In this article we critically consider the efficacy of psychotherapeutic strategies for the treatment of depressed outpatients. Problems with the design of each of the recent major studies are identified; suggestions for improved methodologies are offered. Comments on the current "status of the art" by leading experts in the field are considered. Finally, advances in the social skills treatment of depression are discussed. Factors requiring further research attention in the next decade are identified.
Get full access to this article
View all access options for this article.
References
1.
Bellack, A. S. , Hersen, M., & Himmelhoch, J. M.Social skills training for depression: A treatment manual. JSAS Catalog of Selected Documents, 1980, 10, 92-92. (Ms. no. 2156).
2.
Bellack, A. S. , Hersen, M., & Himmelhoch, J. M.Social skills training, pharmacotherapy, and psychotherapy for unipolar depression. American Journal of Psychiatry, 1981, 138, 1562-1566.
3.
Craighead, W. C.Away from a unitary model of depression . Behavior Therapy, 1980, 11, 122-128.
4.
DeRubeis, R. J. , & Hollon, S. D.Behavioral treatment of affective disorders. In L. Michelson, M. Hersen, & S. M. Turner (eds.), Future perspectives in behavior therapy. New York: Plenum Press, 1981.
5.
Grof, P.Continuation and maintenance antidepressant drug treatment. In F. J. Ayd (Ed.), Clinical depressions: Diagnostic and therapeutic challenges. Baltimore, MD: Ayd Medical Communications, 1980.
6.
Hersen, M.Limitations and problems in the clinical application of behavioral techniques in psychiatric settings . Behavior Therapy, 1979, 10, 65-80.
Hersen, M. , & Bellack, A. S. (Eds.), Behavior therapy in the psychiatric setting. Baltimore: Williams & Wilkins, 1978.
9.
Hersen, M. , Bellack, A. S., & Himmelhoch, J. M.Treatment of unipolar depression with social skills training. Behavior Modification, 1980, 4, 547-556.
10.
Hersen, M.Bellack, A. S. , & Himmelhoch, J. M.A comparison of solicited and nonsolicited female unipolar depressives for treatment outcome research. Journal of Consulting and Clinical Psychology, in press.
11.
Hersen, M. , Bellack, A. S., & Himmelhoch, J. M.Skills training with unipolar depressed women. In J. P. Curran & P. M. Monti (Eds.), Social competence andpsychiatric disorders: Theory and practice. New York: Guilford Press, in press.
12.
Klerman, G. L.Behavior therapy and public policy . Presented at the 14th Annual Convention of the Association for Advancement of Behavior Therapy, New York City, November 21, 1980.
13.
Klerman, G. L. , DiMascio, A., Weissman, M., Prusoff, M.P.H., & Paykel, E. S.Treatment of depression by drugs and psychotherapy. American Journal of Psychiatry, 1974, 131, 186-191.
14.
Klerman, G. L. , Endicott, J., Spitzer, R., & Hirschfeld, R.M.A.Neurotic depressions: A systematic analysis of multiple criteria and meanings. American Journal of Psychiatry, 1979, 136, 57-61.
15.
Kovacs, M.Treating depressive disorders: The efficacy of behavior and cognitive therapies . Behavior Modification, 1979, 3, 496-517.
16.
Lewinsohn, P. M. , & Hoberman, H. M.Depression. In A. S. Bellack, M. Hersen, & A. E. Kazdin (Eds.), International handbook of behavior modification and therapy. New York: Plenum Press, in press.
17.
Liberman, R. P. , & Davis, J.Drugs and behavior analysis. In M. Hersen, R. M. Eisler, & P. M. Miller (Eds.), Progress in behavior modification: Volume I. New York: Academic Press, 1975.
18.
Lloyd, C.Life events and depressive disorder reviewed: I. Events as predisposing factors . Archives of General Psychiatry, 1980, 37, 529-535. (a)
19.
Lloyd, C.Life events and depressive disorder reviewed: II. Events as precipitating factors . Archives of General Psychiatry, 1980, 37, 541-548. (b)
20.
Luborsky, L. , Singer, B., & Luborsky, L.Comparative studies of psychotherapies: Is it true that "everyone has won and all must have prizes"?Archives of General Psychiatry, 1975, 31, 995-1008.
21.
McLean, P. D. , & Hakstian, A. R.Clinical depression: Comparative efficacy of out-patient treatments. Journal of Consulting and Clinical Psychology, 1979, 47, 818-836.
22.
Paykel, E. S. , & Weissman, M. M.Social adjustment and depression: A longitudinal study. Archives of General Psychiatry, 1973, 8, 659-663.
23.
Rehm, L. P. , Fuchs, C. Z., Roth, D. M., Kornblith, S. J., & Romano, J. M.A comparison of self-control and assertion skills treatments of depression. Behavior Therapy, 1979, 10, 429-442.
24.
Rehm, L. P. , & Kornblith, S. J.Behavior therapy for depression: A review of recent developments. Progress in Behavior Modification: Volume 7. New York: Academic Press, 1979.
25.
Rounsaville, B. J. , Prusoff, B. A., & Padian, N.The course of nonbipolar, primary major depression: A prospective 16-month study of ambulatory patients. Journal of Nervous and Mental Disease, 1980, 168, 406-411.
26.
Rush, A. J. , Beck, A. T., Kovacs, M., & Hollon, S.Comparative efficacy of cognitive therapy and pharmacotherapy in the treatment of depressed outpatients. Cognitive Therapy and Research, 1977, 1, 17-37.
27.
Sanchez, V. C. , Lewinsohn, P. M., & Larson, D. W.Assertion training: Effectiveness in the treatment of depression. Journal of Clinical Psychology, 1980, 36, 526-529.
28.
Shaw, B.A comparison of cognitive therapy and behavior therapy in the treatment of depression . Journal of Consulting and Clinical Psychology, 1977, 45, 543-551.
29.
Stein, M. K. , Rickels, K., & Weise, C. C.Maintenance therapy with amitriptyline: A controlled trial. American Journal of Psychiatry, 1980, 137, 370-371.
30.
Weissman, M. M.The psychological treatment of depression: Evidence for the efficacy of psychotherapy alone, in comparison with, and in combination with pharmacotherapy . Archives of General Psychiatry, 1979, 36, 1261-1269.
31.
Weissman, M. M. , Kask, S. V., & Klerman, G. L.Follow-up of depressed women after maintenance treatment. American Journal of Psychiatry, 1976, 133, 757-760.
32.
Weissman, M. M. , Prusoff, B. A., Dimascio, A., Neu, C., Goklaney, M., & Klerman, G. L.The efficacy of drugs and psychotherapy in the treatment of acute depressive episodes. American Journal of Psychiatry, 1979, 136, 555-558.
33.
Wells, K. C. , Hersen, M., Bellack, A. S., & Himmelhoch, J. M.Social skills training in unipolar nonpsychotic depression. American Journal of Psychiatry, 1979, 136, 1331-1332.
34.
Whitehead, A.Psychological treatment of depression: A review . Behavior Research and Therapy, 1979, 17, 495-509.
35.
Wolpe, J.The experimental model and treatment of neurotic depression . Behaviour Research and Therapy, 1979, 17, 555-565.
36.
Zeiss, A. M. , Lewinsohn, P. M., & Munoz, R. F.Nonspecific improvement effects in depression using interpersonal skills training, pleasant activity schedules, or cognitive training. Journal of Consulting and Clinical Psychology, 1979, 47, 427-439.