International Journal of Existential Positive Psychology

Effects of Religious vs. Conventional Cognitive-Behavioral Therapy on Purpose in Life in Clients with Major Depression and Chronic Medical Illness: A Randomized Clinical Trial

Noha Daher, DrPH

Epidemiology, Biostatistics, and Population Medicine, School of Public Health, Loma Linda University

Harold G. Koenig, MD

Duke University Medical Center

Michelle J. Pearce, Ph.D

School of Medicine, University of Maryland

Bruce Nelson

Department of Research, Glendale Adventist Medical Center

Sally F. Shaw, Ph.D

Department of Research, Glendale Adventist Medical Center

Lee S. Berk, DrPH

Department of Pathology and Human Anatomy, School of Medicine, Loma Linda University

Denise Bellinger, Ph.D

Department of Pathology and Human Anatomy, School of Medicine, Loma Linda University

Clive J. Robins, Ph.D

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center

Harvey J. Cohen, MD

Department of Medicine, Duke University Medical Center

Michael B. King, MD, PhD

Division of Psychiatry, Faculty of Brain Sciences, University College

Abstract

We examined the effects of religious cognitive-behavioral therapy (RCBT) compared to conventional CBT (CCBT) on purpose in life (PIL) in clients with major depression and chronic illness. Participants were randomized to either RCBT (n=65) or CCBT (n=67) to receive ten 50-min sessions over 12 weeks. PIL was measured at baseline, 12, and 24 weeks. Growth curve models examined the effects of treatment group on trajectory of change in PIL. While no significant difference was found between RCBT and CCBT on PIL trajectories in the overall sample, RCBT was more effective than CCBT on increasing PIL in clients who were highly religious (group by time interaction B=-5.87, SE=2.57, p=0.026, Cohen’s d=0.64). Furthermore, baseline religiosity correlated positively with baseline PIL (r=0.34, p<0.0001) and predicted an increase in PIL over time (B=0.23, SE=0.05, p<0.0001). RCBT does not appear to increase PIL more than CCBT, although this may depend on the religiosity of the client.

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