Religious vs. Conventional Cognitive Behavioral Therapy for Major Depression in Persons With Chronic Medical Illness

Abstract

We examine the efficacy of conventional cognitive behavioral therapy (CCBT) versus religiously integrated CBT (RCBT) in persons with major depression and chronic medical illness. Participants were randomized to either CCBT (n = 67) or RCBT (n = 65). The intervention in both groups consisted of ten 50-minute sessions delivered remotely during 12 weeks (94% by telephone). Adherence to treatment was similar, except in more religious participants in whom adherence to RCBT was slightly greater (85.7% vs. 65.9%, p = 0.10). The intention-to-treat analysis at 12 weeks indicated no significant difference in outcome between the two groups (B = 0.33; SE, 1.80; p = 0.86). Response rates and remission rates were also similar. Overall religiosity interacted with treatment group (B = -0.10; SE, 0.05; p = 0.048), suggesting that RCBT was slightly more efficacious in the more religious participants. These preliminary findings suggest that CCBT and RCBT are equivalent treatments of major depression in persons with chronic medical illness. Efficacy, as well as adherence, may be affected by client religiosity.

Validation of the Persian version of the Daily Spiritual Experiences Scale (DSES) in Pregnant Women: A Proper Tool to Assess Spirituality Related to Mental Health

“…Since spiritual health has been recognized as an important component of overall health, addressing this particular component of health with interventions directed at increasing daily spiritual experiences may have a positive impact on depressive, anxiety, and other stress-related symptoms. Unfortunately, addressing SR issues in clinical practice is uncommon, despite growing research indicating that spiritually integrated interventions reduce depressive symptoms, for example, to a similar or greater degree than do conventional treatments (especially in those who are more religious) (Koenig et al 2015).…”

The Religious and Spiritual Beliefs and Practices among Practitioners across Five Helping Professions

“…Thus, it is imperative this area of diversity is acknowledged early in treatment and integrated as appropriate. For example, clients utilizing religiously-integrated therapies or relying on their religious beliefs and practices experience fewer depressive symptoms and faster recoveries (Koenig 2004;Koenig et al 2015;McCullough and Larson 1999;Wink and Scott 2005), less anxiety (Koenig 2004;Rosmarin et al 2010; Van Ness and Larson 2002), lower suicide rates (Koenig 2004;, and lower overall mortality (Li et al 2016).…”

Religious Beliefs and Their Relevance for Treatment Adherence in Mental Illness: A Review

“…Although many previous studies analyzed the effects of spirituality and religiousness on treatment outcomes in depression, only one centered around a clearly defined level of treatment adherence (Koenig et al 2015). This randomized study demonstrated that beneficial effect of patient's religiosity is independent of a religious intervention; more religious patients benefited more form the therapy, showed higher levels of treatment adherence and better treatment retention.…”

“…In this study, more religious patients presented with better adherence and had better treatment outcomes. Religiosity was shown to interact with treatment type: religiously-integrated CBT (RBCT) turned out to be slightly more effective in religious participants; also adherence to RCBT in this group was somehow better than in other study subjects (85.7% vs. 65.9%, p = 0.10) (Koenig et al 2015). Importantly, better adherence was not related to the intervention, but resulted from baseline intergroup differences in religiosity levels.…”