1. Heppner et al. Chap 12, 18 Hogg & Deffenbacher (1988)

2.  Design  Independent Variables  Dependent Variables

3.  Design ◦ Pre-test/post-test; experimental  Independent Variables: Categorical ◦ Group IP Treatment ◦ Group Cognitive Behavioral Trtmnt. ◦ Control Group

4.  Dependent Variables- Continuous ◦ BDI Depression ◦ MMPI-D Depression ◦ ATQ Automatic Thghts. ◦ Coopersmith SEI Self Esteem  Therapist Assessment of Client Behavior: ◦ one item assessment of each: depression, coping, anxiety, motivation to change, group participation

5. 1. Treatment Package Strategy 2. Dismantling Strategy 3. Constructive Strategy 4. Parametric Strategy (structural components) 5. Comparative Outcome Strategy 6. Client and Therapist Variation Strategy Moderation Designs

6. 1. Treatment Package Strategy 2. Dismantling Strategy 3. Constructive Strategy 4. Parametric Strategy (structural components) 5. Comparative Outcome Strategy 6. Client and Therapist Variation Strategy ( Moderation Designs )

7.  No – treatment  Placebo ??  Matched

8.  Inclusion Criteria ◦ Cng Center Clients ◦ BDI>14  Exclusion Criteria ◦ Co-morbidity ◦ Suicidal lethality ◦ In therapy ◦ Drug abuse/depend.  Internal Validity ◦ Key issue  External Validity o Key issue

9.  Specificity of Treatment  Therapist Training  Fidelity Checks

10.  Treatment Specificity ◦ CBT: emotional transactions ◦ IPT : CB techniques for daily life  Therapist Training ◦ Crossed by sex and theoretical orientation ◦ Weekly supervision; rating tapes on fidelity  Fidelity Checks: ◦ End of treatment blind raters, and ◦ Client Evaluation of Treatment

11. Main Effects Between Groups Within Groups Treatments: 1.IPT 2.Cog Beh 3.Control Trial (Time) 1.Pre-Test BDI 2.Post Test BDI Interaction: Treatment x Trial

13. BDI Pre- Treatment Post- treatment Overall Means Cognitive21.69 9.85Mean C a IPT19.71 9.43Mean IPT a Control21.0014.30Mean Control a

14. BDI Pre- Treatment Post- treatment Overall Means Cognitive21.69 9.85 IPT19.71 9.43 Control21.0014.30 Mean Pre- Treatment a Mean Post- Treatment a

15. BDI Pre- Treatment Post- Treatment Overall Means Cognitive21.69 a 9.85 a Yes IPT19.71 b 9.43 b Yes Control21.00 c 14.30 c Yes!!!???

16. a) Do clients assigned to CBT show lower BDI scores (Post-T and Pre-Test) than clients assigned to IPT or than clients assigned to control group? (regardless of Time) Treatment Effect- Repeated Measures b) Do clients who receive CBT + IPT + no treatment show lower BDI post-test scores than pre-test BDI scores? Trial Effect – Repeated Measures

17. c) In which of the three experimental groups clients showed change in depression following treatment? Treatment x Trial Interaction – Repeated Measures d) Another way: In which of the three experimental groups clients showed lower levels of depression at the end of treatment?

18. BDI Pre- Treatment Post- Treatment Cognitive21.69 9.85 IPT19.71 9.43 Control21.0014.30

19. BDI Pre- Treatment Covariate Post- Treatment Cognitive21.69 9.85 a IPT19.71 9.43 a Control21.0014.30 a

20.  Expected greater early change in ◦ IPT: Self-esteem ◦ CBT: Automatic thoughts

22.  For the three groups -- CBT, IPT, and control group-- the magnitude of the changes from assessment time to assessment time was statistically significant and indicated lower depression.  Because the effect for all groups was the same, including the no-treatment control group –findings suggests that CBT and IPT were as effective as:

23. TIME*TREATMENT INTERACTION treatment placebo Here the effect of time is NOT the same for both groups. Thus we say that there is TIME and TREATMENT interaction. (Measurement Time) MT1 MT2 PsT F1 F2 F3 Depression Level PrT