This study is designed to further our efforts to establish the efficacy of group, experiential psychotherapy for the treatment of major depression.
The aims of this study are to compare efficacy rates of Focused Expressive Psychotherapy, conventional group Cognitive Therapy, and a minimal treatment condition (bibliotherapy). We hope to establish not only the efficacy of Focused Expressive Psycho-therapy, but to determine some indicators for its use, relative to minimal treatments and Cognitive Therapy. Therapists will be selected and systematically trained in two manualized treatments, Focused Expressive Psychotherapy and Cognitive Therapy. Six therapists who achieve criterion levels of performance 9three in each condition) will conduct the group treatments. Equal numbers of patients/subjects will be selected to represent differences in defensive style as related to the control and management of angry feelings. Ninety patients/subjects, representing major affective disorder-depression and two levels of defensive style, will be randomly assigned to one of three treatment condition. These conditions will be group Cognitive Therapy, group Focused Expressive Therapy, and bibliotherapy. Bibliotherapy will consist of weekly support by telephone, reading assignments, and regular assessment periods. A three week baseline period will be followed by a twenty session treatment period and a six month followup. We will conduct periodic evaluations of patients depression, change in family patterns, medical status, and general psychopathology. We anticipate that those who tend to overcontrol angry impulses will show a better response to Focused Expressive Psychotherapy than will patients who tend to undercontrol those impulses. We additionally anticipate that defensive style will also differentiate between effectiveness rates of Cognitive Therapy and Focused Expressive Psychotherapy.
