Learning cognitive behavior therapy.

BACKGROUND AND OBJECTIVES Progress toward establishing treatments for mental disorders has been good, particularly for cognitive behavior therapy (CBT). However, there is considerable room for improvement. The goal of this study was to begin the process of investigating the potential for improving treatment outcome via improving our understanding of learning processes. METHODS Individuals diagnosed with major depressive disorder (N = 20) participated in three computer-delivered CBT lessons for depression. Indices of learning were taken after each lesson, during three phone calls over the week following the lesson, and one week later. These were: (a) whether the participant thought about the lesson, (b) whether the participant applied the lesson, and (c) whether the participant generalized the lesson. Based on a predetermined list of therapy points (i.e., distinct ideas and principles), all participant responses were coded for the number of therapy points they thought about, applied, or generalized following each lesson. RESULTS Less than half of the thoughts and applications were accurate. Generalization, but not thoughts nor application, was associated with improved depression scores one week later. LIMITATIONS The follow up period was only one week later and there was no comparison group so we cannot speak to the long term outcome of these measures or generalize to other mental disorders. CONCLUSIONS These results point to the importance of improving transfer of learning in CBT and represent a promising first step toward the development of methods to study and optimize learning of CBT so as to improve patient outcomes.