An Investigation of the Phase Model of Psychotherapy Across Therapeutic Orientations: Are Different Approaches Actually All That Different?

The current study investigated the process of change underlying two different evidence-based treatments that yield similar outcome effectiveness in the treatment of depression: Cognitive Therapy (CT) and Interpersonal Therapy (IPT). The phase model of psychotherapeutic change (Howard et al., 1993) change is used to provide both a theoretical and practical framework in which to assess different patterns of change across the treatment modalities. The phase model posits that recovery from distress occurs in three sequential stages: remoralization, remediation and rehabilitation. CT can be conceptualized as a treatment in which the primary focus is on the treatment of symptoms (remediation), whereas IPT can typically be conceptualized as focusing on interpersonal conflicts and functioning (rehabilitation). The study utilized the TDCRP dataset (Elkin et al., 1985). Survival analysis indicated no significant difference in terms of onset or pattern of improvement across treatment orientations. Chi square analyses indicated individuals treated with IPT spend significantly more time engaged in rehabilitation compared to their CT counterparts. Taken together, these findings represent evidence that the process of therapeutic change is similar, if not virtually identical, across therapeutic orientation. The analyses also indicate that the phases of therapy may not necessarily be mutually exclusive and sequential, but may instead represent co-occurring patterns of improvement which are not sequentially determined