Enthusiasm for homework and improvement of psychological distress in subthreshold depression during behavior therapy: secondary analysis of data from a randomized controlled trial

BMC Psychiatry

Research Article

H. Imai¹  T. A. Furukawa¹  Y. Hayasaka¹  T. Sozu²  N. Kawakami³  M. Horikoshi⁴ 

[1] Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Yoshida Konoe-cho, 606-8501, Sakyo-ku, Kyoto, Japan;Department of Management Science, Faculty of Engineering, Tokyo University of Science, 1-3 Kagurazaka, 162-8601, Shinjyuku-ku, Tokyo, Japan;Department of Mental Health, University of Tokyo Graduate School of Medicine, Hongo, 113-0033, Bunkyo-ku, Tokyo, Japan;National Center of Neurology and Psychiatry, 187-8551, Kodaira, Tokyo, Japan;

关键词: Enthusiasm;    Cognitive behavioral therapy;    Telephone cognitive behavioral therapy;    Homework;    Depression;    Subthreshold depression;    Structural equation modeling;   

DOI  :  10.1186/s12888-015-0687-3

 received in 2014-01-29, accepted in 2015-11-19,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundCognitive behavioral therapy (CBT) usually involves homework, the completion of which is a known predictor of a positive outcome. The aim of the present study was to examine the session-by-session relationships between enthusiasm to complete the homework and the improvement of psychological distress in depressed people through the course of therapy.MethodsWorking people with subthreshold depression were recruited to participate in the telephone CBT (tCBT) program with demonstrated effectiveness. Their enthusiasm for homework was enhanced with motivational interviewing techniques and was measured by asking two questions: “How strongly do you feel you want to do this homework?” and “How confident do you feel you can actually accomplish this homework?” at the end of each session. The outcome was the K6 score, which was administered at the start of each session. The K6 is an index of psychological distress including depression and anxiety. We used structural equation modeling (SEM) to elucidate the relationships between enthusiasm and the K6 scores from session to session.ResultsThe best fitting model suggested that, throughout the course of behavior therapy (BT), enthusiasm to complete the homework was negatively correlated with the K6 scores for the subsequent session, while the K6 score measured at the beginning of the session did not influence the enthusiasm to complete the homeworks assigned for that session.ConclusionsEmpirical data now support the practitioners of BT when they try to enhance their patient’s enthusiasm for homework regardless of the participant’s distress, which then would lead to a reduction in distress in the subsequent week.Trial Registration NumberClinicalTrials.gov NCT00885014. April 20, 2009.

【 授权许可】

CC BY   
© Hayasaka et al. 2015