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The Coping With Depression Course: A Group Psychoeducational Intervention for Unipolar Depression

Published online by Cambridge University Press:  06 October 2014

Gregory Clarke  and
Peter M. Lewinsohn
Gregory Clarke*
Affiliation:
Child Psychiatry Division, Oregon Health Sciences University
Peter M. Lewinsohn
Affiliation:
Oregon Research Institute
*
Child Psychiatry Clinic, OP331, Oregon Health Sciences University, 3181 S.W. Sam Jackson Park Rd, Portland OR 97201, USA
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Extract

Cognitive-behavioural interventions developed from a variety of theoretical orientations have been demonstrated to be safe and effective treatments for unipolar depression. In this article, one specific intervention is described: the Coping With Depression (CWD) Course, a multi-modal group psychoeducational treatment. The theoretical rationale and development of the CWD Course is reviewed, as well as the specific course content. Evidence for the efficacy of the CWD Course is presented and discussed. Also described are several modifications of the CWD Course, developed for use with special populations such as depressed adolescents, caretakers of frail elderly, health-impaired Native Americans, and English and Spanish-speaking medical outpatients. Future research and development directions for the CWD Course are examined, including replication of outcome results, generalization to real-life clinical settings and to diagnostically co-morbid populations, and the prevention of depression among individuals at elevated risk of affective disorder.

Type
Research Article
Information
Behaviour Change , Volume 6 , Issue 2 , June 1989 , pp. 54 - 69
Copyright
Copyright © The Author(s) 1989

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References

REFERENCES

Achenbach, T.M. (1978). The child behavior profile: I. Boys aged 6–11. Journal of Consulting and Clinical Psychology, 46, 478–488.Google Scholar
Alexander, J.F. (1973). Defensive and supportive communications in normal and deviant families. Journal of Consulting and Clinical Psychology, 40, 223–231.Google Scholar
Alexander, J.F., Barton, C., Schiavo, R.S. & Parsons, B. V. (1976). Systems-behavioral intervention with families of delinquents: Therapist characteristics, family behavior, and outcome. Journal of Consulting and Clinical Psychology, 44, 656–664.CrossRefGoogle ScholarPubMed
Amenson, C.S. & Lewinsohn, P.M. (1981). An investigation into the observed sex difference in prevalence of unipolar depression. Journal of Abnormal Psychology, 90, 1–13.Google Scholar
Antonuccio, D.O. (1988). Personal communication.Google Scholar
Antonuccio, D.O., Lewinsohn, P.M. & Steinmetz, J.L. (1982). Identification of therapist differences in a group treatment for depression. Journal of Consulting and Clinical Psychology, 50, 433–435.Google Scholar
Antonuccio, D.O., Akins, W.T., Chatham, P.M., Monagin, J.A., Tearnan, B.H. & Zeigler, B.L. (1983). An exploratory study: The psychosocial group treatment of drug-refractory unipolar depression. Journal of Behavioral therapy and Experimental Psychiatry, 15, 309–313.Google Scholar
Beardslee, W.R., Bemporad, J., Keller, M.B. & Klerman, G.L. (1983). Children of parents with affective disorder: A review. American Journal of Psychiatry, 140, 825–831.Google Scholar
Beck, A.T., Hollon, S.D., Young, J.E., Bedrosian, R.C. & Budenz, D. (1985). Treatment of depression with cognitive therapy and amitriptyline. Archives of General Psychiatry, 42, 142–148.CrossRefGoogle ScholarPubMed
Beck, A.T., Rush, A.J., Shaw, B.F. & Emery, G. (1979). Cognitive therapy of depression: A treatment manual. New York: Guilford Press.Google Scholar
Beck, A.T., Ward, G.H., Mendelson, M., Mock, J. & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.CrossRefGoogle ScholarPubMed
