Mechanisms Of Change in Psychotherapy: The Effects of Cognitive Behavioral Therapy and Psychodynamic Therapy in Once - Versus Twice - Weekly Sessions on Outcomes in Depression.

The MOP II study examines how to improve therapy for people struggling with a depressive disorder. Cognitive Behavioral Therapy (CBT) and Short-Term Psychodynamic Psychotherapy (STPP) are two evidence-based treatments for depression that are widely used. Meta-analyses indicate that CBT and STPP are one average equally effective and superior to no treatment. However, many patients do not respond sufficiently and relapse rates after acute phase treatment are high. Earlier research and theoretical insights suggest three promising strategies to enhance the effectiveness of psychotherapy. First, we want to examine whether increasing the frequency of the sessions will increase the effect of therapy. We want to compare once-weekly and twice-weekly sessions in both CBT and STPP to see whether more frequent sessions lead to better and more lasting reductions in depressive symptoms with the same total number of sessions. Second, the study aims to answer what works for whom in two different psychotherapeutic approaches. People with depression differ in personality, life experiences, relationship styles, and how they understand the causes of their depression. Previous findings suggest that patients do better when the therapy approach matches how they see their problems. The MOP II study wants to replicate this finding. Third, the study wants to examine how therapy leads to change. In CBT, improvement is thought to happen through changes in thinking patterns, such as fewer negative automatic thoughts and less rumination. In STPP, change is expected to come from better self-understanding, greater emotional awareness, and healthier ways of relating to others. Consequently, the goal of the MOP II study is to find out whether more frequent therapy, better matching of patients to treatment type, and a clearer understanding of how therapy works can lead to faster improvement of depressive symptoms.