Effects of Religious Versus Conventional Cognitive-Behavioral Therapy on Generosity in Major Depression and Chronic Medical Illness: A Randomized Clinical Trial Michelle J. Pearce University of Maryland and Duke University Harold G. Koenig Duke University and King Abdulaziz University Clive J. Robins Duke University Noha Daher Loma Linda University Sally F. Shaw and Bruce Nelson Glendale Adventist Medical Center, Glendale, California Lee S. Berk Loma Linda University and Duke University Denise Bellinger Loma Linda University Harvey Jay Cohen Duke University Michael B. King University College London Generosity can be an effective coping strategy for dealing with mental and physical health problems. This study examined whether religiously-integrated cognitive behav- ioral therapy (RCBT) was more effective than conventional CBT (CCBT) on increasing generosity among religious persons with major depressive disorder (MDD) and chronic medical illness (CMI). Participants (N = 132) with MDD and CMI were randomized to receive 10 sessions of RCBT or CCBT. Assessment measures administered at baseline, 12 weeks, and 24 weeks included the Interpersonal Generosity Scale, a 29-item scale for religious involvement, and depression diagnosis and severity. Effects This article was published Online First August 10, 2015. Michelle J. Pearce, School of Medicine, University of Maryland; Department of Psychiatry and Behavioral Sci- ences, Duke University Medical Center; and Center for Spirituality, Theology, and Health, Duke University. Har- old G. Koenig, Department of Psychiatry and Behavioral Sciences and Department of Medicine, Duke University Medical Center; Center for Spirituality, Theology, and Health, Duke University; and Department of Medicine, King Abdulaziz University. Clive J. Robins, Department of Psychiatry and Behavioral Sciences and Department of Psychology and Neuroscience, Duke University Medical Center. Noha Daher, Epidemiology, Biostatistics, and Pop- ulation Medicine, School of Public Health, and Allied Health Studies, School of Allied Health Professions, Loma Linda University. Sally F. Shaw and Bruce Nelson, De- partment of Research, Glendale Adventist Medical Center, Glendale, California; Lee S. Berk, Allied Health Studies, School of Allied Health Professions, and Department of Pathology and Human Anatomy, School of Medicine, Loma Linda University; and Center for Spirituality, The- ology, and Health, Duke University. Denise Bellinger, Department of Pathology and Human Anatomy, School of Medicine, Loma Linda University. Harvey Jay Cohen, Center for Spirituality, Theology, and Health, Duke Uni- versity, and Department of Medicine, Duke University Medical Center. Michael B. King, Division of Psychiatry, Faculty of Brain Sciences, University College London. This trial is registered at ClinicalTrials.gov; unique iden- tifier, NCT01208428. The full protocol can be accessed at http://www.spiritualityandhealth.duke.edu/index.php/ religious-cbt-study/study-design. The study sponsor (John Templeton Foundation) had no role in the study design, collection or analysis of data, the interpretation of data, or in the writing of this report. Correspondence concerning this article should be ad- dressed to Michelle J. Pearce, Department of Family and Community Medicine, Center for Integrative Medicine, University of Maryland School of Medicine, 520 West Lombard Street, East Hall, Baltimore, MD 21201. E-mail: mpearce@som.umaryland.edu This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. Spirituality in Clinical Practice © 2015 American Psychological Association 2015, Vol. 2, No. 3, 202–215 2326-4500/15/$12.00 http://dx.doi.org/10.1037/scp0000076 202