Cruwys et a 217 individual-focused interventions-including social skills This section has outlined evidence that compromised training,assertivenes sor conflict resolution training.and social conn ness can precipitate,characterize,and main socia are linical depressio h ial rim,2000:ysa Kashdan.2009:Trivedi et al.2005) ceptualized and measured social connectedness.It is clea Although such inte entions are incr asingly pres for example,that an abundance of terms are used within the (Lewinsohn Clarke, currently,there is no relat the phenomena that we have collectively shins that might allow treating professionals to address these These include social supp ort (Cohen Wills 1985) cemns in a consistent and theoretically informed way loneliness(Cacioppo etal,26),social capital (Putnam only a han ful of studies directly me 、soc1 al net rks (F hrista i,2008) an oc nging (Ba ister itis unelear whether CBT might be enhanced through suring a person's living situation.their number of clo greater focus on social connectedness, or indeed,to wha friends,their employment status,their formal membership of such as mmunity and the in anhat the h about (Collins Do ig3008 ,Auerbach.Derubeis.01) Smith.&Layt tion.a wide variety of formal scales have been used to mea arly,it is unc whether the ett 1y group CBT sure the subjective quality of social exper such CRT of depre the nts of the treatn absence of a unifying frar ork or model that migh researchers have reported that patients atribute much of th lend coherence to the analysis of social connectedness in 9824 ers have rec epre the critical relat T Weissman Research Question 1(RQ1):How should social con- witz speaks R h o tion 2 RO2)Why and how does he outcor in at le of four int affect de that is the mecha role disputes. role transitions or inter nism of action)? Klerman, that Research Question3(RQ3):What types of socialco a in treating 100 addressing social factors in de it doe offer ally derived n del of social relationships in depres- It is with a view to providing a coherent and integrated erbal t was ed as a co e questions n th we the tha ive Res thnthe field of social psychology 1995),it is relatively weak in terms of theory.It espouse nedical "symptom' model of depressic and the goals o The Social Identity Approach re to symptoms ch (SIA)en saville Ch 1984.Weissma n et al.2000).Yet izatio IPT focuses on individual ties rather than group member- theory (Tumer.Hogg.Oakes.Reicher.Wetherell.1987 and no social factors are theorized o routinely mor r,Oakes,Haslam,McGarty,1994).O althoug ope to explanatory model that might account for the central role of 970).the a dominant social-psychological model of groun processe symptomatology,and that has been influential in the study of social and organiza effective tr s10n. ective action (e.g.,see 30 Cruwys et al. 217 individual-focused interventions—including social skills training, assertiveness or conflict resolution training, and increased social activity—are variously recommended as adjuncts to standard treatment (Nilsen, Karevold, Røysamb, Gustavson, & Mathiesen, 2012; Segrin, 2000; Steger & Kashdan, 2009; Trivedi et al., 2005). Although such interventions are increasingly prescribed (Lewinsohn & Clarke, 1999), currently, there is no coherent framework to understand these changes to social relation￾ships that might allow treating professionals to address these concerns in a consistent and theoretically informed way. Furthermore, only a handful of studies have directly mea￾sured social functioning in relation to CBT for depression (e.g., Evans & Connis, 1995; Luk et al., 1991). Consequently, it is unclear whether CBT might be enhanced through a greater focus on social connectedness, or indeed, to what extent the success of strategies such as behavioral activation is in any sense attributable to the improvements in connect￾edness that they may bring about (Collins & Dozois, 2008; Cuijpers et al., 2007; Webb, Auerbach, & Derubeis, 2012). Similarly, it is unclear whether the efficacy of group CBT (which is just as effective in the treatment of depression as individual CBT, see Oei & Dingle, 2008) is attributable to the social components of the treatment. Nevertheless, researchers have reported that patients attribute much of their improvement to group factors (Covi, Roth, & Lipman, 1982). Another key intervention for depression that has proven efficacy is interpersonal psychotherapy (IPT; Elkin et al., 1995). This