Early sudden gains in an acceptance and values-based intervention: Effects on treatment outcome for depression and psychological flexibility

Katariina Keinonen, Heidi Kyllönen, Piia Astikainen, & Raimo Lappalainen

The aim of this study was to explore early temporal patterns of change in a treatment delivered by novice therapists. We examined if early sudden gains (ESGs) in a six-session acceptance and values-based intervention would produce superior treatment outcomes when compared to slower improvements.

The temporal patterns of change of 56 clients diagnosed with depression were analyzed. ESGs were defined as reaching the status of recovered or improved in the Reliable Change Index (RCI) (Jacobson & Truax (1991)) classification after two sessions. The group with ESGs was then compared to participants without ESGs for differences in treatment outcome on measures of symptomatology and measures of therapeutic processes.

The results reflected significant differences between the groups in treatment outcomes. The ESG group (23.2% of participants) showed superior results both on the level of depressive symptomatology and psychological flexibility. Participants with ESGs also reported more hopefulness and less-believable depression-related thoughts after two sessions.

The results suggest that the early, clinically significant change is associated with superior treatment results both on the level of reduced symptom severity and therapeutic processes.

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