Date of Award

12-2000

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Dr. C. Richard Spates

Second Advisor

Dr. Galen Alessi

Third Advisor

Dr. Malcolm H. Robertson

Fourth Advisor

Dr. Roberto Flachier

Abstract

A recent empirical study (Jacobson et al., 1996) suggested that the Behavioral Activation (BA) component of Beck’s Cognitive-Behavioral Therapy (CT) for depression (Beck, Rush, Shaw, & Emery, 1979) may be as effective a treatment for clinical depression as the full CT treatment. BA involves intervention choices that are fewer in number and more straightforward than those contained in CT, making BA a more efficient treatment than CT. The purpose of this study was to extend the research on BA by administering it as a group therapy and to evaluate this treatment in a natural setting. This was achieved by classifying 42 Community Mental Health (CMH) outpatients with Major Depressive Disorder as either Behavioral Activation Group Therapy (BAGT) subjects or wait-list subjects, dependent upon the latency from screening to treatment initiation. Eight B AGT-trained therapists administered the treatment weekly for 10 weeks at four Southwestern Michigan CMH agencies. A co-therapy model was utilized and group sizes ranged from 6 to 11 persons. Treatment subjects were assessed at pretreatment, posttreatment, and 3-month follow-up using the Beck Depression Inventory-Second Edition (BDI-II) (Beck, Steer, Ball, & Ranieri, 1996), the Revised Hamilton Rating Scale for Depression (RHRSD) (Warren, 1996), and the Structured Clinical Interview for DSM-FV (SCID) (First, Spitzer, Gibbon, & Williams, 1997). Wait-list subjects were assessed at prewaiting period, postwaiting period (which also represented pretreatment for these subjects), posttreatment, and 3-month follow-up with the same outcome measures. Results failed to uncover a statistically significant difference between wait-list subjects and treatment subjects from pretreatment to posttreatment in this difficult to treat population. However, a statistically significant difference between wait-list subjects and treatment subjects from pretreatment to follow-up was observed. Additionally, subjects who completed BAGT, regardless of initial classification, experienced statistically significant reductions in depression scale scores after 10 weeks o f treatment and this trend continued at 3-month follow-up. In light of the increased severity of the present sample compared to the Jacobson et al. (1996) sample, it is suggested that these findings support further investigation into BAGT as a treatment for clinical depression.

Access Setting

Dissertation-Open Access

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