Helplessness as a Mechanism of Change in CBT for Depression: Disaggregating Between and Within Patient effects

This study is a secondary data analysis of a randomized control trial originally collected by grosse Holtforth et al. (2019), which examined the efficacy of Cognitive Behavioral Therapy (CBT) vs ECBT-R (Exposure-Based Cognitive Therapy-Revised) in treating depression. This study examines helplessness as a mechanism of change in CBT) for depression, focusing on distinguishing between stable, trait-like helplessness and dynamic, session-specific fluctuations. Through multilevel modeling, this research disaggregates between-patient effects (average helplessness levels) and within-patient effects (session-specific changes) on depressive symptoms, measured by WHO-5 well-being scores. The sample included 138 participants primarily diagnosed with chronic and recurrent depressive conditions.The results indicate that lower levels of trait-like helplessness are associated with reduced depression severity across treatment. Additionally, reductions in state-like helplessness during therapy...Show moreThis study is a secondary data analysis of a randomized control trial originally collected by grosse Holtforth et al. (2019), which examined the efficacy of Cognitive Behavioral Therapy (CBT) vs ECBT-R (Exposure-Based Cognitive Therapy-Revised) in treating depression. This study examines helplessness as a mechanism of change in CBT) for depression, focusing on distinguishing between stable, trait-like helplessness and dynamic, session-specific fluctuations. Through multilevel modeling, this research disaggregates between-patient effects (average helplessness levels) and within-patient effects (session-specific changes) on depressive symptoms, measured by WHO-5 well-being scores. The sample included 138 participants primarily diagnosed with chronic and recurrent depressive conditions.The results indicate that lower levels of trait-like helplessness are associated with reduced depression severity across treatment. Additionally, reductions in state-like helplessness during therapy sessions predict immediate improvements in depressive symptoms. These findings highlight the dynamic nature of helplessness and its critical role in both short-term and long-term therapeutic outcomes. The study suggests that tailored interventions targeting both stable and fluctuating elements of helplessness could enhance CBT's effectiveness in treating depression. Future research should explore how these patterns contribute to relapse prevention and sustained recovery.Show less

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Helplessness as a Mechanism of Change in CBT for Depression: Disaggregating Between and Within Patient effects