Positieve cognitieve gedragstherapie
Positieve cgt (pcgt) integreert het wetenschappelijk onderzoek en de toepassingen van de positieve psychologie en oplossingsgerichte therapie binnen een cognitief gedragstherapeutisch kader. In deze factsheet leer je wat pcgt is, waarvoor het ingezet kan worden en wat de effecten ervan in de behandeling van depressie zijn.
Hoe gebruik je deze factsheet?
De factsheet geeft inzicht in het gebruik van pcgt. Het geeft behandelaars concrete handvatten om pcgt in te zetten.
Auteur: Drs. Frederike Bannink MDR.
Meer informatie over pcgt is de vinden op de pagina van de sectie positieve cgt.
De EABCT (European Association for Behavioral and Cognitive Therapies) heeft Special Interest Group Positive CBT.
Meer informatie over het aangehaalde onderzoek
Objectives of the research at Maastricht University were to compare differential improvement of depressive symptoms (primary outcome), positive affect, and positive mental health indices during positive CBT (Bannink, 2012) versus traditional, problem-focused CBT for major depressive disorder.
Forty-nine patients with major depressive disorder (recruited in an outpatient mental health care facility specialized in mood disorders) received two treatment blocks of eight sessions each (cross-over design, order randomized). In addition to collecting quantitative data, we collected qualitative data by conducting in-depth interviews with the first twelve individuals, and observing treatment trajectories and supervision sessions.
To analyze quantitative data we used mixed regression modelling. We also calculated clinically significant change per treatment and phase. To analyze qualitative data, we adopted a constructivist grounded theory approach, blending inductive (bottom-up) data collection with theory-driven (top-down) interpretation.
Intention-To-Treat mixed regression modelling indicated that depressive symptoms improved similarly during the first, but significantly more in positive CBT compared to traditional CBT during the second treatment block. Positive CBT was associated with significantly higher rates of clinically significant or reliable change for depression, negative affect, and happiness. Effect sizes for the combined treatment were large (pre-post Cohen’s d=2.71 for participants ending with positive CBT, and 1.85 for participants ending with traditional CBT). Positive affect, optimism, subjective happiness and mental health reached normative population averages after treatment.
Analysis of the qualitative data indicated that most clients were sceptic about positive CBT at the start of the treatment, but afterwards preferred positive CBT and indicated experiencing a steeper learning curve during positive, compared to traditional CBT. The preference for positive CBT was attributable to four distinct influences: feeling better and empowered, benefitting from the upward spiral effect of positive emotions, learning to appreciate small ‘baby-steps’, and (re)discovering optimism as a personal strength.
Overall, findings suggest that positive CBT: 1) efficiently counters major depressive symptoms, 2) leads to more clinically significant change than traditional CBT, and 3) is favored over traditional CBT by clients with moderate to severe and largely treatment-resistant depression. Future research is needed to investigate follow-up and relapse-prevention effects.
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