approach places more emphasis on the critical role of social relationships than CBT (Weissman & Markowitz, 1994) and therefore speaks more directly to the evidence reviewed above. IPT proposes that depression is the outcome of problems in at least one of four interpersonal domains: grief, role disputes, role transitions, or interper￾sonal deficits (Weissman, Markowitz, & Klerman, 2000). However, we argue that although the efficacy of IPT (Weissman & Markowitz, 1994) speaks to the importance of addressing social factors in depression, it does not offer a theoretically derived model of social relationships in depres￾sion. In fact, because IPT was originally developed as a con￾trol verbal therapy condition for CBT in the Treatment of Depression Collaborative Research Project (Elkin et al., 1995), it is relatively weak in terms of theory. It espouses a medical “symptom” model of depression, and the goals of therapy are to alleviate symptoms and improve the social functioning of the individual (Klerman, Weissman, Rounsaville, & Chevron, 1984; Weissman et al., 2000). Yet, IPT focuses on individual ties rather than group member￾ships, and no social factors are theorized or routinely moni￾tored to show treatment outcome. Therefore, although IPT orients treatment toward social factors, it does not provide an explanatory model that might account for the central role of social relationships in the etiology, symptomatology, and effective treatment of depression. Below, we expand on what such a model might look like. This section has outlined evidence that compromised social connectedness can precipitate, characterize, and main￾tain clinical depression. The fact that the literature has con￾sistently found these effects is all the more surprising in light of the many different ways in which researchers have con￾ceptualized and measured social connectedness. It is clear, for example, that an abundance of terms are used within the literature to capture the phenomena that we have collectively referred to as “social connectedness” or “social relation￾ships.” These include social support (Cohen & Wills, 1985), loneliness (Cacioppo et al., 2006), social capital (Putnam, 2001), social networks (Fowler & Christakis, 2008), and belonging (Baumeister & Leary, 1995). Moreover, these constructs have been operationalized in ways as diverse as measuring a person’s living situation, their number of close friends, their employment status, their formal membership of community groups, and the frequency and intensity of their contact with family (Berry & Welsh, 2010; Holt-Lunstad, Smith, & Layton, 2010; Kikuchi & Coleman, 2012). In addi￾tion, a wide variety of formal scales have been used to mea￾sure the subjective quality of social experiences such as perceived support (Harpham, Grant, & Thomas, 2002; Heitzmann & Kaplan, 1988). This diversity in turn speaks to the absence of a unifying framework or model that might lend coherence to the analysis of social connectedness in depression. Indeed, although many researchers have recog￾nized the importance of this relationship, it is apparent that there has been little agreement regarding three central issues: Research Question 1 (RQ1): How should social con￾nectedness be measured? Research Question 2 (RQ2): Why and how does social connectedness affect depression (i.e., what is the mecha￾nism of action)? Research Question 3 (RQ3): What types of social con￾nectedness are likely to be the most beneficial in treating (or reducing the likelihood of) depression? It is with a view to providing a coherent and integrated answer to these questions that, in the following section, we outline a body of theory that has addressed similar issues within the field of social psychology. The Social Identity Approach The Social Identity Approach (SIA) encompasses both social identity theory (Tajfel & Turner, 1979) and self-categorization theory (Turner, Hogg, Oakes, Reicher, & Wetherell, 1987; Turner, Oakes, Haslam, & McGarty, 1994). Originally devel￾oped to explain intergroup phenomena, particularly discrimi￾nation and prejudice (Tajfel, 1970), the approach has become a dominant social-psychological model of group processes that has been influential in the study of social and organiza￾tional topics as diverse as leadership, communication, motiva￾tion, and collective action (e.g., see S. A. Haslam, Ellemers, Downloaded from psr.sagepub.com at Remen University of China on September 6, 2015