The Effectiveness of CT of Depression in Private Practice

In a study of Cognitive Therapy under "real world" conditions, Persons, Burns, and Perloff (1988) examined the effectiveness of CT in treating patients seeking treatment for depression in a private practice setting. The subjects were 70 patients seen by Dave Burns and Jackie Persons (both big-time Cognitive Therapists) in their own private practices. Key findings were:

• Although patients in this study had a broader range of psychopathology than did subjects in previously published controlled outcome studies, they had comparably large reductions in Beck Depression Inventory (BDI) scores.
• Patients who completed treatment had an average 65.5% reduction in BDI scores.
• After controlling for other factors, including initial level of depression, patients who did their homework at least half the time improved three times as much as patients who did not.
• Despite significant improvement, 50% of patients terminated treatment prematurely.
• Premature termination was most likely in patients with personality disorders, high initial BDI scores, and no endogenous symptoms.
• While the study did not focus specifically on the impact of personality disorders on treatment, 54.3 % of the subjects met DSM-III criteria for a personality disorder diagnosis. While patients with personality disorders were significantly more likely to drop out of therapy prematurely than patients without personality disorders, those patients with personality disorder diagnoses who persisted in therapy through the completion of treatment showed substantial improvement and did not differ significantly in degree of improvement from patients without personality disorders.

Persons, J. B., Burns, B. D., & Perloff, J. M. (1988). Predictors of drop-out and outcome in cognitive therapy for depression in a private practice setting. Cognitive Therapy and Research, 12, 557-575.

Replies:

CT of Depression in Private Practice is as Effective as in Research Trials, by Jim Pretzer, 12/6/99 Effectiveness of CT of Depression for Individuals with Personality Disorders, by Jim Pretzer, 08/06/01

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