Bellack, A.S., Hersen, M. & Himmelhoch, J. (1981). Social skills training compared with pharmacotherapy and psychotherapy in the treatment of unipolar depression. American Journal of Psychiatry, 138(12), 1562–1567.Google ScholarPubMed
Billings, A.G. & Moos, R.H. (1985). Psychosocial stressors, coping, and depression. In Beckman, E.E. & Leber, W.R. (Eds.) Handbook of depression: Treatment, assessment, and research (pp. 940–976). Homewood, Illinois: Dorsey Press.Google Scholar
Breckenridge, J.S., Zeiss, A.M., Breckinridge, J. & Thompson, L. (1985). Behavioral group with the elderly: A psycho-educational model. In Upper, D. & Ross, S. (Eds.) Handbook of behavioral group therapy. New York: Plenum Press.Google Scholar
Brown, R. & Lewinsohn, P.M. (1984). Participant workbook for the coping with depression course. Eugene, OR: Castalia Press.Google Scholar
Brown, R. & Lewinsohn, P.M. (1984). A psychoeducational approach to the treatment of depression: Comparison of group, individual, and minimal contact procedures. Journal of Consulting and Clinical Psychology, 52, 774–783.Google Scholar
Butler, L., Miezitis, S., Friedman, R. & Cole, E. (1980). The effect of two school-based intervention programs on depressive symptoms in preadolescents. American Educational Research Journal, 17, 111–119.CrossRefGoogle Scholar
Chambers, W.J., Puig-Antich, J., Hirsch, M., Paez, P., Ambrosini, P.J., Tabrizi, M.A. & Davies, M. (1985). The assessment of affective disorders in children and adolescents by semi-structured interview: Test-retest reliability of the K-SADS-P. Archives of General Psychiatry, 42, 696–702.Google Scholar
Clarke, G.N. (1985). A psychoeducational approach to the treatment of depressed adolescents. Unpublished dissertation, University of Oregon, Eugene, OR.Google Scholar
Clarke, G.N. & Lewinsohn, P.M. (1986). Leader manual for the Adolescent Coping With Depression Course. Unpublished manuscript, Oregon Research Institute.Google Scholar
Clayton, P.J., Halikas, J.A. & Maurice, W.L. (1972). The depression of widowhood. British Journal of Psychiatry, 120, 71–78.Google Scholar
Coppell, D.B., Burton, C., Becker, J. & Fiore, J. (1985). Relationships of cognitions associated with coping reactions to depression in spousal caregivers of Alzheimer's disease patients. Cognitive Therapy and Research, 9, 253–266.CrossRefGoogle Scholar
Elkin, I., Parloff, M.B., Hadley, S.W. & Autry, J.H. (1985). NIMH Treatment of Depression Collaborative Research Program: Background and research plan. Archives of General Psychiatry, 42, 305–316.Google Scholar
Ellis, A. & Harper, R. A. (1961). A guide to rational living. Hollywood, CA: Wilshire Book.Google Scholar
Fengler, A.P. & Goodrich, N. (1979). Wives of elderly disabled men: The hidden patients. Gerontologist, 19, 175–183.Google Scholar
Frame, C., Matson, J.L., Sonis, W.A., Falkov, M.J. & Kazdin, A.E. (1982). Behavioral treatment of depression in a prepubertal child. Journal of Behavior Therapy and Experimental Psychiatry, 13, 239–243.Google Scholar
Friedman, R.C., Hurt, S.W., Clarkin, J.F., Corn, R. & Aronoff, M.S. (1983). Symptoms of depression among adolescents and young adults. Journal of Affective Disorders, 5, 37–43.Google Scholar
Gallagher, D., Lovett, S. & Zeiss, A. (in press). Interventions with caregivers of frail elderly persons. In Ory, M. & Bond, K. (Eds.), Aging and health care: Social science and policy perspectives. New York: Tavistock Publications.Google Scholar
Gallagher, D., Wrabetz, A., Lovett, S., DelMaestro, S. & Rose, J. (1988). Depression and other negative effects in family caregivers. In Light, E. & Lebowitz, B. (Eds.) Alzheimer's disease treatment and family stress: Directions for research. Washington, D.C.: U.S. Government Printing Office.Google Scholar
Goldman, L.S. & Luchins, D.J. (1984). Depression in the spouses of demented patients. American Journal of Psychiatry, 141, 1467–1468.Google Scholar
