The main goal of the proposed CRC is to evaluate the clinical utility of two major forms of psychotherapy: cognitive therapy and dynamic therapy. Four disorders will be initially studied: chronic depression, generalized anxiety disorder, and two personality disorders (avoidant and obsessive compulsive). In the first phase of the CRC, six pilot/training projects employing cognitive therapy and dynamic therapy for each of the disorders will be implemented. These pilot projects will allow for trying out new treatment manuals, training therapists, and standardizing procedures across investigators. A seventh pilot project will examine the reformulated learned helplessness theory using a chronic depression population. In the second phase of the CRC, clinical trials (submitted as R01s) comparing the two psychotherapies and standard pharmacotherapy for these disorders will be performed using the therapists trained in the pilot phase. Two additional training/pilot studies focusing on cognitive and dynamic therapies for Dependent Personality Disorder will be performed in years 4 - 5. A final pilot study in years 3 - 5 will pursue the possibility of integrating a brief cognitive therapy based training program with psychodynamic therapy for major depression. In addition, the CRC will support the lines of research in existing ROls, including method development and predictive studies. The current ROls, future ROls, and pilot projects are supported by four integrated cores: 1. Administration, 2. Therapeutics and Training, 3. Assessment and Accrual, and 4. Data Management and Statistics. The CRC will also promote the training of new investigators in this field.
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