PROCESS OF MARITAL THERAPY WITH DEPRESSED PATIENTS

首席调查员目前已经进行了一半以上 一项结果研究的治疗阶段，比较 个人认知治疗，联合行为婚姻治疗，以及 候补对照组在缓解抑郁症状中的作用 婚姻不和的夫妻。预计将有30多对新人 接受行为婚姻疗法的试验。初步结果表明 行为婚姻疗法在这一人群中是有效的。我们 希望深入研究接受这一新信息的夫妇的变化过程 治疗抑郁症的一种形式。 提出了三组相互关联的分析：(1)一组分析 这项研究考察了治疗师和配偶行为对治疗过程的影响 患者行为，(2)检查同一治疗师的一组分析 和配偶行为对症状缓解的影响 疗程，以及(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 微观、中观、宏观三个层面同时进行的治疗过程 层次分析，我们希望提供一个治疗过程的描述 它既足够详细来指导临床活动，也可以 临床相关性足以对临床实践产生影响。 目前的建议侧重于治疗的组成部分，即 夫妻模式的独特之处，即：配偶对 治疗过程。它只是在最近才出现这种形式 已在主要的治疗方法中引入了治疗方法 抑郁症。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为明显 太及时了。还希望提出的三个层次的方法是 对治疗过程的研究可能被证明是临床相关的 处理其他领域的工作。

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.