ABSTRACT
At the beginning of this book I mentioned that cognitive-behavioural therapy was only one amongst a number of structured psychotherapies which had proved to be effective in the acute treatment of depression. This has led some investigators to suggest that the changes brought about by structured psychotherapies are non-specific; they all share a common core of features which are the ones which matter. For example Goldfried (1980) says that most therapeutic strategies involve the following: (a) they provide patients with new corrective experiences; (b) they offer patients direct feedback; (c) they induce in patients the expectation that therapy will help them; (d) they create a therapeutic relationship; and (e) they provide patients with repeated opportunities to test reality. Focusing more specifically on depression, Zeiss et al. (1979) outlined the factors which were common to the therapies which are effective in treating depression. First, these therapies have an elaborate, well-planned rationale which provide an initial structure that guides patients to the belief that they can control their own behaviour and thereby their own depression. Secondly, therapy which is effective provides training in skills that patients can use to feel more effective in solving problems in their life. Thirdly, such therapies emphasize the independent use of these skills by the patient outside the therapy context, and provide sufficient structure so that the patient can attain the independent use of them. Finally, such therapies encourage patients to attribute improvement in their mood to their own increased skilfulness and not that of the therapist.
