The temporal relation of adherence and alliance to symptom change in cognitive therapy for depression.
This study attempted to replicate an earlier study (R. J. DeRubeis & M. Feeley, 1990) of the prediction of symptom change from process variables in cognitive therapy for depressed outpatients. Measures of in-session therapist behavior and therapist-patient interactions were correlated with prior and subsequent symptom change. One of the positive findings was confirmed, but the other received only marginal support. A "concrete" subset of theory-specified therapist actions, measured early in treatment, predicted subsequent change in depression. The therapeutic alliance was predicted by prior symptom change in 1 of the 2 later assessments, but only at a trend level. Several negative findings were similar to those obtained in the earlier study. Specifically, the alliance, an "abstract" subset of theory-specified therapist actions, and facilitative conditions did not predict subsequent change. Implications for causal inferences in psychotherapy process research are discussed.
Feeley
M
M
Department of Psychology, University of Pennsylvania, Philadelphia 19104-1696, USA.
DeRubeis
R J
RJ
Gelfand
L A
LA
D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007099:Imipramine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D011369:Professional-Patient Relations; D016896:Treatment Outcome
D000929:Antidepressive Agents, Tricyclic; D007099:Imipramine