Integration of Cognitive-Behavioral and Interpersonal Therapies in Treating Depression With Concurrent Relational Distress and Chronic Pain

Abstract

This is a single-case study of a middle-aged man presenting with relationship distress and simultaneous major depressive disorder with chronic back pain and a physical tic. Treatment was informed by cognitive-behavioral therapy (CBT), interpersonal psychotherapy (IPT), and psychodynamic principles. Over the course of treatment, a variety of techniques were utilized, including progressive muscle relaxation training, behavioral monitoring, cognitive restructuring, and interpersonal principles to address somatic complaints and underlying feelings of helplessness and inadequacy. Symptoms including general distress, frustration, back pain, worry about his wife’s mental illness, and amount of negative thinking were tracked on a daily basis over three assessment periods. In addition, clinically significant change was assessed using a comparison of baseline and follow-up results from the patient’s Outcome Questionnaire–45 (OQ-45.2). Evidence for symptomatic and characterological change is outlined, and treatment implications are discussed.