Positive cognitive behavior therapy in the treatment of depression: A randomized order within-subject comparison with traditional cognitive behavior therapy

Nicole Geschwind*, Arnoud Arntz, Fredrike Bannink, Frenk Peeters

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Previous research suggests that a stronger focus on positive emotions and positive mental health may improve efficacy of Cognitive Behavior Therapy (CBT). Objectives were to compare differential improvement of depressive symptoms (primary outcome), positive affect, and positive mental health indices during positive CBT (P-CBT; CBT in a solution-focused framework, amplified with optional positive psychology exercises) versus traditional, problem-focused CBT (T-CBT). Forty-nine patients with major depressive disorder (recruited in an outpatient mental health care facility specialized in mood disorders) received two treatment blocks of eight sessions each (cross-over design, order randomized). Intention-To-Treat mixed regression modelling indicated that depressive symptoms improved similarly during the first, but significantly more in P-CBT compared to T-CBT during the second treatment block. Rate of improvement on the less-frequently measured secondary outcomes was not significantly different. However, P-CBT was associated with significantly higher rates of clinically significant or reliable change for depression, negative affect, and happiness. Effect sizes for the combined treatment were large (pre-post Cohen's d = 2.71 for participants ending with P-CBT, and 1.85 for participants ending with T-CBT). Positive affect, optimism, subjective happiness and mental health reached normative population averages after treatment. Overall, findings suggest that explicitly focusing on positive emotions efficiently counters depressive symptoms.

Original languageEnglish
Pages (from-to)119-130
Number of pages12
JournalBehaviour Research and Therapy
Volume116
DOIs
Publication statusPublished - May 2019

Keywords

  • Major depression
  • Positive affect
  • Cognitive behavior therapy
  • Positive psychology
  • Psychotherapeutic interventions
  • Solution focused brief therapy
  • REPORT QIDS-SR
  • QUICK INVENTORY
  • NEGATIVE AFFECT
  • LIFE
  • INTERVENTIONS
  • PSYCHOTHERAPY
  • REMISSION
  • PANAS
  • SYMPTOMATOLOGY
  • INTELLIGENCE

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