The Search for Mode-Specific Effects of Cognitive and Other Therapies: A Methodological Suggestion

The hypothesis that the unique mechanism of action of cognitive therapy ( CT) for depression involves change in underlying cognitions (schema) has not been supported by empirical studies; instead, many therapies seem to produce cognitive change. Likewise, evidence fails to support the hypothesis, drawn from the cognitive theory, that change in underlying cognitions protects patients from relapse. We argue that methodological problems may explain these empirical disconfirmations of the cognitive theory. In particular, the failure to activate latent underlying cognitions before assessing them prevents investigators from adequately testing mode specific hypotheses about the mechanism of action of CT. A similar difficulty may plague tests of mode-specific hypotheses about the mechanisms of action of other therapies.