DIMENSIONS OF COGNITIVE THERAPY FOR DEPRESSION - A CONFIRMATORY ANALYSIS OF SESSION RATINGS

Two previous studies of the dimensionality of cognitive therapy (CBT) have arrived at different structures. While one study found separate behavioral and cognitive components, the other found two different cognitive components, concrete and abstract. The main aim of the present study was to test whether either of these structures could be replicated. Ratings were made of therapist behaviors in 112 sessions of treatment using two subscales from the Collaborative Study Psychotherapy Rating Scale (CSPRS). Two principal components were extracted from the intercorrelations of the items of the cognitive therapy subscale and rotated to maximum congruence with targets based on the previous solutions. The significance of the fit was evaluated by rotating the same matrix of loadings to 5,000 random permutations of each target. The fit to the model consisting of behavioral and cognitive components was highly significant but the model with two kinds of cognitive component could not be confirmed. An additional exploratory analysis, which included the Facilitative Conditions subscale of the CSPRS, revealed a third component reflecting collaborative structure. The identification of a replicable structure is offered as an aid to the discovery of the crucial ingredients of CBT.