PROCESS OF MARITAL THERAPY WITH DEPRESSED PATIENTS

首席研究员目前已完成一半以上的工作， 结果研究的治疗阶段， 个体认知疗法，联合行为婚姻疗法，以及 等待名单对照组在缓解抑郁症的作用 婚姻关系不和的夫妇 预计将有30多对夫妇 接受行为婚姻疗法的试验 初步结果表明 行为婚姻疗法在这类人群中有效 我们 我希望深入研究接受这一新政策的夫妇的变化过程， 抑郁症的治疗方法 提出了三组相互关联的分析：（1）一组分析 研究了治疗师和配偶行为对治疗过程的影响， 患者行为，（2）一组检查同一治疗师的分析 和配偶行为对症状缓解的影响， 治疗过程，和（3）一组分析，检查 这些过程变量与最终结果的关系。 通过检查 同时在微观、中间和宏观上进行治疗的过程 分析的层次，我们希望提供一个治疗过程的描述 它既详细到足以指导临床活动， 临床相关性足以影响临床实践。 目前的建议集中在治疗的组成部分， 夫妻形式的独特之处，即：配偶对婚姻的贡献 治疗过程 直到最近， 在主要的治疗方式中引入了一些方法， 萧条 因此，研究如何最大限度地发挥潜力， 配偶对治疗过程的积极影响尤其重要。 很及时 同时，也希望这三个层次的方法能为 对治疗过程研究可能证明对临床相关的 其他领域的工作。

The Principal Investigator is currently more than half way through the treatment phase of an outcome study comparing the effectiveness of individual cognitive therapy, conjoint behavioral marital therapy, and a wait-list control group in the alleviation of depressive symptomotology in maritally discordant couples. It is anticipated that over 30 couples will receive a trial of behavioral marital therapy. Preliminary results suggest that behavioral marital therapy can be effective in this population. We wish to study intensively the change process for couples receiving this new form of treatment for depression. Three interlocking sets of analyses are proposed: (1) a set of analyses which examine the impact of therapist and spouse behavior on in session patient behavior, (2) a set of analyses which examine the same therapist and spouse behaviors in terms of their impact on symptom remission during the course of therapy, and (3) a set of analyses which examine the relationship of these process variables to final outcome. By examining the process of therapy simultaneously at the micro, intermediate, and macro levels of analysis, we hope to provide a description of therapy process which is both detailed enough to guide clinical activity as well as clinically relevant enough to exert an impact on clinical practice. The current proposal is focussed on the component of therapy which is unique to the couple format, viz: the contribution of the spouse to the therapy process. It has only been very recently that couple format approaches have been introduced in the major treatment modalities for depression. Accordingly, the study of ways to maximize the potential positive impact of the spouse on the therapy process is particularly timely. It is also hoped that the three level approach advanced for the study of therapy process may prove hueristic for clinically relevant process work in other areas.