PERSON ET AL,1in their critique in this issue of the Archives of the "Practice Guideline for Major Depressive Disorder in Adults"2 by the American Psychiatric Association, raise a number of issues familiar to the members of the guideline work group from our deliberations in preparing this monograph.
Their main arguments are that we underestimated the values of verious psychotherapies in general as treatments for major depression, we underestimated the value of psychotherapy as a solo treatment in severe depression, we overestimated the value of combined psychotherapy and pharmacotherapy, and we strayed from available empirical evidence in providing guidance as to the choice of psychotherapies.
Persons and colleagues argue that we understated the value of cognitive therapy. More precisely, in our monograph we commented on cognitive behavior therapy. We relied heavily on the findings of the Treatment of Depression Collaborative Research Program,3 which we found well designed. We accurately reported the conclusions