Mechanisms of change in cognitive therapy for depression: therapist adherence, symptom change and the mediating role of patient skills

Webb C.A., DeRubeis R.J., Amsterdam J.D., Shelton R.C., Hollon S.D. Mechanisms of change in cognitive therapy for depression: therapist adherence, symptom change and the mediating role of patient skills. Journal of Consulting and Clinical Psychology (in press).



This analysis of two large studies of the effects of cognitive behavioral therapy for major depression showed that close adherence by therapists to the cognitive therapy model leads to the development of specific skills in patients, which mediates the beneficial effects of therapy.

This paper reviews the state of cognitive behavior therapy treatment for depression and links treatment outcome with actual behavioral changes in patients. This may provide a better way of assessing outcomes with psychotherapy for depression.

CBT is the best-established psychotherapy for depression and many other disorders. Monitoring behavioral changes in patients may provide a more accurate way of assessing response to treatment.