Treatment of recurrent major depression with attention training

This study evaluated the effectiveness of Attention Training (ATT; Wells, 1990) in the treatment of recurrent major depression. This technique is based on an information processing model of emotional disorders (Wells & Matthews, 1994) in which self-focused attention and metacognition maintain dysfunction. ATT was evaluated in a consecutive single-case series of patients referred for treatment of recurrent major depression. Patients were assigned to no-treatment baselines of 3 to 5 weeks, administered five to eight weekly sessions of ATT, and followed up at 3, 6, and 12 months posttreatment. The effects of ATT on depression, anxiety, negative automatic thoughts, rumination, self-focused attention, and metacognition were assessed. Following ATT, all patients showed clinically significant reductions in depression and anxiety. Reductions in negative automatic thoughts, rumination, and attentional and metacognitive factors showed similar improvements. All scores fell within the normal range on completion of ATT. Treatment gains were maintained at the 12-month follow-up assessments. However, randomized controlled trials of ATT are required before firm conclusions can be drawn.