5 - (OP 1) Outcomes of a Formulation-driven, Integrative Cognitive-behavioral Therapy Model for Depression in Routine Clinical Practice

Objective:
Depression is clinically heterogeneous, and diagnosis alone offers limited guidance for psychotherapy delivery in routine practice. This study evaluated outcomes of a formulation-driven, integrative, and process-focused cognitive-behavioral therapy (CBT) model for patients presenting with depressive symptoms in a naturalistic outpatient setting.

Method:
Data were drawn from adult patients receiving psychotherapy at a specialized CBT clinic in Mexico. Analyses focused on patients who completed a minimum sufficient dose of therapy and had valid baseline and post-baseline outcome data. Depressive symptoms were assessed using the Beck Depression Inventory. Primary outcomes included reliable change and clinically significant recovery. Secondary outcomes assessed post-treatment global functioning (Outcome Questionnaire–45) and psychological well-being (Ryff Psychological Well-Being Scales) using conservative, clinically anchored criteria. Dose–response analyses examined early symptom change and baseline severity as predictors of recovery.

Results:
Among 53 patients included in primary analyses, 75.5% demonstrated reliable improvement in depressive symptoms, and 62.3% met criteria for clinically significant recovery. At post-treatment, 65.1% of patients demonstrated adaptive global functioning, and 36.6% met conservative criteria for adaptive psychological well-being. Outcomes followed a graded pattern, with higher rates of symptom recovery than functional recovery, and lower rates of elevated well-being.

Conclusions:
Under routine clinical conditions, a formulation-driven, integrative CBT model was associated with high rates of reliable and clinically significant improvement in depressive symptoms, accompanied by meaningful functional recovery and more conservative gains in psychological well-being. Findings support the feasibility and effectiveness of individualized, process-focused CBT approaches in real-world clinical settings and underscore the value of evaluating recovery across multiple outcome domains.