Title
Enthusiasm for homework and improvement of psychological distress in subthreshold depression during behavior therapy: Secondary analysis of data from a randomized controlled trial
Date Issued
25 November 2015
Access level
open access
Resource Type
research article
Author(s)
Hayasaka Y.
Furukawa T.A.
Sozu T.
Imai H.
Kawakami N.
Horikoshi M.
Kadota M.
Sasaki M.
Sekiya Y.
Hosogoshi H.
Kashimura M.
Asano K.
Terashima H.
Iwasa K.
Nagasaku M.
Fukumori T.
Niwa M.
Oe Y.
Shibata M.
Fujisato H.
Ito J.
Hirota C.
Kawasaki N.
Shinmei I.
Takagishi Y.
Yamada S.
Hattori M.
Kitagawa S.
Nakazawa K.
Shimada K.
Shimoda H.
Tsuchiya M.
Umeda M.
Yamagishi A.
Grothaus L.C.
Abstract
Background: Cognitive behavioral therapy (CBT) usually involves homework, the completion of which is a known predictor of a positive outcome. The aim of the present study was to examine the session-by-session relationships between enthusiasm to complete the homework and the improvement of psychological distress in depressed people through the course of therapy. Methods: Working people with subthreshold depression were recruited to participate in the telephone CBT (tCBT) program with demonstrated effectiveness. Their enthusiasm for homework was enhanced with motivational interviewing techniques and was measured by asking two questions: "How strongly do you feel you want to do this homework?" and "How confident do you feel you can actually accomplish this homework?" at the end of each session. The outcome was the K6 score, which was administered at the start of each session. The K6 is an index of psychological distress including depression and anxiety. We used structural equation modeling (SEM) to elucidate the relationships between enthusiasm and the K6 scores from session to session. Results: The best fitting model suggested that, throughout the course of behavior therapy (BT), enthusiasm to complete the homework was negatively correlated with the K6 scores for the subsequent session, while the K6 score measured at the beginning of the session did not influence the enthusiasm to complete the homeworks assigned for that session. Conclusions: Empirical data now support the practitioners of BT when they try to enhance their patient's enthusiasm for homework regardless of the participant's distress, which then would lead to a reduction in distress in the subsequent week.
Volume
15
Issue
1
Language
English
OCDE Knowledge area
Psiquiatría
Subjects
Scopus EID
2-s2.0-84947976375
PubMed ID
Source
BMC Psychiatry
Sponsor(s)
This study was supported in part by JSPS KAKENHI Grant number 25293150 to TAF. GENKI Project collaborators include: Principal Investigator: – Toshiaki A. Furukawa, MD, PhD, Kyoto University Graduate School of Medicine/School of Public Health, Department of Health Promotion and Human Behavior, Kyoto, Japan Co-principal Investigators: – Masaru Horikoshi, PhD, National Center of Neurology and Psychiatry, Kodaira, Japan – Norito Kawakami, MD, PhD, Department of Mental Health, University of Tokyo Graduate School of Medicine, Tokyo, Japan Project and Data Managers: – Masayo Kadota, RN, MSc, Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan – Megumi Sasaki, PhD, Center for Education and Research on the Science of Preventive Education, Naruto University of Education, Naruto, Japan Investigators: – Yuki Sekiya, MA, University of Tsukuba Graduate School of Comprehensive Human Science, Tsukuba, Japan. – Hiroki Hosogoshi, PhD, Faculty of Clinical Psychology, Kyoto Bunkyo University, Kyoto, Japan
YH, HI and MH have no competing interests to declare. TAF has received lecture fees from Eli Lilly, Meiji, Mochida, MSD, Pfizer and Tanabe-Mitsubishi, and consultancy fees from Sekisui and Takeda Science Foundation. He is diplomate of the Academy of Cognitive Therapy. He has received royalties from Igaku-Shoin, Seiwa-Shoten and Nihon Bunka Kagaku-sha. The Japanese Ministry of Education, Science, and Technology, the Japanese Ministry of Health, Labor and Welfare, and the Japan Foundation for Neuroscience and Mental Health have funded his research projects. TS reports grants from The Japanese Ministry of Education, Culture, Sports, Science and Technology, and Janssen Pharmaceutical K.K, personal fees from Tokyo University of Science, Mukogawa Women’s University, National Cardiovascular Center, Takeda Pharmaceutical Company Limited, Ono Pharmaceutical Co., LTD, Kowa Pharmaceutical Co., LTD, Toa Eiyo LTD., Sanwa Kagaku Kenkyusho Co.,LTD, Union of Japanese Scientists and Engineers, National Institute of Health Sciences, Consortium Kansai for Advanced Medical Engineering and Informatics, SKETCH Research Group, Kobe Pharmaceutical University, Ishiyaku Publishers, Inc., outside the submitted work. NK has received lecture fees from Meiji, Otsuka, EAP Consulting, Fujitsu Software Technologies, Japan Productivity Center, Occupational Health Foundation, Japan Housing Finance Agency, Aishin-Seiki, and Japan Dental Association, and consultancy fees from Sekisui Chemicals, Junpukai Health Care Center, and Osaka Chamber of Commerce and Industry. He has received royalties from Igaku-Shoin, Taishu-kan, Nanko-do, Nanzan-do, PHP Publication, and Fujitsu Software Technologies, Ltd., and research grants from The Japanese Ministry of Education, Science, and Technology, the Japanese Ministry of Health, Labor and Welfare, Fujitsu Software Technologies, Ltd., Softbank, Co., Ltd., and Japan Management Association.
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