A Primer on Psychotherapy Process Research: A Review of Cognitive Therapy of Depression

Researchers conducting psychotherapy process research aim to understand the process by which efficacious psychotherapies achieve therapeutic benefits. A key challenge in this research is how to maximise what can be learned from naturalistic longitudinal data. We provide a selective overview of research examining the process of change in cognitive therapy of depression. While the efficacy of this treatment is widely recognised, a consensus regarding how the treatment reduces depressive symptoms and provides protection from relapse and recurrence has yet to be reached. We review the current state of the research addressing the process of change in cognitive therapy, highlighting how specific methodological features can be used to better understand the process by which this treatment achieves its effects. We highlight the importance of two key challenges to making causal inferences from a process–outcome relation: (a) establishing the temporal precedence of predictors to outcome variables, and (b) evaluating whether any relations identified could be spurious. We argue that methodologically rigorous studies tend to support key claims of the model underlying cognitive therapy of depression. We conclude by considering future directions. For example, we highlight the importance of efforts to understand patient characteristics that may moderate process–outcome relations and could ultimately prove useful in tailoring treatment to best suit individual patients.     

Recopition memory for syntactic and semantic aspects of connected discourse

This study investigates the pattern of retention of syntactic and semantic information shortly after comprehension of connected discourse. Ninety-six Ss listened to 24 taped passages and, after each passage, heard one recognition test sentence which was either identical to a sentence that had occurred in the passage, or was changed in some slight way. The Ss responded “identical” or “changed,” rated their confidence, and classified changes as “meaning” or “form.” Two independent variables were manipulated: (1) The relationship between the original sentence in the passage and the test sentence. The test sentence was (a) semantically changed, (b) changed from active to passive voice or vice versa, (c) formally changed in other ways that did not affect the meaning, or (d) unchanged. Each sentence appeared in all change types. (2) The amount of interpolated material between the original and test sentences was zero, 80, or 160 syllables of connected discourse which was a continuation of the passage. Each S heard passages representing all levels of each variable. All combinations of particular passages, relationship of original and test sentence, and amount of interpolated material were tested. When the test sentence was heard immediately after the original, retention was high for all test types. But after 80½160 syllables, recognition for syntactic changes had dropped to near chance levels while remaining high for semantic changes. Even when the meaning of a sentence was remembered, formal properties that were not necessary for that meaning were forgotten very quickly. The results suggest that the original form of the sentence is stored only for the short time necessary for comprehension to occur. When a semantic interpretation has been made, the meaning is stored. Thus the memory of the meaning is not dependent on memory of the original form of the sentence.