Results of Randomized Controlled Trials of Cognitive Therapy for Depression Generalize to Private Practice

Abstract

We compared outcomes of 45 depressed patientstreated in private practice with cognitive therapy orwith cognitive therapy plus pharmacotherapy to outcomesof patients receiving those treatments in two randomized controlled trials. Private practiceand research samples differed considerably, with privatepractice patients having more psychiatric and medicalcomorbidities and a greater range of initial depression severity. Treatment in privatepractice and research settings also differed, withprivate practice treatment conducted in a more flexiblemanner using an idiographic, formulation-drivenapproach. As predicted, private practice patients showedstatistically significant reductions in depressivesymptomatology over the course of treatment, and at posttreatment, Beck Depression Inventory (BDI) scores of patients treated in private practice andresearch settings were not statistically significantlydifferent. Clinical significance of outcomes was alsocomparable in the clinical and research samples. Of the variables measuring demographic,illness, and treatment factors, only pretreatment BDIscore predicted post treatment BDI score in the privatepractice sample.

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