Use and Effects of Therapist Memory Support Strategies in Cognitive Behavioral Therapy and Interpersonal Psychotherapy for Depression

Purpose: The use of memory support strategies could help patients with major depressive disorder (MDD) to improve their memory for the content of therapy, leading to better treatment outcomes. Constructive memory support strategies prompt patients to construct new ideas. Non-constructive memory support strategies encourage the passive processing of therapy content. Building on previous work in a university setting, our goal was to investigate the effects of therapists’ natural use of memory support strategies in cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for MDD in routine clinical practice. Methods: In the context of a multicenter randomized trial, comparing once- versus twice weekly sessions of CBT and IPT for MDD in routine clinical practice, videos of therapy sessions from 75 patients during different phases of treatment (n = 67 between session 1–4, n = 59 between session 5–8, n = 56 between session 9–12) were rated on therapist use of memory support strategies and how the patient responded to the information given by the therapist (patient learning behavior). Hypotheses were investigated with mixed models. Results: Memory support strategies were related to more patient learning behavior. Constructive memory support strategies were related to reduced depression in the next session, but not to recall or change in therapy skills or depression at the end of treatment. Conclusions: Memory support strategies might be beneficial in routine clinical practice in increasing patient learning behavior and reducing next session depression. Future studies should find out which strategy works for whom and whether a higher dose leads to change in depression over treatment.