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.

Research into the efficacy of cognitive behaviour therapy (CBT) has repeatedly demonstrated that it is a useful method for alleviating the symptoms of clinical depression. However, the underlying mechanism of the recovery process has remained a matter of debate in the literature. Although at no point in the literature has it been stated that cognitions ‘cause’ depression, this has been a strong implication in the design of many of the studies. The lack of consensus on the issue of causation is due partly to the lack of a co-ordinated approach to investigating the process of cognitive change and other variables in the depressive patient. Also the failure of many research designs to eliminate alternative hypotheses has led to confusion and debate about the direction which CBT research should take. The overall effect has limited the possibilities for an integrated model of depression. This paper looks at the various working models of depression in the literature and suggests the direction for future investigators' testing of these models.

This study involves the description of the presence or absence of several theoretically relevant skill deficits in 35 cases of depression. Until recently, most research and theory about depression has been based on the assumption that this is a homogeneous disorder with one determinant common to all incidences. Theories proposed by Beck (1967), Lewinsohn (1974), Seligman (Abramson, Seligman & Teasdale, 1978), and Rehm (1977) are examples of unitary theories. It is argued that a comprehensive account of depression must involve a multivariate theory such as that proposed by Staats and Heiby (1985). The case study involves a preliminary uncontrolled test of the hypothesis that there exist several skills deficits that may determine depression. The findings suggest support for the possibility that the following skill deficits deserve further investigation for their role in depression aetiology and treatment: logical errors including misattributions, poor self-control skills, poor social skills in terms of excessive aggression and deficit assertiveness, and inadequate hedonic capacity in terms of deficit positive interests and excessive negative interests (anhedonia). Suggestions for future research are offered.

The aim of this paper is to examine the treatment-outcome literature related to cognitive-behaviour therapy for depression in adults. Evidence for the effectiveness of cognitive-behaviour therapy is obtained from comparisons with waiting-list controls, non-specific controls, and other treatments, including pharmacotherapy. Short term effects are superior to those obtained with waitinglist controls, but are at least equivalent to pharmacotherapy. Longer term effects are difficult to evaluate due to methodological problems in such studies, particularly the lack of maintenance medication comparison groups. Nevertheless, the long term effects appear to be promising. Issues and data concerning the prediction and prevention of relapse are discussed. It is recommended that future research should focus on broader assessment goals and include cost-benefit analyses.

Cognitive theories and therapies of emotional dysfunctions are based on the premise that the affective, behavioural, and cognitive response repertoires are fused and highly interdependent. Such views have been criticised with the argument that affect and cognition are relatively independent and that there is a much more direct and stronger link between affect and behaviour. In an attempt to clarify potential differences in the interplay between affect, behaviour, and cognition in unipolar depression and phobic anxiety, a quantitative review of the relative efficacy of performance-based (behavioural) versus cognitive intervention for these disorders was conducted. The relative superiority of cognitive over performance-based interventions in the treatment of unipolar depression supports the notion of a reasonably direct link between cognition and affect for this disorder providing a fairly effective pathway for treatment. On the other hand, the relative success of performance-based techniques in the treatment of phobias suggests that for these disorders the link between behaviour and affect is more direct and much stronger than the link between cognition and affect. It is concluded that the relative effectiveness of cognitive and performance-based intervention techniques depends on and points to differences in the specific type of affect-behaviour-cognition interface that underlies and is controlling depression and phobic anxiety.