title: The process of change in cognitive therapy for depression when combined with antidepressant medication: Predictors of early intersession symptom gains.
abstract: OBJECTIVE
  Previous studies of cognitive therapy (CT) for depression have examined therapist adherence and the therapeutic alliance as predictors of subsequent symptom change. However, little is known about these CT process variables when CT is delivered in combination with antidepressant medication.
  
  
  METHODS
  In a sample of 176 depressed outpatients randomized to the combined condition of a clinical trial, we examined ratings of adherence and alliance as predictors of subsequent session-to-session symptom change across early CT sessions.
  
  
  RESULTS
  Both adherence to Behavioral Methods/Homework and the therapeutic alliance significantly predicted session-to-session symptom change. In models in which patients' medication regimen and prior symptom change were covaried, only Behavioral Methods/Homework remained a significant predictor of subsequent symptom change.
  
  
  CONCLUSIONS
  Our findings highlight the utility of Behavioral Methods/Homework in combined treatment for promoting early session-to-session symptom change.
authors: Department of Psychology, Ohio State University, 1835 Neil Avenue, Columbus, OH 43210, USA. strunk.20@osu.edu
authors: Daniel R
authors: DR
authors: Strunk
authors: Andrew A
authors: AA
authors: Cooper
authors: Elizabeth T
authors: ET
authors: Ryan
authors: Robert J
authors: RJ
authors: DeRubeis
authors: Steven D
authors: SD
authors: Hollon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003863:Depression / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011237:Predictive Value of Tests; D011369:Professional-Patient Relations; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents