Psychology

A closer look at the treatment rationale and homework compliance in cognitive-behavioral therapy for depression

Document Type

Article

Abstract

This study examined the relationships between acceptance of the treatment rationale (ATR), homework compliance, and change during cognitive- behavioral therapy (CBT) for depression. By evaluating the associations between these variables over time it was possible to compare competing theories of change in CBT. Clients meeting criteria for major depression (N = 150) were assessed longitudinally for their reaction to the treatment rationale and homework compliance over the course of a 20-session treatment. The results suggest that both ATR and homework compliance make independent contributions to predicting within-treatment change and treatment outcome. There was no evidence that compliance mediates the effect of ATR on treatment outcome. These findings support a multiprocess model of change in CBT. Acceptance of the treatment rationale may facilitate involvement in treatment and nonspecific change processes, while compliance with homework assignments contributes to additional change. We discuss these findings in regard to alternative theories of change and the dissemination of CBT to real-world clinical settings.

Publication Title

Cognitive Therapy and Research

Publication Date

2000

Volume

24

Issue

3

First Page

313

Last Page

326

ISSN

0147-5916

DOI

10.1023/A:1005563304265

Keywords

cognitive-behavioral therapy, depression, homework compliance, process of change, treatment rationale

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