Only absorption component of cognitive behavioral therapy effective in reducing depression

Key Takeaways

• Only absorption training made a significant difference in reducing depression symptoms.
• All other components of CBT had no significant effect on depression symptoms.

Only the absorption component of cognitive behavioral therapy significantly reduced depression symptoms, according to a study published in JAMA Psychiatry.

“In this randomized optimization trial of adults with depression, of 7 specific components, only absorption may have uniquely contributed to reduced depression at 6-month follow-up,” Edward Watkins, PhD, a professor of experimental and applied clinical psychology at the University of Exeter in the U.K., and colleagues wrote. “Given this trial’s novelty, limitations, and nonsignificant findings, we cautiously suggest that internet-delivered cognitive behavioral therapy (CBT) may reduce depression through an as-yet-undetermined combination of spontaneous remission, pan-therapy common factors, and factors common to all CBT components, although further replication is.”

Watkins and colleagues conducted a randomized optimization trial of 506 adults with depression in which participants received internet-delivered CBT. Seven experimental factors, each corresponding to a CBT component, were analyzed: activity scheduling, functional analysis, thought challenging, relaxation, concreteness training, self-compassion training and absorption training.

The researchers found no significant effect on depression symptoms for the presence vs. absence of the first six components at 6-month follow up. Only absorption training had a significant effect on depression symptoms, they wrote.

“The findings suggest that treatment benefit from internet-delivered CBT probably accrues from spontaneous remission, factors common to all CBT components and nonspecific therapy factors, with the possible exception of absorption focused on enhancing direct contact with positive reinforcers,” Watkins and colleagues wrote.