Szu-Yu Chen

Graduation Semester and Year




Document Type


Degree Name

Doctor of Philosophy in Social Work


Social Work

First Advisor

Catheleen Jordan


Cognitive behavioral therapy (CBT) is among the most extensively tested psychotherapies for depression. Although its effect on depression alleviation has been widely recognized, little is known regarding its therapeutic mechanism on depression alleviation. Among empirical explanations about the mechanism of CBT, the cognitive mediation hypothesis has historically dominated the field. Although findings of prior studies support this hypothesis by showing a correlation between cognitive changes and depression changes, there is still an absence of sufficient evidence to support that patients' depression improvements are caused by their cognitive changes. In recent years, several studies further observed that patients' depression was improved before their cognition changes taking place. These studies suggested that patients' depression improvement may be due to the interplay of certain therapeutic factors and patients' psychological factors. In light of these findings, the present study attempted to explore the mechanism of CBT through examining the role of patients' problem-solving appraisal in the therapy. Because problem-solving appraisal was found by prior studies to exhibit a stress buffering relationship with depression, the present study suspected the existence of a stress moderating effect of problem-solving appraisal on depression alleviation in CBT. A two group pretest and post test design was utilized. Interestingly, findings showed that the significant correlation between depression change and problem-solving change was only found in CBT group but not in the religious therapy group, whereas the stress moderating effect of problem-solving appraisal on depression was not found in CBT group. In sum, findings suggested that instead of moderating the negative influence of stress on depression, patients' problem-solving appraisal seemed to directly correlate with depression improvement in CBT. Furthermore, the significant relationship of problem solving appraisal and depression was only found in CBT group but was not found in a non cognitive behavioral modality. As such, it can be inferred that the mechanism of problem-solving appraisal and depression alleviation exists specifically in CBT and is part of its therapeutic mechanism. Replications by future studies are called for.


Social and Behavioral Sciences | Social Work


Degree granted by The University of Texas at Arlington

Included in

Social Work Commons