Evaluation of Rumination-Focused Cognitive Behavior Therapy efficacy on reducing rumination, depressive symptoms and improving problem solving strategies

Rumination is a common residual symptom of depression which plays an important role in onset and permanence of depressive episodes. The aim of this study is to evaluate the efficacy of Rumination-Focused cognitive behavior therapy on decreasing rumination habit, depressive symptoms and improving problem solving strategies.

The research method was single-subject with multiple baseline and repetitive evaluation design. Seven participants (4 women and 3 men-one woman as pilot participant) meeting the including criteria, took part in 12, 60 minute therapy sessions. Depression, rumination and problem solving strategies were measured by BDI-II, Response Style Questionnaire (RSQ) and Cassidy and Long’s problem-solving Scale, before first session, during therapy sessions and after last one. Treatment specifically focused on switching patients from less helpful to more helpful styles of thinking through the use of functional analysis, experiential/imagery exercises and behavioral experiments.

Treatment produced significant improvements in depressive symptoms and rumination: Nearly % 71/43 of the sample showed % 50/6 reduction in RSQ and % 51/6 reduction in BDI-II. The improvement was sustained in one month fallow up. The sample’s scores in orienting strategy of Cassidy and Long’s problem-solving Scale showed some increasement. After treatment, participants did not fulfill criteria for Major Depressive Disorder.

Treating depressive rumination appears to yield generalized improvement in depression and co-morbidity. This study provides preliminary evidence that rumination-focused CBT may be an efficacious treatment for medication-refractory residual depression.