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Depression, Cognitive Therapy, & Relapse (4-10-01)

Terry Gorski and other member of the GORSKI-CENAPS Team are Available To Train & Consult On Areas Related To Depression & Relapse
Gorski - CENAPS, 17900 Dixie Hwy, Homewood, IL 60430, 708-799-5000 www.tgorski.com, www.cenaps.com

Depression is a serious problem that can lead to relapse in addicted clients.  The following article describes a specific application of cognitive therapy to the treatment of depression that significant reduces relapse rates to depression.  Adaptations of this method may prove effective in treating relapse prone addicts with coexisting depression.

Abstract From Archive of General Psychiatry

Preventing Recurrent Depression Using Cognitive Therapy With and Without a Continuation Phase  
 
A Randomized Clinical Trial 
 
Author Information  Robin B. Jarrett, PhD; Dolores Kraft, PhD; Jeanette Doyle, MA; Barbara M. Foster, PhD; G. Greg Eaves, PhD; Paul C. Silver, PhD

Background  Cognitive therapy (CT) may reduce depressive relapse and recurrence when patients learn and use the associated skills. Reported relapse and recurrence rates after CT discontinuation vary widely. The factors that determine when CT is preventive remain unidentified. We developed continuation-phase CT (C-CT) to teach responders skills to prevent relapse. This is the first randomized trial comparing CT with and without a continuation phase in responders to CT who were vulnerable, given their history of recurrent unipolar depression.

Methods  Patients aged 18 to 65 years (n = 156) with recurrent DSM-IV major depressive disorder (MDD) entered 20 sessions of acute-phase CT (A-CT). Unmedicated responders (ie, no MDD and 17-item Hamilton Rating Scale for Depression score 9; n = 84) were randomized to either 8 months (10 sessions) of C-CT or control (evaluation without CT). Follow-up lasted an additional 16 months. A clinician blind to assignment evaluated relapse and recurrence (ie, DSM-IV MDD).

Results  Over an 8-month period, C-CT significantly reduced relapse estimates more than control (10% vs 31%). Over 24 months, including the CT-free follow-up, age of onset and quality of remission during the late phase of A-CT each interacted with condition assignment to influence durability of effects. In patients with early-onset MDD, C-CT significantly reduced relapse and recurrence estimates (16% vs 67% in control). When patients had unstable remission during late A-CT, C-CT significantly reduced relapse and recurrence estimates to 37% (vs 62% in control).

Conclusions  Findings suggest that 8 months of C-CT significantly reduces relapse and recurrence in the highest-risk patients with recurrent MDD. Risk factors influenced the necessity for C-CT.

Arch Gen Psychiatry. 2001;58:381-388

Terry Gorski and other member of the GORSKI-CENAPS Team are Available To Train & Consult On Areas Related To Depression & Relapse
Gorski - CENAPS, 17900 Dixie Hwy, Homewood, IL 60430, 708-799-5000 www.tgorski.com, www.cenaps.com

 

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GORSKI-CENAPS Clinical Model --- Research-Based Best Practice Principles

Special Focus:  Mental Health, Substance Abuse, & Terrorism

Terry Gorski and Other Members of the GORSKI-CENAPS Team are Available To Train & Consult On Areas Related To Recovery, Relapse Prevention, & Relapse Early Intervention

Address: 6147 Deltona Blvd, Spring Hill, FL  34606
info@enaps.com; www.tgorski.com, www.cenaps.com, www.relapse.org