Chapter 9. Combining Cognitive-Behavioral Therapy With Medication

Edward S. Friedman, M.D.; Michael E. Thase, M.D.
DOI: 10.1176/appi.books.9781585623648.369567



Although it may seem intuitively correct to routinely combine cognitive-behavioral therapy (CBT) and medications for treatment of a wide range of disorders, the advantage of this therapeutic approach is not strongly supported by the results of randomized controlled trials (RCTs). In this chapter we briefly review the issue of combining medications and CBT in the major categories of psychiatric disorders: schizophrenia, anxiety disorders, and mood disorders. Because of the dearth of data on the combination of medication and CBT in the treatment of schizophrenia and the anxiety disorders, we focus on the mood disorders. We also examine the methodological problems inherent in combination treatment studies and, using the example of major depressive disorder, present another model to better understand the effects of combining CBT and medication therapy.

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Table Reference Number
Table 9–1. Cognitive-Behavioral Analysis System of Psychotherapy (CBASP) treatment modifications for chronic depression
Table Reference Number
Table 9–2. Meta-analysis of response to pharmacotherapy alone versus combination therapy with cognitive-behavioral therapy and pharmacotherapy in randomized controlled trials for major depressive disorder
Table Reference Number
Table 9–3. Methods for combining cognitive-behavioral therapy (CBT) with antidepressant medication


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