Gottman, J., Notarius, C., Gonso, J. & Markman, H. (1976). A couple's guide to communication. Champaign, IL: Research Press.Google Scholar
Hedlund, B. & Thompson, L.W. (1980). Teaching the elderly to control depression using an educational format. Paper presented at the meeting of the American Psychological Association, Montreal, Canada.Google Scholar
Hoberman, H.H. & Lewinsohn, P.M. (1985). The behavioral treatment of depression. In Beckman, E.E. & Leber, W.R. (Eds.) Handbook of depression: Treatment, assessment, and research (pp.39–81). Homewood, Illinois: Dorsey Press.Google Scholar
Hoberman, H.H., Lewinsohn, P.M. & Tilson, M. (1988). Group treatment of depression: Individual predictors of outcome. Journal of Consulting and Clinical Psychology, 56, 393–398.CrossRefGoogle ScholarPubMed
Jacobson, E. (1929). Progressive relaxation. Chicago: University of Chicago Press.Google Scholar
Kathol, R.G. (1985). Depression associated with physical disease. In Beckman, E.E. & Leber, W.R. (Eds.) Handbook of depression: Treatment, assessment, and research (pp. 745–762). Homewood, Illinois: Dorsey Press.Google Scholar
Keller, T.W. (1987). Beating the blues. Spokane County Medical Society's Medical Bulletin, Fall.Google Scholar
Lehmann, L. (1985). The relationship of depression to other DSM-III Axis I disorders. In Beckman, E.E. & Leber, W.R. (Eds.) Handbook of depression: Treatment, assessment, and research (pp. 669–699). Homewood, Illinois: Dorsey Press.Google Scholar
Lewinsohn, P.M.Antonuccio, D.O., Steinmetz, J.L. & Teri, L. (1984). The Coping with Depression course: A psychoeducational intervention for unipolar depression. Eugene, OR: Castalia Publishing.Google Scholar
Lewinsohn, P.M. & Atwood, G. (1969). Depression: A clinical-research approach. The case of Mrs. G. Psychotherapy: Theory, Research and Practice, 6, 166–171.CrossRefGoogle Scholar
Lewinsohn, P.M. & Clarke, G.N. (1986). Leader manual for the group for parents of adolescents enrolled in the Adolescent Coping With Depression course. Unpublished manuscript, Oregon Research Institute.Google Scholar
Lewinsohn, P.M., Clarke, G.N. & Hops, H. (1988). Cognitive-behavioral group treatment of depression in adolescents: Replication. Unpublished manuscript, Oregon Research Institute.Google Scholar
Lewinsohn, P.M.Clarke, G.N., Hops, H., Andrews, J & Osteen, V. (1988). Cognitive-behavioral group treatment of depression in adolescents. Unpublished manuscript, Oregon Research Institute.Google Scholar
Lewinsohn, P.M.Hoberman, H.M. & Rosenbaum, M. (1988). A perspective study of risk factors for unipolar depression. Journal of Abnormal Psychology, 97, 251–264.Google Scholar
Lewinsohn, P.M., Munoz, R.F., Youngren, M.A. & Zeiss, A.M. (1986). Control Your Depression (2nd edition). Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
Lewinsohn, P.M. & Shaffer, M. (1971). Use of home observations as an integral part of the treatment of depression: Preliminary report and case studies. Journal of Consulting and Clinical Psychology, 37, 87–94.CrossRefGoogle ScholarPubMed
Lewinsohn, P.M. & Shaw, D.A. (1969). Feedback about interpersonal behavior as an agent of behavior change: A case study in the treatment of depression. Psychotherapy and Psychosomatics, 17, 82–88.Google Scholar
Lewinsohn, P.M., Weinstein, M. & Alper, T. (1970). A behavioral approach to the group treatment of depressed persons: A methodological contribution. Journal of Clinical Psychology, 26, 525–532.Google Scholar
Lewinsohn, P.M., Weinstein, M. & Shaw, D. (1969). Depression: A clinical-research approach. In Rubin, R.D. & Frank, C.M. (Eds.), Advances in behavior therapy (pp.231–240). New York: Academic Press.Google Scholar
Lewinsohn, P.M., Youngren, M.A. & Grosscup, S.J. (1979). Reinforcement and depression. In Dupue, R.A. (Ed.), The psychobiology of depressive disorders: Implications for the effects of stress (pp. 291–316). New York: Academic Press.Google Scholar
