Mechanistic pathways of change in twice weekly versus once weekly sessions of psychotherapy for depression.

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Publisher: Elsevier Science Publishers
Document Type: Report; Brief article
Length: 391 words

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Keywords Depression; Mechanisms of change; Cognitive-behavioral therapy; Interpersonal psychotherapy; Therapy skills Highlights * Pathways of change in different session frequencies of psychotherapy for depression. * Latent difference score models were used to investigate temporal relations and mediation. * IPT skill change mediated the relation between session frequency and depression change. * Depression change related to subsequent change in CBT skills, motivation and alliance. * IPT skills may explain why a twice weekly higher session frequency is more effective. Abstract Background Recently, we showed that twice weekly sessions of cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for depression lead to better and faster treatment outcomes compared to once weekly sessions (). The present study investigated which pathways of change may account for the effects of different session frequencies. Method The sample consisted of 200 patients who were randomized to CBT weekly, CBT twice weekly, IPT weekly, or IPT twice weekly. Outcome and therapy processes were measured at baseline, two weeks and monthly up to month 6 after the start of treatment. Latent change score models investigated temporal relations between change in therapy processes and change in depression and tested whether change in the therapy processes mediated the effect of session frequency on change in depression. Results IPT skills mediated the relation between session frequency and change in depression. A decrease in depression was related to subsequent improvement in CBT skills and subsequent decrease in motivation for therapy. Conclusion The development of IPT skills may explain why a twice weekly higher session frequency is more effective in reducing depression compared to a once-weekly session frequency. Future studies should disentangle the causal effects of therapy process change throughout the course of therapy. Author Affiliation: (a) Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany (b) Vrije Universiteit Amsterdam, LEARN! Research Institute, Amsterdam, Netherlands (c) Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands (d) Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands (e) Department of Psychology, University of Pennsylvania, Philadelphia, United States * Corresponding author. University of Freiburg, Engelbergerstrasse 41, 79106, Freiburg, Germany. Article History: Received 22 June 2021; Revised 18 November 2021; Accepted 13 January 2022 Byline: Sanne J.E. Bruijniks [] (a,*), Martijn Meeter (b), Lotte Lemmens (c), Frenk Peeters (c), Pim Cuijpers (d), Fritz Renner (a), Marcus J.H. Huibers (d,e)

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Gale Document Number: GALE|A696275035