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Fostering Cognitive Change in Cognitive Therapy of Depression: An Investigation of Therapeutic Strategies

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Abstract

There is little evidence regarding which therapist strategies promote cognitive change in cognitive therapy (CT) of depression. Drawing from a sample of CT patients, we selected two consecutive sessions for which patients reported markedly different amounts of cognitive change (CC; i.e., a low and high cognitive change session). We then investigated whether four observer-rated psychotherapy process variables differentiated high and low CC sessions. Our analyses focused on 62 patients with large session-to-session differences in self-reported CC. Results from single predictor models showed the therapeutic alliance and therapists’ use of cognitive methods predicted high versus low CC session type. In a model including multiple predictors, only cognitive methods remained significant. These findings are consistent with the view that cognitive methods promote CC in CT.

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Data Availability

Pending IRB approval for sharing, the dataset described in this paper is available from the corresponding author on reasonable request.

Notes

  1. Multiple patients near the 50th percentile had the same maximum absolute value of CC difference scores. We opted to select the patients with maximum scores greater than these values. This resulted in selecting 62 patients representing the top 49% of session-to-session shifts in CC.

  2. Using data from the 62 included patients only, we calculated the z-score for high and low cognitive change sessions for each patient. The average of these scores was 0.91 for high CC sessions, which corresponds to the 82nd percentile of all CC scores in this group. For low CC sessions, the average was − 1.88, which corresponds to the 3rd percentile of CC scores in this group.

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Author notes

  1. Suzannah J. Stone

    Present address: Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH, 45701, USA

Authors and Affiliations

  1. Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA

    Suzannah J. Stone & Daniel R. Strunk

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  1. Suzannah J. Stone
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Correspondence to Daniel R. Strunk.

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Suzannah J. Stone and Daniel R. Strunk declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional and/or National Research Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Stone, S.J., Strunk, D.R. Fostering Cognitive Change in Cognitive Therapy of Depression: An Investigation of Therapeutic Strategies. Cogn Ther Res 44, 21–27 (2020). https://doi.org/10.1007/s10608-019-10055-6

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