Lovett, S. & Gallagher, D. (1988). Psychoeducational interventions for family caregivers: Preliminary efficacy data. Behavior Therapy, 19, 321–330.Google Scholar
Manson, S.M. (1988). Overview: A preventive intervention trial for older American Indians. Unpublished manuscript, University of Denver.Google Scholar
Manson, S.M., Moseley, R.M. & Brenneman, D.L. (1988). Physical illness, depression, and older American Indians: A preventive intervention trial. Unpublished manuscript, Oregon Health Sciences University.Google Scholar
McLean, P.D. & Hakstian, A.R. (1979). Clinical depression: Comparative efficacy of outpatient treatments. Journal of Clinical and Consulting Psychology, 47, 818–836.Google Scholar
McLean, P.D., Ogston, K. & Grauer, L. (1973). A behavioral approach to the treatment of depression. Journal of Behavior Therapy and Experimental Psychiatry, 4, 323–330.Google Scholar
MacPhillamy, D.J. & Lewinsohn, P.M. (1982). The pleasant events schedule: Studies on reliability, validity, and scale intercorrelation. Journal of Consulting and Clinical Psychology, 50, 363–380.Google Scholar
Maser, J.D. & Clonniger, C.R. (in press). Co-morbidity in anxiety and mood disorders. Washington, D.C.: American Psychiatric Press.Google Scholar
Munoz, R.F., Ying, Y.W., Armas, R., Chan, F. & Gurza, R. (1987). The San Francisco Depression Prevention Research Project: A randomized trial with medical outpatients. In Munoz, R.F. (Ed.), Depression prevention: Research directions (pp. 199–215). Washington, D.C: Hemisphere Press.Google Scholar
Munoz, R.F., Ying, Y.W., Bernal, G., Perez-Stable, E.J., Sorensen, J.L. & Hargreaves, W.A. (1988). The prevention of clinical depression: A randomized controlled trial. Unpublished manuscript, University of California, San Francisco.Google Scholar
Murphy, G.E., Simons, A.D., Wetzel, R.D. & Lustman, P.J. (1984). Cognitive therapy and pharmacotherapy. Archives of General Psychiatry, 41, 33–41.Google Scholar
Orvaschel, H. & Puig-Antich, J. (1986). Schedule for affective disorder and schizophrenia for school-age children. Epidemiologic version: Kiddie-SADS-E (K-SADS-E) (4th version). Technical report, Western Psychiatric Institute and Clinic, Pittsburgh, PA.Google Scholar
Paykel, E.S. (1982). Life events and early environment. In Paykel, E.S. (Ed.) Handbook of affective disorders (pp. 146–161). New York: Guilford Press.Google Scholar
Petti, T.A., Bornstein, M., Delamater, A. & Conners, C.K. (1980). Evaluation and multimodality treatment of a depressed prepubertal girl. Journal of the American Academy of Child Psychiatry, 19, 690–702.Google Scholar
Puig-Antich, J. (1982). The use of RDC criteria for major depressive disorder in children and adolescents. Journal of the American Academy of Child Psychiatry, 21, 291–293.Google Scholar
Rabins, P.R., Mace, N.L. & Lucas, M.J. (1982). The impact of dementia in the family. Journal of the Ameriçan Medical Association, 248, 333–335.Google Scholar
Radloff, L.S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 358–401.CrossRefGoogle Scholar
Rehm, L.P. (1977). A self-control model of depression. Behavior Therapy, 8, 787–804.CrossRefGoogle Scholar
Reynolds, W.M. & Coats, K.I. (1986). A comparison of cognitive-behavioral therapy and relaxation training for the treatment of depression in adolescents. Journal of Consulting and Clinical Psychology, 54, 653–660.CrossRefGoogle ScholarPubMed
Robin, A.L. (1979). Problem-solving communication training: A behavioral approach to the treatment of parent-adolescent conflict. The American Journal of Family Therapy, 7, 69–82.Google Scholar
Robin, A.L., Kent, R.N., O'Leary, K.D., Foster, S. & Prinz, R.J. (1977). An approach to teaching parents and adolescents problem-solving communication skills: A preliminary report, Behavior Therapy, 8, 639–643.Google Scholar
