Clinical Psychology

original hypothesis, no evidence for differential and
specific impact of ACT on anxiety symptoms and
IPT on depressive symptoms was obtained.
This example is a good illustration of how the
single-subject design can be used to document the

efficacy of treatment (single or combined) for a

commonly occurring clinical condition. Further,

Moras et al., using a variant of the multiple baseline

design, were able to test a hypothesis regarding the

specificity of treatment effects.

BOX4-4 Clinical Applications: The Treatment of Mixed Anxiety and Depression

Moras, Telfer, and Barlow (1993, p. 414) provided the

following description of Case 2:

The patient was a man in his mid-30s who had

three children (ranging in age from 4 to 12). He

worked full-time in a semiskilled position. His

complaints were“breaking down easy and cry-

ing a lot,”a“no care attitude,”feeling ner-

vous, and feeling like running from his job.

When asked about relationships in his life, he

said that he and his wife“seemed to be going

their own separate ways.”However, he then

quickly negated the statement by saying

that they didn’t seem to be growing apart;

rather they seemed to be closer but more

independent.

The diagnosis based on two independent

structured diagnostic interviews was co-principal

Major Depression Episode (recurrent, moderate)

5 and GAD 5.

Following are the weekly scores produced by

Case 2 on the Beck Anxiety Inventory (BAI) and Beck

Depression Inventory (BDI).

Weekly changes in Beck Anxiety Inventory (BAI; Beck, Epstein, & Brown, 1988) and Beck Depression Inventory (BDI;

Beck, Steer, & Garbin, 1988) scores for Case 2. (Ba1 = Baseline Week 1; Ba2 = Baseline Week 2; ACT = anxiety control

treatment; Asmt = assessment week; IPT = Interpersonal Psychotherapy of Depression treatment)

SOURCE: Moras, K., Telfer, L. A., & Barlow, D. H. (1993). Efficacy and specific effects data on new treatments: A case study strategy with mixed anxiety-

depression.Journal of Consulting and Clinical Psychology, 61, 412–420. Copyright © 1993 by the American Psychological Association. Reprinted with

permission.

60

50

40

30

20

10

0

Treatment Sessions

Weekly BAI & BDI Score

Ba2Ba1 1234 6 Asmt 7

ACT IPT

5 8 9 10 11 12 Asmt

BAI Score

BDI Score

Case 2

116 CHAPTER 4