Journal article
A randomized-controlled trial of cognitive-behavioral therapy for depression with integrated techniques from emotion-focused and exposure therapies

Publication Details
Grosse Holtforth, M.; Krieger, T.; Zimmermann, J.; Altenstein-Yamanaka, D.; Dörig, N.; Meisch, L.; Hayes, A.
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Psychotherapy research : journal of the Society for Psychotherapy Research
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BACKGROUND Emotional processing (EP) is hypothesized to be a key mechanism of change in psychotherapy that may enhance its long-term efficacy. To study the effects of fostering EP in psychotherapy for depression, this randomized-controlled clinical trial compares the efficacy and pattern of change of a cognitive-behavioral therapy that integrates emotion-focused techniques within an exposure framework (Exposure-Based Cognitive Therapy for depression; EBCT-R) to a standard cognitive-behavioral therapy (CBT). METHODS One hundred and forty-nine depressed outpatients were randomized to a maximum of 22 sessions of manualized EBCT-R (N = 77) or CBT (N = 72). Primary outcomes were self-reported and clinician-rated depressive symptoms at posttreatment and 12-month follow-up. Secondary outcomes were self-esteem, interpersonal problems, and avoidance thoughts and behaviors. RESULTS Depressive symptoms improved significantly over therapy in both treatments, with large within-group effect sizes for CBT (d = -1.95) and EBCT-R (d = -1.77). The pattern of depression change during treatment did not differ between treatments. Symptom relief lasted over 12 months and did not differ between EBCT-R and CBT. CONCLUSIONS Results suggest that both treatments produced significant short- and long-term improvement in depression symptoms, but the integration of emotion-focused techniques within an exposure framework did not have added benefit. TRIAL REGISTRATION Identifier: NCT01012856 Clinical or methodological significance of this article: This trial compares cognitive-behavioral therapy (CBT) with a similarly structured CBT that was designed to foster emotional processing by integrating emotion-focused techniques within an exposure framework. Results indicate that this form of assimilative integration did not improve outcomes at 12-month follow-up.

Last updated on 2020-08-11 at 17:11