Cognitive Therapy and Research

, Volume 27, Issue 2, pp 205–222 | Cite as

Effects of Etiology on Perceived Helpfulness of Treatments for Depression

  • Marie-Geneviève Iselin
  • Michael E. Addis


Perceptions of the credibility and helpfulness of various treatments for depression can affect the success of different treatment options. While previous research has demonstrated individual differences in credibility ratings, no studies have evaluated the impact of different etiological theories on the perceptions of various treatment options. In this study, 36 mental health clients and 36 undergraduates rated 7 depression treatments presented first alone, then with 6 different etiological vignettes. All participants considered treatments more helpful when cause and treatment focus were congruent (i.e., both psychological or both physical). Students regarded treatments as less helpful than did clients. We discuss implications for treatment credibility and acceptability research, and suggest ways of presenting to clients etiological information in relation to treatments.

depression treatment matching treatment credibility lay theories 


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  1. Addis, M. E., & Carpenter, K. (1999). Why, why, why?: Reason-giving and rumination as predictors of response to activation-and insight-oriented treatment rationales. Journal of Clinical Psychology, 55(7), 881–894.Google Scholar
  2. Addis, M. E., & Carpenter, K. (2000). The treatment rationale in cognitive behavioral therapy: Psychological mechanisms and clinical guidelines. Cognitive and Behavioral Practice, 7(2), 147–156.Google Scholar
  3. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
  4. Atkinson, D. R., Worthington, R. L., Dana, D. M., & Good, G. E. (1991). Etiology beliefs, pbl]References for counseling orientations, and counseling effectiveness. Journal of Counseling Psychology, 38(3), 258–264.Google Scholar
  5. Banken, D. M., & Wilson, G. L. (1992). Treatment acceptability of alternative therapies for depression: A comparative analysis. Psychotherapy, 29(4), 610–619.Google Scholar
  6. Chilvers, C., Dewey, M., Fielding, K., Gretton, V., Miller, P., Palmer, B., et al. (2001). Antidepressant drugs and generic counseling for treatment of major depression in primary care: Randomised trial with patient preference arms. British Medical Journal, 322(7289), 772–775.Google Scholar
  7. Clairborn, C. D., Ward, S. R., & Strong, S. R. (1981). Effects of congruence between counselor interpretations and client beliefs. Journal of Counseling Psychology, 28(2), 101–109.Google Scholar
  8. Cooper-Patrick, L., Powe, N. R., Jenckes, M. W., Gonzales, J. J., Levine, D. M., & Ford, D. E. (1997). Identification of patient attitudes and pbl]References regarding treatment of depression. Journal of General Internal Medicine, 12, 431–438.Google Scholar
  9. Cranston-Cuebas, M. A., Barlow, D. H., Mitchell, W., & Athanasiou, R. (1994). Differential effects of misattribution manipulation on sexually functional and dysfunctional men. Journal of Abnormal Psychology, 102(4), 525–533.Google Scholar
  10. Cross Calvert, S., & Johnston, C. (1990). Acceptability of treatments for child behavior problems: Issues and implications for future research. Journal of Clinical Child Psychology, 19(1), 61–74.Google Scholar
  11. Cunningham, J. A., Sobell, L. S., & Sobell, M. B. (1996). Are disease and other conceptions of alcohol abuse related to beliefs about outcome and recovery? Journal of Applied Social Psychology, 26(9), 773–780.Google Scholar
  12. Devilly, G. J., & Borkovec, T. D. (2000). Psychometric properties of the credibility/expectancy questionnaire. Journal of Behavior Therapy and Experimental Psychiatry, 31, 73–86.Google Scholar
  13. Dowrick, C., Dunn, G., Ayuso-Mateos, J. L., Dalgard, O. S., Page, H., Lehtinen, V. et al. (2000). Problem solving treatment and group psychoeducation for depression: Multicentre randomised controlled trial. British Medical Journal, 321, 1–6.Google Scholar
  14. Fennel, M. J., & Teasdale, J. D. (1987). Cognitive therapy for depression: Individual differences and the process of change. Cognitive Therapy and Research, 11(2), 253–271.Google Scholar
