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Every individual responds to therapy in their own way. Some people have sudden enlightenments during therapy, while others see a gradual reduction in symptoms little by little between their therapy sessions. These reductions in symptom severity are called sudden gains and are common among people receiving treatment for depression and anxiety. Previous research has shown that one of the biggest benefits of sudden gains is the residual effect they have. “Individuals who experienced sudden gains reported lower levels of depressive symptoms at post-treatment, 6 months following treatment and 18 months following treatment, compared with individuals who did not experience sudden gains,” said Idan M. Aderka of the Department of Psychology at Boston University, and lead author of a recent analysis of sudden gains. “These findings suggested that sudden gains were related to better treatment outcome at termination and at follow-up.”

Sudden gains are believed to be the result of cognitive changes achieved during cognitive behavioral therapy and other methods. “Importantly, in supportive-expressive therapy, cognitive changes were unrelated to sudden gains, but greater therapist interpretation accuracy was found to precede the gains,” said Aderka. “Sudden gains during the course of psychological treatment have been documented across diverse populations and interventions, and have been associated with better treatment outcome.”

After reviewing 16 studies that contained data from over 1,100 individuals being treated for anxiety or depression, Aderka found that sudden gains were achieved more often by those in cognitive therapy than those who were receiving other forms of treatment. Additionally, the sudden gains provided long-term benefits,that lasted after the treatment ended. “This suggests that the reason for the differences in effects may lie not in the gains themselves but rather in their influence on further improvements made in treatment,” said Aderka. He noted that these gains often lead to a positive cycle of behavior, called an upward spiral. “A possible explanation for our findings is that upward spirals occur in CBT interventions more than they occur in non-CBT interventions.” Aderka added, “Our findings suggest that CBT interventions may be especially successful in capitalizing on sudden gains and creating subsequent positive upward spirals.”

Aderka, I. M., Nickerson, A., Bøe, H. J., & Hofmann, S. G. (2011, November 28). Sudden Gains During Psychological Treatments of Anxiety and Depression: A Meta-Analysis. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0026455


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