Marriage and Family Therapy

Changing Thoughts Key to Battling Even Severe Depression

Moderate to severely depressed clients showed greater improvement in cognitive therapy when therapists emphasized changing how they think rather than how they behave, new research has found.

The results suggest cognitive therapists should concentrate, at least during the first few sessions, on using cognitive techniques to help those with more severe depression to break out of negative thought patterns and to see events in their lives more realistically.

The study found that a concentration on changing behavior -- such as having patients schedule activities to get them out of the house, and tracking how they spent their time -- did not significantly predict subsequent change in depressive symptoms.

"There has been a lot of attention recently on behavioral approaches to treating severe depression, and that may lead some people to suspect that cognitive techniques are not important for more severely depressed patients," said Daniel Strunk, co-author of the study and assistant professor of psychology at Ohio State University.

"But our results suggest that it was the cognitive strategies that actually helped patients improve the most during the first critical weeks of cognitive-behavioral therapy."

"We're trying to understand if cognitive therapy leads people to a profound change in their basic self view, or if it teaches them a set of skills that they have to continually practice over time," he said.

Strunk said these results suggest that, despite the recent attention given to behavioral approaches to treating depression, cognitive techniques appear to be quite powerful.

"In our sample of cognitive therapy patients, cognitive techniques appeared to promote a lessening of depression symptoms in a way that was not true of behavioral techniques," he said.

Read entire article: ScienceDaily (May 14, 2010)


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