Online cognitive behavioral therapy and problem-solving therapy for depressive symptoms: Exploring mechanisms of change
Section snippets
Background
Several forms of psychotherapy that have been subjected to empirical study have been shown to produce therapeutic change with depressed adults (Lambert, 2004). However, little is known about how or why treatment works. The psychological processes responsible for therapeutic change are often referred to as mediators. A mediator is an intervening variable that may account (statistically) for the relationship between the independent and dependent variable (Kazdin, 2007). There are several reasons
Participants
A comprehensive description of the participants and the procedures can be found in (Warmerdam, van Straten, & Cuijpers, 2007). Participants were recruited through advertisements in daily and weekly newspapers and via the Internet. All adults aged 18 years and older with depressive symptoms willing to participate in a self-help course, were eligible for this study. The main inclusion criterion was the presence of depressive symptoms as indicated by a score of 16 or more on the Center of
Participants
The average age of the participants at baseline was 45 years (SD = 12.1). Most participants were female (71%) and the majority (91%) had been educated at a medium or higher level. Almost all participants were Dutch (92%). There were no statistically significant differences between the three groups with respect to the demographics. The mean score of the participants on the CES-D at baseline was 31.7 (SD: 7.5, median: 31.0). There were no statistically significant differences between the three
Discussion
The purpose of this study was to contribute to research on mechanisms of change in psychological treatment for depressive symptoms. We compared two theoretically different treatments, online CBT and online PST, with a waiting list control group. The first requirement of testing mediation was met, as we found in a previous study that both treatments were significantly more effective in reducing depression than a waiting list control group (Warmerdam et al., 2008). The current study showed that
Acknowledgements
This study is funded by the Faculty of Psychology and Education of the VU University, Amsterdam.
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