A need for an improved psychosocial treatment for depression is indicated by the relatively small number of patients who achieve full recovery (around 50%, 11, 69, 70). We propose a study for the development and preliminary evaluation of a new psychosocial treatment for depression based on Beck's Cognitive Therapy for depression (CT). A more effective version of CT would be a cost effective use of existing resources of experienced therapist and techniques. The modifications will 1) broaden the rationale presented to clients so that there will improve matching between the client's experience and the therapeutic process and 2) maximize the use of the therapeutic relationship as an in-vivo teaching opportunity in order to capitalize on the greatly increased effectiveness obtained when behavior therapy is done in-vivo. The therapeutic procedures to be added to CT will be guided by Kohlenberg and Tsai's approach to using the client-therapist relationship known as FAP (2). The new treatment is referred to as FAP Enhanced Cognitive Therapy (FECT). The proposed study will involve: 1) the interrelated activities of developing the treatment manual (used with Beck's CT and FAP books) developing adherence and competency measures, training therapists in FECT, and completion of pilot cases 2) the application of FECT to 20 depressed clients, and 3) the evaluation of outcome process, and adherence data. Evaluation will be aided by the use of the historical comparison group from a prior study (69). The comparison group was treated with CT by the same therapist that will be used in the proposed study. Research methods and data collection will parallel those used in two prior federally funded clinical outcome studies by the CoPI, Neil Jacobson. Promising findings would form the basis of a research proposal for a clinical outcome study comparing FECT to other treatment for depression.
| Bolling, Madelon Y; Kohlenberg, Robert J (2004) Reasons for quitting serotonin reuptake inhibitor therapy: paradoxical psychological side effects and patient satisfaction. Psychother Psychosom 73:380-5 |
