John T. Watkins

Initial severity and differential treatment outcome in the National Institute of Mental Health Treatment of Depression Collaborative Research Program

Random regression models (RRMs) were used to investigate the role of initial severity in the outcome of 4 treatments (cognitive-behavior therapy [CBT], interpersonal psychotherapy [IPT], imipramine plus clinical management [IMI-CM], and placebo plus clinical management [PLA-CM]) for outpatients with major depressive disorder seen in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Initial severity of depression and impairment of functioning significantly predicted differential treatment effects. A larger number of differences than previously reported were found among the active treatments for the more severely ill patients; this was due, in large part, to the greater power of the present statistical analyses.

Therapist Competence Ratings in Relation to Clinical Outcome in Cognitive Therapy of Depression

This study reports on the relationship of therapist competence to the outcome of cognitive-behavioral treatment in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Outpatients suffering from major depressive disorder were treated by cognitive-behavioral therapists at each of 3 U.S. sites using a format of 20 sessions in 16 weeks. Findings provide some support for the relationship of therapist competence (as measured by the Cognitive Therapy Scale) to reduction of depressive symptomatology when controlling for therapist adherence and facilitative conditions. The results are, however, not as strong or consistent as expected. The component of competence that was most highly related to outcome is a factor that reflects the therapists ability to structure the treatment.

The use of psychotherapy with dying patients: An exploratory study†

A group of terminally ill patients received six sessions of psychotherapy. A second group of six patients served as nontreated controls. At the conclusion of the treatment sessions, psychotherapy patients reported a significantly greater increase in death-related anxiety and in their perceived purpose in life than did the nontreated group. Clinical impressions indicated that patients who participated in psychotherapy perceived their treatment experience positively and appreciated the opportunity to explore their feelings about imminent death. These results offer considerable support for the usefulness of psychotherapy to help such patients cope with the emotional stress generated by their limited life expectancy.