"Research growing out of practice"
best describes the way Dr. James P. McCullough, Jr., Professor of Psychology & Psychiatry of Virginia Commonwealth University, has conducted his over 35-year university career. During the mid-1970s, Dr. McCullough began working with chronically depressed outpatients. At that time, chronic depression was considered to be a personality disorder and not thought to be responsive to either medication or psychotherapy. Dr. McCullough developed his therapy model, Cognitive Behavioral Analysis System of Psychotherapy (CBASP), while working with chronically depressed patients. He investigated the treatment efficacy of CBASP using single-case design methodology and published the first articles on CBASP in 1980 and 1984. With the publication of the Diagnostic and Statistical Manual of Mental Disorders-Third Edition (DSM-III) in 1980, the American Psychiatric Association removed chronic depression from its personality disorder status and redefined it as a psychological disorder. Chronic depression was suddenly thrust into the mainstream of clinical treatment and research where it has remained ever since.

In addition to developing a psychotherapy method to treat the disorder, in 1980, Dr. McCullough also began a series of diagnostic investigations studying chronically depressed community adults for extended periods of time. The subjects were not receiving treatment. The aims of this research were to investigate the psychological characteristics of chronically depressed individuals over time, to try to determine when the disorder begins, and to see if the disorder would remit spontaneously over time. He found very few remissions (13%), and of those who did, over half relapsed within two years. The majority of the subjects reported an onset which began during adolescence. Dr. McCullough concluded that chronic depression is in large measure a disorder of adolescence and indeed a lifetime problem that doesn’t improve over time without adequate treatment. His diagnostic research has continued up to the present time in several national treatment studies of chronically depressed outpatients.

In the late 1980s, Dr. McCullough served as a Field Trial Site Coordinator studying dysthymia, major depression, and two minor depressions in the American Psychiatric Association’s DSM-IV revision project. He has also participated as a Principal Investigator in three national, multi-site investigations involving 2166 chronically depressed outpatients. The second study utilized CBASP alone and in combination with medication and compared both groups to a medication alone group. Patients who completed the study and who received combination treatment obtained the highest response rates (85%) ever reported in a depression study. Dr. MCullough is currently participating as a Principal Investigator in a NIMH 4-year treatment project enrolling 850 chronically depressed outpatients at 8 sites in the U.S.

Dr. McCullough has recently completed a new CBASP book, Treating Chronic Depression with Disciplined Personal Involvement: CBASP (2006), published by Springer Press. He has written three other books on CBASP, all of which have been published by Guilford Press. The books are Treatment for Chronic Depression: Cognitive Behavioral Analysis System of Psychotherapy (2000); Skills Training Manual for Diagnosing and Treating Chronic Depression: Cognitive Behavioral Analysis System of Psychotherapy (2001); and Patient’s Manual for CBASP (2003).