For many decades, particularly in light of the debate and conversation surrounding movies such as the Secret, and the concept of the Law of Attraction, cognitive behavioral therapy—changing the way a person thinks about a certain aspect of life, can improve depressions.


People with moderate to severe depression, according to a recent study conducted by Ohio State University researchers, showed greater improvement in cognitive therapy when therapists emphasized changing how they think rather than how they behave.


The findings suggest that therapy should initially focus on employing cognitive techniques to help those with severe depression get out of their negative thought patterns and to view their life events more realistically.


The research also determined that therapy that focused on altering behavior and activities did not significantly affect the symptoms of depression.


“There has been a lot of attention recently on behavioral approaches to treating severe depression, and that may lead some people to suspect that cognitive techniques are not important for more severely depressed patients,” remarked Daniel Strunk, an assistant professor of psychology at Ohio State University and co-author of the study.


“But our results suggest that it was the cognitive strategies that actually helped patients improve the most during the first critical weeks of cognitive behavioral therapy.


Sixty patients with major depression were involved in the study.  They agreed to have their therapy sessions videotaped for study.


Two trained raters reviewed the videotapes of the first through the fourth therapy sessions. They also measure the degree to which the therapists relied on cognitive and behavioral methods and other aspects of the sessions.


Also, patients completed a questionnaire at each session that measured their depression levels.


The study was conducted with Robert DeRubeis of the University of Pennsylvania and Melissa Brotman of the National Institute of Mental Health.


The researchers examined the relationship between specific techniques used by their therapists and the extent of improvement in patients’ depression scores from one session to the next.


The study focused on the first few weeks of therapy because other studies suggest that is when patients make the largest improvement in depression levels, Strunk said.


Results showed that patients’ depression scores improved significantly when their therapists focused on cognitive techniques, and remained the same when their therapists focused on behavioral techniques.


The study also found there were other factors also associated with patient improvement, the study found. The patients improved more when they collaborated with their therapists about a plan for treatment and followed that plan.


The patients also showed greater improvement when they were more engaged in the therapy process and were open to suggestions from their therapist.


“If you’re a patient and willing to fully commit to the therapy process, our data suggest you will see more benefit,” Strunk said.


He also noted these results suggest that, despite the recent attention given to behavioral approaches to treating depression, cognitive techniques appear to be quite powerful.