Behaviour Change

Standard Papers

Cognitive Behavioural Analysis System of Psychotherapy for Treatment-Resistant Depression: Adaptation to a Group Modality

Liliane Sayegha1 c1, Kenneth D. Lockea2, Daniele Pistillia1, J. Kim Penberthya3, Eduardo Chachamovicha1, James P. McCullough Jr.a4 and Gustavo Tureckia5

a1 Douglas Mental Health University Institute, Canada

a2 Department of Psychology and Communication Studies, University of Idaho, USA

a3 Department of Psychiatry & Neurobehavioral Sciences, University of Virginia, USA

a4 Department of Psychology, Virginia Commonwealth University, USA

a5 Department of Psychiatry, McGill University, Canada


Studies researching psychotherapeutic interventions for treatment-resistant depression (TRD) are quite new to the field. The Cognitive Behavioural Analysis System of Psychotherapy (CBASP) is the only model developed specifically to treat the chronically depressed patient. While empirical evidence indicates that CBASP is an effective treatment for chronic depression, little is known about its adaptation to a group modality. Treating these patients in a group approach would have the added benefits of being cost-effective and providing in vivo previously avoided interpersonal situations for practising social skills and role-plays. This single arm study asks whether CBASP adapted to a group modality can be effective. All patients received 12 CBASP group therapy sessions with two to four individual preparatory sessions before the group. Our results suggest that CBASP group treatment demonstrated positive effects on patient outcomes. Specifically, patients showed significant decreases in symptoms of depression and the use of emotion-oriented coping, as well as increases in overall social adjustment and interpersonal self-efficacy when compared to pretreatment levels. However, patients did not achieve normative levels in these areas by the end of treatment. These pilot results are encouraging and support further study of the effectiveness of CBASP group treatment with a control group.


  • TRD;
  • depression;
  • cognitive;
  • group;
  • therapy


c1 Address for correspondence: Liliane Sayegh, Psychologist, Depressive Disorders Program, Douglas Mental Health University Institute, 6875 Boul. LaSalle Montréal, Qc, Canada, H4H 13R. Email: