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Sudden gains in behavioural activation for depression

Masterson, Ciara; Ekers, David; Gilbody, Simon; Richards, David; Toner-Clewes, Benjamin; McMillian, Dean

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Ciara Masterson

David Ekers

Simon Gilbody

David Richards

Benjamin Toner-Clewes

Dean McMillian


Sudden gains have been linked to improved outcomes in cognitive behaviour therapy for depression. The relationship between sudden gains and outcome is less clear in other treatment modalities, including interpersonal psychotherapy and supportive expressive therapy, which may indicate different mechanisms of change between treatment modalities. The current study examined sudden gains in adults meeting diagnostic criteria for depression (N = 40) offered up to 12 sessions of behavioural activation treatment. Sudden gains were found in 42.5% of the sample. Sudden gains occurred early (median pre-gain session 2) and were related to outcome: those who experienced a sudden gain had significantly lower post-treatment scores on the PHQ-9. Furthermore, the proportion meeting the reliable and clinically significant change criteria at end of treatment was higher in the sudden gain group. These findings highlight the importance of understanding the mechanisms by which sudden gains relate to therapy outcome in behavioural activation.

Journal Article Type Article
Acceptance Date Jun 30, 2014
Online Publication Date Jul 8, 2014
Publication Date Sep 1, 2014
Deposit Date Jul 22, 2014
Publicly Available Date Jun 15, 2018
Journal Behaviour Research and Therapy
Print ISSN 0005-7967
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 60
Pages 34-38
Public URL
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