This chapter has provided a description ofthe cognitive model ofdepression and the typical process of CT for depression. The typical behavioral, cognitive restructuring, and assumptive interventions employed in CT are associated with clinical outcomes that are as strong as those in any other treatment in depression, and potentially with stronger long-term effects that phar-macotherapy (Hollon, Stewart, & Strunk, 2006). It also appears that CT is effective across the range of depression severity, so it can be used in different clinical settings. Furthermore, given the concerns about side effects of some antidepressant medications, some treatment guidelines now recommend the use of CT or related models as the preferred treatment in less severe cases of depression (National Institute for Clinical Excellence, 2006). Despite the overall value of CT and the fact that it is generally recognized as an empirically supported therapy (Chambless & Ollendick, 2001), about one-third of patients fail to respond to this treatment model. Furthermore, relapse rates of about 25% at 1 year following treatment suggest that there is more to learn about treatment failure and relapse.

I concluded the chapter with a brief description of some of the research related to the CT model and therapy. Much remains to be known about CT for depression. We still do not know as much as would be ideal about the treatment factors associated with positive outcome in CT for depression. Additional dismantling and process studies are needed to explore these dimensions. Finally, we know relatively little about patient predictors of outcome in CT for depression. Although higher levels of initial depres sion severity, more chronicity, and more comorbidity are predictors of more negative outcomes, much more research is needed to explore factors such as depression subtypes or other factors that may affect patients' short- and long-term responses to this treatment model. Also, the field desperately needs studies that examine the predictors of outcome in CT relative to other evidence-based treatments. In summary, the field has at this point in the history of established its overall efficacy, but it now needs to address issues related to its effectiveness (Nathan, Stuart, & Dolan, 2000), and its efficacy relative to other empirically supported treatments for depression.


Academy of Cognitive Therapy. (2006). Information for patients about depression. Accessed October 21, 2006, from {bc1F26BC-b39e-44ad-a7f1—369E3275c8cd}/pagevars/library/infomanage/guide. htm. Ackermann, R., & DeRubeis, R.J. (1991). Is depressive realism real? Clinical Psychology Review, 11, 565-584. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author. Beck, A. T. (1970). Cognitive therapy: Nature and relation to behavior therapy.

Behavior Therapy, 1, 184-200. Beck, A. T., Brown, G., Steer, R. A., & Weissman, A. N. (1991). Factor analysis of the Dysfunctional Attitudes Scale in a clinical population. Psychological Assessment, 3, 478-483.

Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression.

New York: Guilford Press. Beck, A. T., Steer, R. A., & Garbin, H. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77-100.

Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford Press. Beck,J. S. (2005). Cognitive therapy for challenging problems. New York: Guilford Press. Beutler, L. E., Clarkin, J. F., & Bongar, B. (2000). Guidelines for the systematic treatment of the depressed patient. New York: Oxford University Press. Bieling, P. J., & Antony, M. M. (2003). Ending the depression cycle: A step-by-step guide for preventing relapse. Oakland, CA: New Harbinger. Bieling, P. J., Beck, A. T., & Brown, G. K. (2004). Stability and change of sociotropy and autonomy subscales in cognitive therapy of depression. Journal of Cognitive Psychotherapy, 18, 135-148. Burns, D. (1980). Feeling good. New York: Morrow.

Burns, D. D., & Nolen-Hoeksema, S. (1991). Coping styles, homework compliance, and the effectiveness of cognitive-behavioral therapy. Journal of Consulting and Clinical Psychology, 59(2), 305-311. Cane, D. B., Olinger, L. J., Gotlib, I. H., & Kuiper, N. A. (1986). Factor structure of the Dysfunctional Attitude Scale in the student population. Journal of Clinical Psychology, 42(2), 307-309.

Chambless, D., & Ollendick, T. H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52, 685-716.

Clark, D. A., & Beck, A. T. (1991). Personality factors in dysphoria: A psychometric refinement of Beck's Sociotropy-Autonomy Scale. Journal of Psychopathology and Behavioral Assessment, 13, 369-388.

Clark, D. A., Beck, A. T., & Alford, B. A. (1999). Scientific foundations of cognitive theory and therapy of depression. Hoboken, NJ: Wiley.

Coyne, J. C. (1976). Toward an interactional description of depression. Psychiatry, 39, 28-40.

Davila, J., Hammen, C., Burge, D., Paley, B., & Daley, S. E. (1997). Poor interpersonal problem solving as a mechanism of stress generation in depression. Journal of Abnormal Psychology, 104(4), 592-600.

DeRubeis, R. J., & Feeley, M. (1990). Determinants of change in cognitive therapy for depression. Cognitive Therapy and Research, 14(5), 469-582.

DeRubeis, R. J., Gelfand, L. A., Tang, T. Z., & Simons, A. D. (1999). Medications versus cognitive behavioral therapy for severely depressed outpatients: Mega-analysis of four randomized comparisons. American Journal of Psychiatry, 156, 1007-1013.