  15. Foulks, E. F., Persons, J. B., & Merkel, R. L. (1986). The effect of patients' beliefs about their illnesses on compliance in psychotherapy. American Journal of Psychiatry, 143(3), 340–344.Google Scholar
  16. Foxx, R. M., Bremer, B. A., Shultz, C., Valdez, J., & Johndrow, C. (1996). Increasing treatment acceptability through video. Behavioral Interventions, 11(4), 171–180.Google Scholar
  17. Foxx, R. M., McHenry, W. C. K., III, & Bremer, B. A. (1996). The effects of a video vignette on increasing treatment acceptability. Behavioral Interventions, 11(3), 1Google Scholar
  18. Frank, J. D., & Frank, J. B. (1991). Persuasion and healing. Baltimore, MD: Johns Hopkins University Press. (Original work published 1961)Google Scholar
  19. Friedberg, R. D., Viglione, D. J., Stinson, B. L., Beal, K. G., Fidaleo, R. A., & Celeste, B. (1999). Perceptions of treatment helpfulness and depressive symptomatology in psychiatric inpatients on a cognitive therapy unit. Journal of Rational Emotive and Cognitive Behavior Therapy, 17(1), 33–50.Google Scholar
  20. Furnham, A., & Kuyken, W. (1991). Lay theories of depression. Journal of Social Behavior and Personality, 6(2), 329–342.Google Scholar
  21. Furnham, A., & Manning, R. (1997). Young people's theories of anorexia nervosa and obesity. Counselling Psychology Quarterly, 10(4), 389–414.Google Scholar
  22. Furnham, A., & Taylor, L. (1990). Lay theories of homosexuality. British Journal of Social Psychology, 29, 135–147.Google Scholar
  23. Gage, J. D., & Wilson, L. J. (2000). Acceptability of attention-deficit/hyperactivity disorder interventions: A comparison of parents. Journal of Attention Disorders, 4(3), 174–182.Google Scholar
  24. Hall, L. H., & Robertson, M. H. (1998). Undergraduate ratings of the acceptability of single and combined treatments for depression: A comparative analysis. Professional Psychology: Research and Practice, 29(3), 269–272.Google Scholar
  25. Hambrecht, M., & Hohmann, M. (1993). Causal attributions in psychiatric patients. European Archives of Psychiatry and Clinical Neuroscience, 242, 318–320.Google Scholar
  26. Hilsenroth, M. J., Ackerman, S. J., & Blagys, M. D. (2001). Evaluating the phase model of change during short-term psychodynamic psychotherapy. Psychotherapy Research, 11(1), 29–47.Google Scholar
  27. House, W. C. (1981). Outpatients' attributions of the causes of their psychological problems. The Journal of Psychology, 108, 81–84.Google Scholar
  28. Hunsley, J. (1993). Treatment acceptability of symptom prescription techniques. Journal of Counseling Psychology, 40(2), 139–143.Google Scholar
  29. Johnson, M. R., Gold, P. B., Semion, L., Magruder, K. M., Frueh, B. C., & Santos, A.B. (2000). Panic disorder in primary care: Patients' attributions of illness causes and willingness to accept psychiatric treatment. International Journal of Psychiatry in Medicine, 30(4), 367–384.Google Scholar
  30. Jorm, A. F., Christensen, H., Medway, J., Korten, A. E., Jacomb, P. A., & Rogers, B. (2000). Public belief systems about the helpfulness of interventions for depression: Associations with history of depression and professional help-seeking. Social Psychiatry and Psychiatric Epidemiology, 35, 211–219.Google Scholar
  31. Jorm, A. F., Korten, A. E., Jacomb, P. A., Rodgers, B., & Pollitt, P. (1997). Beliefs about the helpfulness of interventions for mental disorders: A comparison of general practitioners, psychiatrists and clinical psychologists. Australian and New Zealand Journal of Psychiatry, 31(6), 844–851.Google Scholar
  32. Katon, W., Russo, J., Frank, E., Barrett, J., Williams, J. W., Oxman, T., et al. (2002). Predictors of nonresponse to treatment in primary care patients with dysthymia. General Hospital Psychiatry, 24, 20–27.Google Scholar
  33. Kazdin, A. E. (1984). Acceptability of aversive procedures and medication as treatment alternatives for deviant child behavior. Journal of Abnormal Child Psychology, 12, 289–302.Google Scholar
  34. Kazdin, A. E. (2000). Perceived barriers to treatment participation and treatment acceptability among antisocial children and their families. Journal of Child and Family Studies, 9(2), 157–174.Google Scholar
  35. Kim-Goh, M. (1993). Conceptualization of mental illness among Korean-American clergymen and implications for mental health service delivery. Community Mental Health Journal, 29(5), 405–411.Google Scholar
