Cognitive-behavioral treatment for depression: Relapse prevention

This study presents 2-year follow-up data of a comparison between complete cognitive-behavioral therapy for depression (CT) and its 2 major components: behavioral activation (BA) and BA with automatic thoughts modification. Data are reported on 137 participants who were randomly assigned to 1 of these 3 treatments for up to 20 sessions with experienced cognitive-behavioral therapists. Long-term effects of the therapy were evaluated through relapse rates, number of asymptomatic or minimally symptomatic weeks and survival times throughout the follow-up. CT was no more effective than its components in preventing relapse. This study also examined the reliability of therapist competence ratings, as measured by the Cognitive Therapy Scale (CTS). Results showed that expert raters were unable to agree on judgments of competence. Both clinical and theoretical implications of these findings are discussed.