PREDICTING THE EFFECT OF COGNITIVE THERAPY FOR DEPRESSION - A STUDY OF UNIQUE AND COMMON FACTORS

The ability of several process variables to predict therapy outcome wa s tested with 30 depressed clients who received cognitive therapy with or without medication. Two types of process variables were studied: 1 variable that is unique to cognitive therapy and 2 variables that thi s approach is assumed to share with other forms of treatment. The clie nt's improvement was found to be predicted by the 2 common factors mea sured: the therapeutic alliance and the client's emotional involvement (experiencing). The results also indicated, however, that a unique as pect of cognitive therapy (i.e., therapist's focus on the impact of di storted cognitions on depressive symptoms) correlated negatively with outcome at the end of treatment. Descriptive analyses that were conduc ted to understand this negative correlation suggest that therapists so metimes increased their adherence to cognitive rationales and techniqu es to correct problems in the therapeutic alliance. Such increased foc us, however, seems to worsen alliance strains, thereby interfering wit h therapeutic change.