Development of attachment-focused cognitive behavioral therapy for treatment-resistant depression

2021 Fiscal Year Final Research Report

• Project/Area Number: 18K13354
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 10030:Clinical psychology-related
• Research Institution: Keio University
• Principal Investigator: Kudo Yuka 慶應義塾大学, 医学部(信濃町), 共同研究員 (20815831)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Keywords: アタッチメント / 愛着障害 / 不適切な養育 / 治療抵抗性うつ病 / 認知行動療法 / 家族療法 / メディカルアーツ / 治療同盟

Outline of Final Research Achievements

Depression has been said that patients need to change their way of life to recover. However, about a half of depressed patients grew up in inadequate caregiving environments and it is difficult for them to change because their way of life may be their way of surviving. Principal investigator thought it is critical for patients to have attachment figures to change. Thus, we have developed therapeutic interviews which are called “Secure Base establishing Interviewing for Change". The main features of the current interview are that therapists are not neutral to the patients but completely on patients’ side. And the therapeutic interview is a two-person perspective in which therapists show their own feelings as one person. Six patients with persistent depressive disorder underwent the therapeutic interview for one and a half years. Therefore, we confirmed that the feasibility and the safety were maintained. We also conducted qualitative study and validated the contents of the interview.

Free Research Field

臨床心理学

Academic Significance and Societal Importance of the Research Achievements

うつ病において、考え方や対人関係の持ち方などの変化を促進させる心理療法は有効性が実証されているが、効果がある患者は限られている。虐待を含む「不適切な養育環境」で育った患者の多くは、信頼の問題があり、生き方の変化は容易ではない。本研究では、そのような患者が、心理療法家に対して安心して頼りにできるための心理療法の技術を開発し、変化を促進する心理療法に取り組む素地を提供する。
心理療法家と患者の信頼関係の構築は、数多くの心理療法で強調されてきたが、専門家の経験に基づく無形の技術であった。本研究では、マニュアルを開発することで技術の可視化に成功し、初学者にも学びやすいツールを開発することができた。