title: A re-examination of process-outcome relations in cognitive therapy for depression: Disaggregating within-patient and between-patient effects.
abstract: We previously examined alliance and therapist adherence as predictors of symptom change. Applying a new analytic strategy, we can ensure that any relations identified were not attributable to stable patient characteristics.
  
  
  
  Participants were 57 depressed cognitive therapy patients. We disaggregated within- and between-patient variation in process measures.
  
  
  
  Between-patients, variability in adherence to Cognitive Methods and Negotiating/Structuring predicted patients' symptom change. Within-patients, only variability in ratings of adherence to Cognitive Methods predicted next-session symptom change.
  
  
  
  Relations involving between-patient process variables are potentially attributable to stable patient characteristics. However, the relation of within-patient Cognitive Methods and session-to-session symptom change cannot be attributed to stable characteristics and is consistent with a causal relationship.
authors: a Department of Psychology , The Ohio State University , Columbus , OH , USA.
authors: Katherine E
authors: KE
authors: Sasso
authors: a Department of Psychology , The Ohio State University , Columbus , OH , USA.
authors: Daniel R
authors: DR
authors: Strunk
authors: a Department of Psychology , The Ohio State University , Columbus , OH , USA.
authors: Justin D
authors: JD
authors: Braun
authors: b Department of Psychology , University of Pennsylvania , Philadelphia , PA , USA.
authors: Robert J
authors: RJ
authors: DeRubeis
authors: c Mood and Anxiety Disorders Program, National Institute of Mental Health , Bethesda , MD , USA.
authors: Melissa A
authors: MA
authors: Brotman
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003866:Depressive Disorder / Q000628:therapy*; D019983:Guideline Adherence; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011369:Professional-Patient Relations
keywords: alliance; cognitive behavior therapy; depression; process research; statistical methods