DeRubeis, R. J., Hollon, S. D., Amsterdam, J. D., Shelton, R. C., Young, P R., Salomon, R. M., et al. (2005). Cognitive therapy vs medications in the treatment of moderate to severe depression. Archives of General Psychiatry, 62, 409416.

Detweiler, J. B., & Whisman, M. A. (1999). The role of homework assignments in cognitive therapy for depression: Potential methods for enhancing adherence. Clinical Psychology: Science and Practice, 6, 267-282.

Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., et al. (2006). Randomized trial ofbehavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 174, 658-670.

Dobson, K. S. (1989). A meta-analysis of the efficacy of cognitive therapy for depression. Journal of Consulting and Clinical Psychology, 57, 414-419.

Dobson, K. S., & Dozois, D.J. A. (2001). Historical and philosophical bases of the cognitive-behavioral therapies. In K. S. Dobson (Ed.), Handbook of cognitive-behavioral therapies (2nd ed., pp. 3-39). New York: Guilford Press.

Dobson, K., & Franche, R.-L. (1989). A conceptual and empirical review of the depressive realism hypothesis. Canadian Journal of Behavioural Science, 21, 419433.

Dobson, K. S., Hollon, S. D., Dimidjian, S., Schmaling, K. B., Kohlenberg, R. J., Gallop, R., et al. (2007). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the prevention of relapse and recurrence of major depression in adults. Unpublished manuscript, University of Calgary.

Dozois, D. J. A., & Dobson, K. S. (2002). Depression. In M. M. Antony & D. H. Barlow (Eds.), Handbook of assessment and treatment planning for psychological disorders (pp. 259-299). New York: Guilford Press.

Elkin, I., Shea, M. T., Watkins, J. T., Imber, S. D., Sotsky, S. M., Collins, J. F., et al. (1989). NIMH treatment of depression collaborative research program: I. General effectiveness of treatments. Archives of General Psychiatry, 46, 971-983.

Feeley, M., DeRubeis, R. J., & Gelfand, L. A. (1999). The temporal relation of adherence and alliance to symptom change in cognitive therapy for depression. Journal of Consulting and Clinical Psychology, 67(4), 451-459.

Gilbert, P. E. (2001). Overcoming depression (2nd ed.). New York: Oxford University Press.

Gloaguen, V., Cottraux, J., Cucherat, M., & Blackburn, I. (1998). A meta-analysis of the effects of cognitive therapy in depressed outpatients. Journal of Affective Disorders, 49, 59-72.

Gollan, J., Raffety, B., Gortner, E., & Dobson, K. (2005). Course profiles of early-and adult-onset depression. Journal of Affective Disorders, 86, 81-86.

Gortner, E. T., Gollan, J. K., Dobson, K. S., & Jacobson, N. S. (1998). Cognitive-behavioral treatment for depression: Relapse prevention. Journal of Consulting and Clinical Psychology, 66(2), 377-384.

Greenberger, D., & Padesky, C. A. (1995). Mind over mood: Change how you feel by changing the way you think. New York: Guilford Press.

Hamilton, K. E., & Dobson, K. S. (2002). Cognitive therapy of depression: Pretreat-ment patient predictors of outcome. Clinical Psychology Review, 22, 875-894.

Harvey, A. G. (2005). A cognitive theory and therapy for chronic insomnia.Journal of Cognitive Psychotherapy, 19, 41-59.

Held, B. S. (1995). Back to reality: A critique of postmodern theory in psychotherapy. New York: Norton.

Hollon, S. D., & Beck, A. T. (1994). Cognitive and cognitive-behavioral therapies. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (4th ed., pp. 428-466). New York: Wiley.

Hollon, S. D., DeRubeis, R. J., Shelton, R. C., Amsterdam, J. D., Salomon, R. M., O'Reardon, J. P., et al. (2005). Prevention of relapse following cognitive therapy vs. medications in moderate to severe depression. Archives of General Psychiatry, 62, 417-422.

Hollon, S. D., Stewart, M., & Strunk, D. (2006). Enduring effects for cognitive behavior therapy in the treatment of depression and anxiety. Annual Review of Psychology, 57, 285-315.

Hollon, S. D., Thase, M., & Markowitz, J. C. (2002). Treatment and prevention of depression. Psychological Science in the Public Interest, 3, 39-77.

Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis,M. E., Koerner, K., Gollan,J. K., et al. (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64(2), 295-304.

Joiner, T. E. (2000). Depression's vicious scree: Self-propagating and erosive processes in depression chronicity. Clinical Psychology: Science and Practice, 7, 203-218.

Joiner, T. E., & Schmidt, N. B. (1998). Excessive reassurance-seeking predicts depressive but not anxious reactions to acute stress. Journal of Abnormal Psychology, 107(3), 533-537.

Kazantzis, N., & Deane, F. P. (1999). Psychologists' use of homework assignments in clinical practice. Professional Psychology: Research and Practice, 30(6), 581-585.

