Now we come to the most important result of the clinical research. you can learn to deal with your moods more effectively if you master methods that will help you pinpoint and eliminate the mental distortions which cause you feel upset. as you begin to think more objectively, you will begin to feel better.
Several years ago group of investigators at the center for cognitive therapy at the university of Pennsylvania school of medicine including Drs.John Rush, Aaron beck, Maria Kovacs and Steve Hollon began a pilot study comparing cognitive therapy with one of the most widely use and effective antidepressant drugs on the market, tofranil (imipramine hydrochloride).
Over forty severely depressed patients were randomly assigned to two groups. One group was to receive individual cognitive therapy sessions and no drugs while the other group would be treat with tofranil and no therapy. This either-or research design was chosen because it provided the maximum opportunity to sec how the treatments compared. Up to that time, no form of psychotherapy had been shown to be as effective for depression as treatment with an antidepressant drug. This is why antidepressants have experienced such a wave of interest from the media, and have come to be regarded by the professionals community in the past two decades as the best treatment for most serious forms of depressions. Both groups of patients were treated for a twelve-week period. all patients were systematically evaluated with extensive psychological testing prior to therapy, as well as at several monthly intervals for one year after completion of treatment. the doctors who performed the psychological test were not the therapists who administered the treatment. This ensured an objective assessment of the merits of each form of treatment. The patients were suffering from moderate to severe depressive episodes.The majority had failed to improve in spite of previous treatment with two or more therapists at other clinics. Three quarters were suicidal at the time of their referral. the average patient had been troubled by chronic or intermittent depression for eight years. Many were absolutely convinced their problems may not seem as overwhelming as theirs. A tough patient population was chosen so that the treatment could be tested under the most difficult,challenging conditions.
The outcome of the study was quite unexpected and encouraging. the cognitive therapy was at least as effective as, if not more effective than, the antidepressant drug therapy. as you can see (table 1) fifteen of the nineteen patients treated with cognitive therapy had shown a substantial reduction of symptoms after twelve weeks of active treatment.
An additional two individuals had improved, but were still experiencing borderline to mild depression. Only one patients had dropped out of treatment, and one had not yet begun to improve at the end of this period. In contrast, only five of the twenty-five patients assigned to antidepressant drug therapy had shown complete recovery by the end of the twelve-week period. Eight of these patients dropped out of therapy as a result of the adverse side effects of the medication, and twelve others showed no improvement or only partial improvement.
Of particular importance was the discovery that many patients treated with cognitive therapy improved more rapidly than those successfully treated with drugs. Within the first week or two, there was a pronounced reduction in suicidal thoughts among the cognitive therapy group. The effectiveness of cognitive therapy should be encouraging for individuals who prefer nit to rely on drugs to raise their spirits, but prefer to develop an understanding of what is troubling them and do something to cope with it.
- How effective is cognitive therapy compared with other established and accepted methods for treating depression?
- Can the new therapy enable severely depressed individuals to get better without drugs?
- How rapidly does cognitive therapy work?
- Do the results last?
Several years ago group of investigators at the center for cognitive therapy at the university of Pennsylvania school of medicine including Drs.John Rush, Aaron beck, Maria Kovacs and Steve Hollon began a pilot study comparing cognitive therapy with one of the most widely use and effective antidepressant drugs on the market, tofranil (imipramine hydrochloride).
Over forty severely depressed patients were randomly assigned to two groups. One group was to receive individual cognitive therapy sessions and no drugs while the other group would be treat with tofranil and no therapy. This either-or research design was chosen because it provided the maximum opportunity to sec how the treatments compared. Up to that time, no form of psychotherapy had been shown to be as effective for depression as treatment with an antidepressant drug. This is why antidepressants have experienced such a wave of interest from the media, and have come to be regarded by the professionals community in the past two decades as the best treatment for most serious forms of depressions. Both groups of patients were treated for a twelve-week period. all patients were systematically evaluated with extensive psychological testing prior to therapy, as well as at several monthly intervals for one year after completion of treatment. the doctors who performed the psychological test were not the therapists who administered the treatment. This ensured an objective assessment of the merits of each form of treatment. The patients were suffering from moderate to severe depressive episodes.The majority had failed to improve in spite of previous treatment with two or more therapists at other clinics. Three quarters were suicidal at the time of their referral. the average patient had been troubled by chronic or intermittent depression for eight years. Many were absolutely convinced their problems may not seem as overwhelming as theirs. A tough patient population was chosen so that the treatment could be tested under the most difficult,challenging conditions.
The outcome of the study was quite unexpected and encouraging. the cognitive therapy was at least as effective as, if not more effective than, the antidepressant drug therapy. as you can see (table 1) fifteen of the nineteen patients treated with cognitive therapy had shown a substantial reduction of symptoms after twelve weeks of active treatment.
An additional two individuals had improved, but were still experiencing borderline to mild depression. Only one patients had dropped out of treatment, and one had not yet begun to improve at the end of this period. In contrast, only five of the twenty-five patients assigned to antidepressant drug therapy had shown complete recovery by the end of the twelve-week period. Eight of these patients dropped out of therapy as a result of the adverse side effects of the medication, and twelve others showed no improvement or only partial improvement.
Of particular importance was the discovery that many patients treated with cognitive therapy improved more rapidly than those successfully treated with drugs. Within the first week or two, there was a pronounced reduction in suicidal thoughts among the cognitive therapy group. The effectiveness of cognitive therapy should be encouraging for individuals who prefer nit to rely on drugs to raise their spirits, but prefer to develop an understanding of what is troubling them and do something to cope with it.
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