterns that may help or hinder the effectiveness of cognitive therapy (CT) for depression. Method The Structural Analysis of Social Behavior (Benjamin, 1974) was used to code CT sessions for individuals with depression. Dyads (N = 16) were divided into high‐ and low‐change groups. Lag Sequential Analysis (Sackett, 1979) was used to analyse first order sequences in client and therapist interpersonal behaviour. Findings As expected, complementarity was better among high‐change dyads for affiliative behaviour. Low‐change dyads demonstrated stronger patterns of complementarity along the autonomy axis. Conclusion This preliminary investigation illustrates different communication patterns among high‐ and low‐change dyads. Implications for clinical practice are discussed.