The Mechanisms of Sudden Gains in Supportive–Expressive Therapy for Depression

Andrusyna, Tomasz; Luborsky, Lester; Pham, T.; Tang, Tuo-Xian

doi:10.1080/10503300600591379

Cited by 70 publications

(70 citation statements)

References 29 publications

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“…However, others have had difficulty replicating this finding using alternate assessment methods in a CBT-oriented intervention (Kelly, Roberts & Ciesla, 2005). Further, as previously stated, sudden gains have been found to occur across several treatment modalities (Tang & DeRubeis, 1999b;Tang et al, 2002Tang et al, , 2005Stiles et al, 2005;Andrusyna et al, 2006) and among samples who are not receiving active treatment (Kelly et al, 2007;Vittengl et al 2003). This suggests that the precipitants and meaning of sudden gains in the remediation of depressive symptoms have yet to be fully understood.…”

Section: Introductionmentioning

confidence: 78%

Sudden gains in interpersonal psychotherapy for depression

Kelly

Cyranowski

Frank

2007

Behaviour Research and Therapy

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Sudden, precipitous improvements in depressive symptom severity have been identified as occurring among unipolar depressed individuals. These "sudden gains" have been associated with superior acute treatment outcome in several treatment modalities, including cognitive therapy. A better understanding of sudden gains may provide insight into the mechanisms of action in these and other psychotherapies. One efficacious therapy that has been overlooked in sudden gains research is interpersonal psychotherapy (IPT;Weissman et al. 2000). The present research examined the rates and concomitant features of sudden, precipitous improvements in depressive symptomotology among 185 women receiving IPT for recurrent depression. Sudden gains, defined using extant criteria for the Beck Depression Inventory, were assessed over 12 weeks of acute IPT treatment for depression and occurred for 33.5% of the sample. Sudden gains were not associated with diagnostic and demographic characteristics or with differential likelihood of achieving depression remission with IPT monotherapy during active treatment. Further, those with sudden gains were no more likely to maintain their recovery through maintenance treatment. The lack of impact of sudden gains on eventual outcome is discussed in terms of potentially disparate emphases and mechanisms of change between IPT and CBT.

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Section: Introductionmentioning

confidence: 78%

Sudden gains in interpersonal psychotherapy for depression

Kelly

Cyranowski

Frank

2007

Behaviour Research and Therapy

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“…Both have good to excellent internal, inter-rater, and testretest reliability (e.g. Andrusyna et al, 2001) by conventional criteria. In this study, internal consistency coeffi cients ranged between acceptable and excellent (see Ross et al, unpublished data).…”

Section: Therapeutic Alliancementioning

confidence: 98%

Do early therapeutic alliance, motivation, and stages of change predict therapy change for high‐risk, psychopathic violent prisoners?

Polaschek

Ross

2010

Criminal Behav Ment Health

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“…We did not directly examine these factors in the present study, but it remains possible that non-specific factors may lead to sudden gains [e.g. [6,17]]. Alternatively, sudden gains may represent normal fluctuations in symptoms that are consolidated when active treatment is provided [8].…”

Section: Discussionmentioning

confidence: 99%

“…Tang and DeRubeis [1] found that cognitive changes frequently precede sudden gains, and thus suggested cognitive changes as a possible causal factor. Despite some support for this proposed mechanism [4], other studies found sudden gains to be unrelated to cognitive changes [6,17]. Additional proposed predictors of sudden gains that have not received support include changes in therapeutic alliance [1], changes in self-esteem [5], positive and negative life events [2], pre-treatment demographic and clinical measures [e.g.…”

Section: Introductionmentioning

confidence: 99%

Sudden Gains in the Treatment of Obsessive-Compulsive Disorder

Aderka

Anholt

Balkom

et al. 2011

Psychother Psychosom

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Background: The present study examined sudden gains during treatment for obsessive-compulsive disorder (OCD) and their relationship to short- and long-term outcome. Methods: Ninety-one individuals (age 19–64) completed either cognitive treatment, exposure treatment, or their combination with fluvoxamine for OCD. Participants’ obsessive-compulsive symptoms were assessed before each weekly treatment session. In addition, obsessive-compulsive and depressive symptoms were assessed pre treatment and post treatment as well as 12 months following treatment termination. Results: Sudden gains were found among 34.1% of participants and constituted 65.5% of the total reduction in obsessive-compulsive symptoms. Compared to individuals who did not experience sudden gains, individuals who experienced sudden gains reported lower levels of OCD symptoms post treatment, and this was maintained during follow-up. Conclusions: Sudden gains are common in treatments for OCD and are predictive of treatment outcome and follow-up. Sudden gains mark a distinct trajectory of response to treatment for OCD. Individuals with sudden gains greatly improve during treatment and maintain their gains during follow-up, whereas individuals without sudden gains improve to a significantly lesser extent. Thus, treatment planning and development can benefit from considering sudden gains and the intra-individual course of improvement.

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The Mechanisms of Sudden Gains in Supportive–Expressive Therapy for Depression

Cited by 70 publications

References 29 publications

Sudden gains in interpersonal psychotherapy for depression

Sudden gains in interpersonal psychotherapy for depression

Do early therapeutic alliance, motivation, and stages of change predict therapy change for high‐risk, psychopathic violent prisoners?

Sudden Gains in the Treatment of Obsessive-Compulsive Disorder

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