Acceptance as a Predictor of Depression Severity in Cognitive Behavioural Therapy

Global depression prevalence continues to rise despite the clinical literature offering ubiquitous evidence-based treatments, necessitating the identification of interventions’ key mechanisms that instigate meaningful clinical change. The present study addresses this gap in the field by investigating acceptance of unpleasant experiences as a change mechanism in participants’ depression severity during CBT on both within- and between-participant levels. We hypothesised, first, that individual participants’ session-wise increases in acceptance of unpleasant experiences predict lower depression severity. Second, we hypothesised that across participants, higher average levels of acceptance of unpleasant experiences across treatment predict lower depression severity. In a sample of 139 participants with major depressive disorder undertaking 22 sessions of CBT, we utilised multilevel modelling to disaggregate the within- and between-participant effects of session-wise fluctuations in...Show moreGlobal depression prevalence continues to rise despite the clinical literature offering ubiquitous evidence-based treatments, necessitating the identification of interventions’ key mechanisms that instigate meaningful clinical change. The present study addresses this gap in the field by investigating acceptance of unpleasant experiences as a change mechanism in participants’ depression severity during CBT on both within- and between-participant levels. We hypothesised, first, that individual participants’ session-wise increases in acceptance of unpleasant experiences predict lower depression severity. Second, we hypothesised that across participants, higher average levels of acceptance of unpleasant experiences across treatment predict lower depression severity. In a sample of 139 participants with major depressive disorder undertaking 22 sessions of CBT, we utilised multilevel modelling to disaggregate the within- and between-participant effects of session-wise fluctuations in acceptance on depression severity. The results supported both our hypotheses, demonstrating that fluctuations in individuals’ session-wise levels of acceptance predicted fluctuations in their depression severity and that the more acceptance people experienced over the course of the intervention, the lower their depression severity across treatment. Taken together, the results supported acceptance of unpleasant experiences as a notable mechanism of change in depression treatment on both the individual- and group-levels. Consequently, these findings contribute to improving clinical interventions by elucidating how therapeutic change occurs in individuals undergoing treatment. Future research is encouraged to optimise treatments by increasing patients’ acceptance of unpleasant experiences. The clinical implications of this may improve psychotherapeutic outcomes in CBT for depression, enhancing treatment effectiveness to reduce the global burden of mental health care.Show less

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Acceptance as a Predictor of Depression Severity in Cognitive Behavioural Therapy