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Comparing CBT and IPT Effects on Depression: A Study on Treatment Efficacy and Outcome Measures

This study explores the effects of Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) on depression outcomes, utilizing a pre-test/post-test design with independent and dependent variables. The primary measures of depression include the BDI, MMPI-D, and ATQ assessments. Treatment efficacy is evaluated through various outcome strategies, including treatment-package and parametric strategies. Key issues of internal and external validity are addressed, alongside therapist fidelity and training. The analysis focuses on understanding the interactions between time and treatment types regarding changes in depression scores.

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Comparing CBT and IPT Effects on Depression: A Study on Treatment Efficacy and Outcome Measures

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  1. Class 10 Heppner et al. Chap 12, 18 Hogg & Deffenbacher(1988)

  2. Hogg & Deffenbacher (1988) • Design • Independent Variables • Dependent Variables

  3. Hogg & Deffenbacher (1988) • Design • Pre-test/post-test; experimental • Independent Variables: Categorical • Group IP Treatment • Group Cognitive Behavioral Trtmnt. • Control Group

  4. Hogg & Deffenbacher (1988) • Dependent Variables- Continuous • BDI Depression • MMPI-D Depression • ATQ Automatic Thghts. • Coopersmith SEI Self Esteem • Therapist Assessment of Client Behavior: • one item assessment of: depression, coping, anxiety, motivation to change, group participation

  5. Types Outcome Studies Kazdin (chap 18) • Treatment Package Strategy • Dismantling Strategy • Constructive Strategy • Parametric Strategy (structural components) • Comparative Outcome Strategy • Client and Therapist Variation Strategy Moderation Designs

  6. Types Outcome Studies Kazdin (chap 18) • Treatment Package Strategy • Dismantling Strategy • Constructive Strategy • Parametric Strategy (structural components) • Comparative Outcome Strategy • Client and Therapist Variation Strategy (Moderation Designs )

  7. Types of Control Group • No – treatment • Placebo ?? • Matched

  8. Internal/External Validity • Inclusion Criteria • Cng Center Clients • BDI>14 • Exclusion Criteria • Co-morbidity • Suicidal lethality • In therapy • Drug abuse/depend. • Internal Validity • Key issue • External Validity • Key issue

  9. Treatment Implementation Validity • Specificity of Treatment • Therapist Training • Fidelity Checks

  10. Treatment Validity • Treatment Specificity • CBT: emotional transactions • IPT : CB techniques for daily life • Therapist Training • Crossed by sex and theoretical orientation • Weekly supervision; rating tapes on fidelity • Fidelity Checks: • End of treatment blind raters, and • Client Evaluation of Treatment

  11. 3 X 2 Repeated Measures ANOVADep vs. Pre-test BDI & Post-Test BDI

  12. Treatment Effect: Between GroupsDo the treatment groups differ in the BDI, regardless of TIME? NS

  13. Trial Effect**: Within GroupsDo the Time groups differ regardless of Treatment? Time effect S*

  14. Interaction Effect : Do the Time groups differ in the BDI, by Treatment Group? NS

  15. Questions Addressed • Do clients who receive CBT, or IPT or no treatment show lower (or higher) BDI post-test scores than pre-test BDI scores? Trial Effect – Repeated Measures • Do clients who receive CBT show lower BDI scores at the end of the 8 weeks than clients who receive IPT or than clients who do not receive any treatment? (regardless of Time) Treatment Effect- Repeated Measures

  16. Questions Addressed • In which of the three experimental groups clients showed change in depression following treatment? Treatment x Trial Interaction – Repeated Measures • In which of the three experimental groups clients showed lower levels of depression at the end of treatment? Treatment Effect/Reg ANOVA

  17. Specific Change Mechanisms • Greater early change in • IPT: Self-esteem • CBT: Automatic thoughts

  18. Specific Treatment Changes

  19. Cholesterol Level (mg/dl) treatment placebo 12 10 0 6 8 2 4 TIME (months) Profile Plots Illustrating the Questions of Interest TIME*TREATMENT INTERACTION Here the effect of time is NOT the same for both groups. Thus we say that there is TIME and TREATMENT interaction.

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