By Christine A. Padesky, PhD / updated and reprinted from January 6, 2017 email
CLINICAL TIP: A premature focus on core beliefs in therapy with depressed clients could lead to worsening of symptoms. Keep your focus on behavioral activation and cognitive restructuring.
While CBT homework has been linked to better outcomes and lower relapse, there has been little research on the differential impact of different types of homework practice. Significant findings by Hawley et al. strongly suggest we play close attention to the type of homework used in groups for depression. All clinicians need to update their interventions to ensure they are providing the best evidence based practices with their depressed clients in brief group outpatient therapy.
- Depressed clients in brief group outpatient therapy benefited significantly from Mind Over Mood homework involving behavioral activation or cognitive restructuring via Thought Records. Contrary to other studies, behavioral activation was more effective for clients with mild to moderate depressive symptoms than clients with severe symptoms.
- Homework focusing on core beliefs led to worsening depression symptoms
These empirical findings influenced the rewriting of the 2nd edition of Mind Over Mood which has a reduced emphasis on core beliefs and an increased focus on behavioral activation and cognitive restructuring for depression. This research alerts therapists that a premature focus on core beliefs in therapy with depressed clients could lead to worsening of symptoms. More research in this area will be useful to clarify and test the strength of these findings.
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To read/download the complete article, visit our Clinical Corner Publications page. The Hawley article is in the Depression section.
Greenberger, D., & Padesky, C.A. (2016). Mind Over Mood: Change How You Feel by Changing the Way You Think. Guilford Press.
Hawley, L. L., Padesky, C. A., Hollon, S. D., Mancuso, E., Laposa, J. M., Brozina, K., & Segal, Z. V. (2017) Cognitive-Behavioral Therapy for Depression Using Mind Over Mood: CBT Skill Use and Differential Symptom Alleviation. Behavior Therapy, 48(1), pp 29-44.