  36. Kirk, L., Brody, C., Solomon, A., & Haaga, D. A. F. (1999). Lay theories concerning causes and treatments of depression. Journal of Rational Emotive and Cognitive Behavior Therapy, 17(4), 237–248.Google Scholar
  37. Kirsch, I., & Henry, D. (1979). Self-desensitization and meditation in the reduction of public speaking anxiety. Journal of Consulting and Clinical Psychology, 47(3), 536–541.Google Scholar
  38. Kuyken, W., Brewin, C. R., Power, M. J., & Furnham, A. (1992). Causal beliefs about depression in depressed patients, clinical psychologists and lay persons. British Journal of Medical Psychology, 65, 257–268.Google Scholar
  39. Landreville, P., & Guerette, A. (1998). Psychometric properties of a modified version of the Treatment Evaluation Inventory for assessing the acceptability of treatments for geriatric depression. Canadian Journal on Aging, 17(4), 414–424.Google Scholar
  40. Luk, C.-L., & Bond, M. H. (1992). Chinese lay beliefs about the causes and cures of psychological problems. Journal of Social and Clinical Psychology, 11(2), 140–157.Google Scholar
  41. Lundervold, D., & Lewin, L. M. (1990). Older adults' acceptability of pharmacotherapy and behavior therapy for depression: Initial results. The Journal of Applied Gerontology, 9, 211–215.Google Scholar
  42. Lundervold, D., & Young, L. G. (1992). Treatment acceptability ratings for sexual offenders: Effects of diagnosis and offense. Research in Developmental Disabilities, 13(3), 229–237.Google Scholar
  43. Lyddon, W. J. (1989). Personal epistemology and preference for counseling. Journal of Counseling Psychology, 36(4), 423–429.Google Scholar
  44. McDonnell, A. A., & Sturmey, P. (2000). The social validation of three physical restraint procedures: A comparison of young people and professional groups. Research in Developmental Disabilities, 21(2), 85–92.Google Scholar
  45. Miller, D. L., Manne, S., & Palevsky, S. (1998). Acceptance of behavioral interventions for children with cancer: Perceptions of parents, nurses, and community controls. Journal of Pediatric Psychology, 23(4), 267–271.Google Scholar
  46. Miltenberger, R. G. (1990). Assessment of treatment acceptability: A review of the literature. Topics in Early Childhood Special Education, 10(3), 24–38.Google Scholar
  47. Mulatu, M. S. (1999). Perceptions of mental and physical illnesses in north-western Ethiopia: Causes, treatments, and attitudes. Journal of Health Psychology, 4(4), 531–549.Google Scholar
  48. Neimeyer, G. J., Prichard, S., Lyddon, W. J., & Sherrard, P. A. D. (1993). The role of epistemic style in counseling preference and orientation. Journal of Counseling and Development, 71, 515–523.Google Scholar
  49. Nisbett, R. E., & Ross, L. (1991). Human inference: Strategies and shortcomings of social judgment. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  50. Nisbett, R. E., & Wilson, T. D. (1977). Telling more than we can know: Verbal reports on mental processes. Psychological Review, 84(3), 231–259.Google Scholar
  51. Noble, L. M., Douglas, B. C., & Newman, S. P. (2001). What do patients expect of psychiatric services? A systematic and critical review of empirical studies. Social Science and Medicine, 52, 985–998.Google Scholar
  52. Osgood-Hynes, D. J., Greist, J. H., Marks, I. M., Baer, L., Heneman, S. W., Wenzel, K. W., et al. (1998). Self-administered psychotherapy for depression using a telephone-accessed computer system plus booklets: An open U.S.–U.K. study. Journal of Clinical Psychiatry, 59(7), 358–365.Google Scholar
  53. öst, L.-G., Stridh, B.-M., & Wolf, M. (1998). A clinical study of spider phobia: Prediction of outcome after self-help and therapist-directed treatments. Behaviour Research and Therapy, 36, 17–35.Google Scholar
  54. Parker, G., Mahendran, R., Yeo, S. G., Loh, M. I., & Jorm, A. F. (1999). Diagnosis and treatment of mental disorders: A survey of Singapore mental health professionals. Social Psychiatry and Psychiatric Epidemiology, 34(10), 555–563.Google Scholar
  55. Phares, V., Ehrbar, L. A., & Lum, J. J. (1996). Parental perceptions of the development and treatment of children's and adolescents' emotional/behavioral problems. Child and Family Behavior Therapy, 18(4), 19–36.Google Scholar