Robin, A.L. & Weiss, J.G. (1980). Criterion-related validity of behavioral and self-report measures of problem-solving communication skills in distressed and nondistressed parent-adolescent dyads. Behavioral Assessment, 3, 339–352.Google Scholar
Robinson, J.C. & Lewinsohn, P.M. (1973). Behavior modification of speech characteristics in a chronically depressed man. Behavior Therapy, 4, 291–295.Google Scholar
Rush, A.J., Beck, A.T., Kovacs, M. & Hollon, S.D. (1977). Comparative efficacy of cognitive therapy versus pharmacotherapy in outpatient depressives. Cognitive Therapy and Research, 1, 17–37.CrossRefGoogle Scholar
Sacco, W.P. & Beck, A.T. (1985). Cognitive therapy of depression. In Beckman, E.E. & Leber, W.R. (Eds.) Handbook of depression: Treatment, assessment, and research (pp.3–38). Homewood, Illinois: Dorsey Press.Google Scholar
Sanchez, V.C., Lewinsohn, P.M. & Larson, D.W. (1980). Assertion training: Effectiveness in the treatment of depression. Journal of Clinical Psychology, 36, 526–529.Google Scholar
Spitzer, R.L. & Endicott, J. (1978). Schedule for affective disorders and schizophrenia: Life version (SADS-L). New York: New York State Psychiatric Institute.Google Scholar
Spitzer, R.L., Endicott, J. & Robins, E. (1978). Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773–782.Google Scholar
Stark, K.D., Kaslow, N.J. & Reynolds, W.M. (1987). A comparison of the relative efficacy of self-control therapy and a behavioral problem-solving therapy for depression in children. Journal of Abnormal Child Pscyhotherapy, 15, 91–113.Google Scholar
Steinmetz, J.L., Lewinsohn, P.M. & Antonuccio, D.O. (1983). Prediction of individual outcome in a group intervention for depression. Journal of Consulting and Clinical Psychology, 51, 331–337.Google Scholar
Stoudemire, A. & Brown, J.T. (1984). Delayed and distorted grief: Pathological patterns of bereavement. Trauma, 26, 1–20.Google Scholar
Strober, M. & Carlson, G. (1982). Bipolar illness in adolescents with major depression: Clinical, genetic, and psychopharmacologic predictors in a three-to-four-year prospective follow-up investigation. Archives of General Psychiatry, 39, 549–555.Google Scholar
Teri, L. & Lewinsohn, P.M. (1985). Individual and group treatment of unipolar depression: comparison of treatment outcome and identification of predictors of successful outcome. Behaviour Therapy, 17, 215–228.Google Scholar
Thompson, L.W., Gallagher, D., Nies, G. & Epstein, D. (1983). Evaluation of the effectiveness of professionals and nonprofessionals as instructors of Coping with Depression classes for elders. Gerontologist, 23, 390–396.Google Scholar
Weissman, M.M., Klerman, G.L., Paykel, E.S., Prussoff, B.A. & Hauson, B. (1974). Treatment effects on the social adjustment of depressed patients. Archives of General Psychiatry, 30, 771–778.Google Scholar
Weissman, M.M., Prusoff, B.A., DiMascio, A., Neu, C., Goklaney, M. & Klerman, G.L. (1979). The efficacy of drugs and psychotherapy in the treatment of acute depressive episodes. American Journal of Psychiatry, 136, 555–558.Google Scholar
Weissman, M.M., Prusoff, B.A., Gammon, P.D., Merikangas, K.R., Leckman, J.F. & Kidd, K.K. (1984). Psychopathology of children (ages 6–18) of depressed and normal parents. Journal of the American Academy of Child Psychiatry, 23, 78–84.Google Scholar
York, J.L. & Calsyn, R.J. (1977). Family involvement in nursing homes. The Gerontologist, 17, 500–505.Google Scholar
Zarit, S.H., Reever, K. & Bach-Peterson, J. (1980). Relatives of the impaired elderly: Correlates of feelings of burden. The Gerontologist, 20, 649–655.Google Scholar
Zeiss, A.M., Lewinsohn, P.M. & Muñoz, R.F. (1979). Nonspecific improvement effects in depression using interpersonal, cognitive, and pleasant events focused treatments. Journal of Consulting and Clinical Psychology, 47, 427–439.Google Scholar