VCU news

By Mike Porter

A Virginia Commonwealth University psychology and psychiatry professor’s treatment program for chronically depressed patients, adopted by many U.S. clinicians, is now being implemented worldwide.

James P. McCullough Jr., Ph.D., spent 25 years developing the Cognitive Behavioral Analysis System of Psychotherapy, or CBASP, to treat chronically depressed patients. These are individuals who have been continuously depressed for two or more years. Seventy-five percent have been depressed since mid-adolescence. When combined with medication, CBASP therapy has been shown to be 85 percent effective in treating chronic depression for patients who complete treatment.

A 2000 article in the New England Journal of Medicine reported the effectiveness of CBASP based on the results of a study of 681 chronically depressed outpatients who completed a randomized clinical trial at 12 medical sites in the United States. McCullough also published his first CBASP text in 2000, “Treatment for Chronic Depression: Cognitive Behavioral Analysis System of Psychotherapy.”

After the journal article appeared, widespread international interest in CBASP arose, McCullough said. 

McCullough has presented CBASP at lectures, seminars and workshops for psychiatry faculty and residents and psychologists at the University of Freiburg and the University of Lubeck in Germany. He was also invited to present at the Universities of Helsinki and Tampere in Finland, and McGill University in Montreal and the University of Toronto in Canada.

McCullough has also conducted workshops, seminars and lectures at the University of Tokyo, the University of Hiroshima, and the Nagoya City Medical School in Japan, and his plans include travel to Germany, Holland, Ireland, Switzerland and South Africa.

The CBASP method approaches chronic depression as a lifestyle disorder and trains patients to change basic interpersonal patterns of living. Patients also learn to recognize that the way they live affects others in highly specific ways. The psychotherapy provides them with interpersonal skills to change the destructive effects they have on others.

While psychology professionals from other countries were eager to learn CBASP, training them initially proved to be cumbersome and expensive. Last year, however, McCullough began supervising CBASP trainees using an inexpensive Internet videoconferencing technology.

One professional who benefits from the online training is Dr. Toshi Furukawa, who interacts with McCullough from Nagoya City, Japan, nearly 7,000 miles away. Furukawa is chairman of the Department of Psychiatry at Nagoya City Medical School, where he treats patients and conducts research.

“Psychotherapy is just gaining a foothold in Japan,” McCullough said. The Japanese Society of Mood Disorders held its first meeting on July 3, 2004.

While some prefer receiving their training on-line, others choose the old-fashioned way, personally attending one of McCullough’s regularly-scheduled CBASP training sessions in the Richmond area.

A group of faculty members from McGill University in Montreal trained in Richmond in March.

“We were attracted to CBASP by the studies showing its effectiveness in treating chronic depression,” said Gail Myhr, a McGill University psychiatry professor who participated in the March training session. “We came because we wanted to hear directly from the guy who created the treatment method. Everything he teaches is grounded by evidence.”

“His program has captured the essence of what we’ve believed to be true in treating chronically depressed people, but we weren’t able to put it all together in a way that works,” said Jeanne Talbot who is also a McGill University psychiatry professor.

McCullough estimates the number of chronically depressed people worldwide at 3 to 4 percent.

“My goal now is to train people who can then train others and in this way increase the number of people who can administer the methodology,” he said. In addition to increasing the number of professionals certified in delivering CBASP, McCullough also wants to find new and inexpensive video conferencing technology that will allow him to train simultaneously in multiple sites.