Comparing the Effects of Rumination-Focused Cognitive-Behavioral Therapy and Classic Cognitive Behavioral Therapy on Rumination and Depression Symptoms

Depression is among the most prevalent mental disorders, i.e., related to rumination. Moreover, it affects 20% of women and 10% of men in their lifetimes. It is a frequent mental health problem that causes decreased mood, loss of interest or pleasure, feelings of guilt or low self–esteem, disturbed sleep or appetite, decreased energy, and poor concentration. The etiology of depression is not entirely understood. Numerous mental health professionals consider rumination as the hallmark of depression; it can predict the duration of depressive symptoms. Rumination is defined as a mode of responding to distress that involves repetitively and passively, focusing on symptoms of distress. There are sufficient reasons to choose rumination as a primary therapeutic target. Depressed patients report elevated levels of rumination, compared to those who have never been depressed. Despite the high frequency of all depression types, we still face a significant treatment gap. Most individuals with depression fail to receive treatment; about one–third of those who do receive treatment fail to respond to the current therapeutic approaches. Rumination–Focused Cognitive–Behavioral Therapy (RFCBT) and classic Cognitive Behavioral Therapy (CBT) are the two psychotherapy approaches used in depression management. RFCBT is an extended and practical form of CBT, i.e., applicable to depressed individuals. This treatment method helps patients to develop effective alternatives to habitual and dysfunctional ruminative patterns. Besides, it assists them in becoming more concrete and action–oriented toward problem–solving strategies, instead of fostering an abstract and passive attitude. CBT is empirically–validated psychotherapy, i.e., recommended as a first–line treatment for depression. CBT is a structured, short–term, and present–oriented approach to psychotherapy that helps patients modify inefficient patterns of thinking and behavior to resolve current problems. The current study aimed to compare the effects of RFCBT and classic CBT on rumination and depression symptoms.

This study was a quasi–experimental study with a pretest–posttest, follow–up, and a control group design. The statistical population of the study comprised all females with depressive disorder referring to counseling centers in Dezful City, Iran, in 2018.  Of them, 24 subjects with depression were selected by purposive sampling method using a structured clinical interview. Then, they were randomly assigned into two experimental groups (RFCBT & classic CBT) and a control group. Each group included 12 participants. The interventions included 12 sessions for each test group. The research tools included the Beck Depression Inventory–Second Edition (BDI–II) and the Rumination–Reflection Questionnaire (RRQ). These tools were completed by the study participants in the pretest, posttest, and follow–up stages. These scales’ validity and reliability have been confirmed in previous studies. The analysis of data was accomplished at two levels. In the descriptive level, mean and standard deviation were used, and in inferential level, mixed analysis of variance was used in SPSS. p<0.01 was considered statistically significant.

The obtained data suggested that both treatment interventions (RFCBT & classic CBT) effectively reduced rumination and depression symptoms in the studied samples (p<0.001). Moreover, there was no significant difference between the two groups in different time series.

According to the present study results, RFCBT and classic CBT could be used as efficient approaches to reduce rumination and depression symptoms.