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      Comparative outcomes for individual cognitive-behavior therapy, supportive-expressive group psychotherapy, and sertraline for the treatment of depression in multiple sclerosis.

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          Abstract

          This study compared the efficacy of 3 16-week treatments for depression in 63 patients with multiple sclerosis (MS) and major depressive disorder (MDD): individual cognitive-behavioral therapy (CBT), supportive-expressive group therapy (SEG). and the antidepressant sertraline. Significant reductions were seen from pre- to posttreatment in all measures of depression. Intent-to-treat and completers analyses using the Beck Depression Inventory (BDI; A. T. Beck, C. H. Ward. M. Medelson. J. Mock, & J. Erbaugh, 1961) and MDD diagnosis found that CBT and sertraline were more effective than SEG at reducing depression. These results were largely supported by the BDI-18, which eliminates BDI items confounded with MS. However, the Hamilton Rating Scale for Depression (M. Hamilton, 1960) did not show consistent differences between treatments. Reasons for this inconsistency are discussed. These findings suggest that CBT or sertraline is more likely to be effective in treating MDD in MS compared with supportive group treatments.

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          Methods for defining and determining the clinical significance of treatment effects: description, application, and alternatives.

          This article summarizes and scrutinizes the growth of the development of clinically relevant and psychometrically sound approaches for determining the clinical significance of treatment effects in mental health research by tracing its evolution, by examining modifications in the method, and by discussing representative applications. Future directions for this methodology are proposed.
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            Normative comparisons for the evaluation of clinical significance.

            Normative comparisons are a procedure for evaluating the clinical significance of therapeutic interventions. This procedure, consisting of comparing data on treated individuals with that of normative individuals, is described, and a step-by-step statistical methodology for conducting normative comparisons in the context of treatment-outcome research is presented. Four examples of the methodology are outlined in detail. Attention is paid to potential theoretical, statistical, and methodological challenges to the implementation of normative comparisons, as well as to the advantages of normative comparisons in providing evidence for the beneficial gains of treatment.
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              Group Support for Patients With Metastatic Cancer

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                Author and article information

                Journal
                Journal of Consulting and Clinical Psychology
                Journal of Consulting and Clinical Psychology
                American Psychological Association (APA)
                1939-2117
                0022-006X
                2001
                2001
                : 69
                : 6
                : 942-949
                Article
                10.1037/0022-006X.69.6.942
                11777121
                d13ed513-e882-4c74-b56a-832d223a2890
                © 2001
                History

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