Kazantzis, N., Deane, F P., Ronan, K. R., & L'Abate, L. (Eds.). Using homework assignments in cognitive behavioral therapy. New York: Routledge.

Klerman, G. L., Weissman, M. M., Rounsaville, B. J., & Chevron, C. S. (1984). Interpersonal psychotherapy of depression. New York: Basic Books.

Kovacs, M., & Beck, A. T. (1978). Maladaptive cognitive structures in depression. American Journal of Psychiatry, 135, 525-533.

Monroe, S., & Simons, A. (1991). Diathesis—stress theories in the context of life stress research: Implications for the depressive disorders. Psychological Bulletin, 110(3), 406-425.

Nathan, P. E., Stuart, S. P., & Dolan, S. L. (2000). Research on psychotherapy efficacy and effectiveness: Between Scylla and Charybdis? Psychological Bulletin, 126, 964-981.

National Institute for Clinical Excellence. (2006). Compilation—Issue 10: Mental health. Retrieved October 15, 2006, from 272364.

Nezu, A. M., Ronan, G. F, Meadows, E. A., & McClure, K. S. (2000). Practitioner's guide to empirically based measures of depression. Dordrecht, The Netherlands: Kluwer.

Paykel, E. S., Scott, J., Cornwall, P. L., Abbott, R., Crane, C., Pope, M., et al. (2005). Duration of relapse prevention after cognitive therapy in residual depression: Follow-up of controlled trial. Psychological Medicine, 35, 59-68.

Persons, J. B. (1989). Cognitive therapy in practice: A case formulation approach. New York: Norton.

Persons, J. B., & Davidson, J. (2001). Cognitive-behavioral case formulation. In K. S. Dobson (Ed.), Handbook of cognitive-behavioral therapies (pp. 86-110). New York: Guilford Press.

Robins, C. J., & Block, P (1989). Cognitive theories of depression viewed from a diathesis-stress perspective: Evaluations of the models of Beck and of Abram-son, Seligman, and Teasdale. Cognitive Therapy and Research, 13(4), 297-314.

Rush, A. J., Beck, A. T., Kovacs, M., & Hollon, S. (1977). Comparative efficacy of cognitive therapy and pharmacotherapy in the treatment of depressed outpatients. Cognitive Therapy and Research, 11(1), 17-37.

Rush, A. J., Hollon, S. D., Beck, A. T., & Kovacs, M. (1978). Depression: Must psychotherapy fail for cognitive therapy to succeed? Cognitive Therapy and Research, 2(2), 199-206.

Schmidt, N. B.,Joiner, T. E., Young,J. E., & Telch, M.J. (1995). The Schema Questionnaire: Investigation of psychometric properties and the hierarchical structure of a measure of maladaptive schemas. Cognitive Therapy and Research, 19, 295-322.

Shaw, B. F., Elkin, I., Yamaguchi, J., Olmsted, M., Vallis, T. M., Dobson, K. S., et al. (1999). Therapist competence ratings in relation to clinical outcome in cognitive therapy of depression. Journal of Consulting and Clinical Psychology, 67, 837— 846.

Startup, M., & Edmonds, J. (1994). Compliance with homework assignments in cognitive-behavioral psychotherapy for depression: Relation to outcome and methods of enhancement. Cognitive Therapy and Research, 18(6), 567—580.

Tang, T. Z., & DeRubeis, R. J. (1999). Sudden gains and critical sessions in cognitive-behavioral therapy for depression. Journal of Consulting and Clinical Psychology, 67(6), 894-904.

Tang, T. Z., DeRubeis, R. J., Beberman, R., & Pham, T. (2005). Cognitive changes, critical sessions, and sudden gains in cognitive-behavioral therapy for depression. Journal of Consulting and Clinical Psychology, 73, 168-172.

Tompkins, M. A. (2004). Using homework in psychotherapy: Strategies, guidelines and forms. New York: Guilford Press.

Trepka, C., Rees, A., Shapiro, D. A., Hardy, G. E., & Barkham, M. (2004). Therapist competence and outcome of cognitive therapy for depression. Cognitive Therapy and Research, 28, 143-157.

Wright, J. H., Wright, A. S., Salmon, P., Beck, A. T., Kuykendall, J., Goldsmith, L. J., et al. (2002). Development and initial testing of a multimedia program for computer-assisted cognitive therapy. American Journal of Psychotherapy, 56(1), 76-86.

Young, J. E., & Brown, G. (1990). Young Schema Questionnaire. New York: Cognitive Therapy Center of New York.

Young, J. E., & Klosko, K. S. (1994). Reinventing your life. New York: Plume.

Young, J. E., Klosko, K. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner's guide. New York: Guilford Press.

Liberation Lifestyles

Liberation Lifestyles

The People Who Read This Book Will End Up Feeling Freedom Mentally, Emotionally And Spiritually. Free Your Mind, Body And Live A Happy Life.

Get My Free Ebook

Post a comment