3 - (SYM 15) Use and Effects of Therapist Memory Support Strategies in Cognitive Behavioral Therapy and Interpersonal Psychotherapy for Depression in Routine Clinical Practice

Objective: The use of memory support strategies could help patients with major depressive disorder (MDD) to improve their memory for the content of therapy, leading to better treatment outcomes. Constructive memory support strategies prompt patients to construct new ideas. Non-constructive memory support strategies encourage the passive processing of therapy content. Our goal was to investigate the effects of therapists’ “natural use” of memory support strategies in cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for MDD. We expected more constructive memory support to be associated with better patient learning behavior, recall, change in therapy skills and less depression. Educational level and working memory were potential moderators.

Method: In the context of a multicenter randomized trial, comparing once- versus twice weekly sessions of CBT and IPT for MDD in routine clinical practice in the Netherlands, videos of therapy sessions from 75 patients during different phases of treatment (n = 68 between session 1-4, n = 59 between session 5-8, n = 56 between session 9-12) were rated on therapist use of memory support strategies and patient learning behavior.

Results: Overall dose of memory support use was low, using 2-4 strategies per session. Constructive and non-constructive memory support strategies were related to more patient learning behavior. Constructive, but not non-constructive, memory support strategies were related to reduced depression in the next session, but not to recall or change in therapy skills or depression at the end of treatment. Educational level and working memory did not moderate these effects.

Conclusions: Therapist natural use of memory support strategies can be beneficial in routine clinical practice. The present study showed that even in a low dose, constructive memory support strategies are related to patient constructive learning behavior and reduced next session depression and provides support for the pantreatment use of memory support strategies. Future studies should examine which dose and strategy is most beneficial for which therapeutic procedure and for whom.