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August/September 2014 (vol. 11/2)

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Research Plus

Smart CBT?

Cognitive behavioural therapy (CBT) is used increasingly to treat anxiety, depression and other disorders, but not every patient benefits. This study suggests that an individual’s ‘capacity for participating in the CBT process’ – essentially their ability to articulate and share thoughts and feelings in a non-defensive way in a clinical setting – is a more useful indicator of therapeutic benefit than is their attitude to the process itself. The study comprised 256 working-age patients diagnosed with depression and anxiety disorders, two-thirds of whom were employed. Each was assessed using the 10-item Suitability for Short- Term Cognitive Therapy (SSCT) scale, with symptom severity rated on the Clinical Global Impression (CGI) scale.

Participants were given weekly CBT sessions (mean of 19 sessions). The mean pre-treatment CGI score was 4.01 (‘moderate symptom severity’), falling to 2.73 (‘borderline to mild’) post-treatment. Two-thirds of the variance in CGI score change was accounted for by two broad factors each covering four items in the SSCT: ‘capacity for participation in the CBT process’ and ‘attitudes relevant to the CBT process’. After controlling for pre-treatment CGI, higher scores for both factors were predictive of post-treatment CGI; however, after multiple regression analysis only ‘capacity for participation’ remained statistically significant. Patients rated as having a higher capacity to participate in the CBT process experienced greater symptom improvements than those with lower capacity to participate, regardless of their attitude to the process, the authors conclude.

Predicting who benefits most from cognitive-behavioral therapy for anxiety and depression. Journal of Clinical Psychology 2014; online first: doi: 10.1002/jclp.22099. 

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Occupational Health at Work August/September 2014 (vol. 11/2) pp42