Future and Additional Uses of Psychosocial Interventions to Prevent Relapse

In an ongoing, two-site randomized trial conducted by the team of Jarrett and Thase (Jarrett et al., 2003), patients who presented with recurrent MDD and showed incomplete remission after A-CT were randomized to receive continuation-phase pharmacotherapy. Preliminary experience with this sequential treatment of A-CT followed by continuation-phase pharma-cotherapy (i.e., fluoxetine/Prozac) suggests that a group of responders to a psychosocial intervention will accept pharmacotherapy as a reasonable method to promote remission and reduce the risk of relapse. Psychoeduca-tion regarding the risks of recurrent depression is important in promoting patient acceptability, engagement, and compliance relative to this sequence.

As the work from the teams of Fava, Grandi, Zielezny, Rafinelli, and Canestrari (1996), Blackburn and Moore (1997), Paykel et al. (1999), Teasdale et al. (2000), and Bockting et al. (2005) shows, psychosocial relapse prevention strategies similar to C-CT (by Jarrett, 1989) are efficacious after some level of remission has been achieved with pharmacotherapy. We look forward to learning what "ingredients," mechanisms, and moderators produce these comparable, preventive effects. We are curious about what similarities and differences in these "functionally related" psychosocial continuation-phase treatments are responsible for their important preventive effects.

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