  56. Pickering, D., & Morgan, S. B. (1985). Parental ratings of treatment of self injurious behavior. Journal of Autism and Developmental Disorders, 15, 303–314.Google Scholar
  57. Rasnake, L. K. (1993). Treatment acceptability research: Relevance to treatment selection decisions. Child and Adolescent Mental Health Care, 3(1), 31–47.Google Scholar
  58. Reimers, T. M., Wacker, D. P., Cooper, L. J., & De Raad, A. O. (1992). Acceptability of behavioral treatments for children: Analog and naturalistic evaluations by parents. School Psychology Review, 21(4), 628–643.Google Scholar
  59. Rokke, P. D., Carter, A. S., Rehm, L. P., & Veltum, L. G. (1990). Comparative credibility of current treatments for depression. Psychotherapy, 27(2), 235–242.Google Scholar
  60. Scheel, M. J., Conoley, C. W., & Ivey, D. C. (1998). Using client positions as a technique for increasing the acceptability of marriage therapy interventions. American Journal of Family Therapy, 26(3), 203–214.Google Scholar
  61. Schnittker, J., Freese, J., & Powell, B. (2000). Nature, nurture, neither, nor: Black–White differences in beliefs about the causes and appropriate treatment of mental illness. Social Forces, 78(3), 1101–1132.Google Scholar
  62. Shenkel, R. J., Snyder, C. R., Batson, C. D., & Clark, G. M. (1979). Effects of prior diagnostic information on clinicians' causal attributions of a client's problems. Journal of Consulting and Clinical Psychology, 47(2), 404–406.Google Scholar
  63. Sinnott, J. D., Burgio, L. D., Lakein, D., Pappas, K., DeLeonardo, L., & Spencer, F. M. (1998). Acceptability ratings of psychotherapeutic treatments for elderly individuals. Journal of Applied Gerontology, 17(2), 172–185.Google Scholar
  64. Tabachnick, B. G., & Fidell, L. S. (2001). Computer-assisted research design and analysis. Boston, MA: Allyn & Bacon.Google Scholar
  65. Thompson, C., & Hirschman, E. (1995). Understanding the socialized body: A poststructuralist analysis of consumers' self-conceptions, body-images, and self-care practices. Journal of Consumer Research, 22(2), 139–153.Google Scholar
  66. Tracey, T. J. (1988. Relationship of responsibility attribution congruence to psychotherapy outcome. Journal of Social and Clinical Psychology, 7(2/3), 131–146.Google Scholar
  67. Trivedi, M. H., & Rush, J. (1995). Does a placebo run-in or a placebo treatment cell affect the efficacy of antidepressant medications? Neuropsychopharmacology, 11(1), 33–43.Google Scholar
  68. Van Audenhove, C., & Vertommen, H. (2000). A negotiation approach to intake and treatment choice. Journal of Psychotherapy Integration, 10(3), 287–299.Google Scholar
  69. Vincent, N., & Lionberg, C. (2001). Treatment preference and patient satisfaction in chronic insomnia. Journal of Sleep and Sleep Disorders Research, 24(4), 411–417.Google Scholar
  70. Volovitz, B., Dueñas-Meza, E., Chmielewska-Szewczyk, D. A., Kosa, L., Astafieva, N. G., Villaran, C., et al. (2000). Comparison of oral montelukast and inhaled cromolyn with respect to preference, satisfaction, and adherence: A multi-center, randomized, open-label, crossover study in children with mild to moderate persistent asthma. Current Therapeutic Research, 61(7), 490–506.Google Scholar
  71. Walker, J., Vincent, N., Furer, P., Cox, B., & Kjernisted, K. (1999). Treatment preference in hypochondriasis. Journal of Behavior Therapy and Experimental Psychiatry, 30(4), 251–258.Google Scholar
  72. White, J. M., Danz, C., Kneebone, J., La Vicente, S. F., Newcombe, A. L., & Ali, R. L. (2002). Relationship between LAAM-methadone preference and treatment outcomes. Drug and Alcohol Dependency, 66, 295–301.Google Scholar
  73. Whittle, P. (1996). Causal beliefs and acute psychiatric hospital admission. British Journal of Medical Psychology, 69, 355–370.Google Scholar
  74. Worthington, R. L., & Atkinson, D. R. (1996). Effects of perceived etiology attribution similarity on client ratings of counselor credibility. Journal of Counseling Psychology, 43(4), 423–429.Google Scholar

Copyright information

© Plenum Publishing Corporation 2003

Authors and Affiliations

  • Marie-Geneviève Iselin
    • 1
  • Michael E. Addis
    • 1
  1. 1.Department of PsychologyClark UniversityWorcester

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