There is a considerable range of psychotherapy approaches which have demonstrated success in treating depression. Below is a selection of some of the most common ones in use today. Nowadays, many therapists are trained in more than one psychotherapy approach. This is commonly known as integrative psychotherapy. Integrative therapists can draw on a range of theories and techniques, which can help tackle depression symptoms from a range of different angles. The most common therapies they will be trained in are: psychodynamic , person centred and CBT see more about these below.
An experienced integrative therapist should be able to work effectively within a brief time frame and also have the skills to help you tackle more long-standing symptoms of depression. It demonstrates good success rates in treating mild to moderate depression. CBT provides some excellent exercises and tools that can help you understand depression cycles and symptoms and help you devise strategies to address them effectively.
Homework assignments are agreed upon with your therapist so you can develop your skills outside of the therapy, using specific exercises to address areas of difficulty.
However, the government have discovered that CBT is not always the best treatment for every individual and other therapies are needed to bridge this gap. Interpersonal Therapy is a relatively new therapy provided by the NHS to address the fact that CBT is not suitable for treating all cases of depression.
In essence, IPT shares many similarities to most other forms of psychotherapy such as integrative, psychodynamic and humanistic, which have been in existence for many years and also show good evidence of effectiveness with depression. Psychodynamic psychotherapy is one of the oldest of the modern therapies. It helps people understand the influence that their past has on their current emotional state as well as their actions and helps them deal with unresolved conflicts.
This type of therapy also gives people better ways to deal with challenging situations. In addition to depression, it can also help with addictions, anxiety, and eating disorders. It has a strong focus on the here and now, and it focuses on the way personal responsibility is connected to self-empowerment.
It treats depression as a chance for you to grow and develop your full potential. There is a wide range of therapies that fall under the humanistic therapy banner which include: person centred psychotherapy, transactional analysis, existential psychotherapy and gestalt psychotherapy. A trusting relationship with your psychotherapist is the key to feeling better.
If you do not feel comfortable sharing confidences after about two to three sessions, you might want to find a therapist who is a better match. Whilst it is true that therapy can be challenging at times, this is simply because you are dealing with issues which have made you feel depressed. Therefore, touching upon these is bound to bring up feelings.
However, you should not be feeling overwhelmed, over-exposed or really confused. A well matched depression psychotherapist will support you to explore important issues, at a pace that you feel in control of. You should feel safe, understood and contained and that you are growing and learning through the difficult patches. It is also important to keep in mind that some people who suffer from severe depression or bipolar disorder might not see benefits from psychotherapy alone. She was successful in her career, but constantly complained about her life and the men she was dating.
She added that all I cared about were my Mickey Mouse techniques—not her. Although it may sound uncharitable, I admit that she did frustrate me. But after two more years, Karen was still complaining bitterly and refusing homework, and was still just as angry, depressed, and lonely as ever. Eventually, she dropped out of therapy without any real improvement.
Over time, I began to see other clients like Karen in my practice, because the ones who followed my suggestions and did their between-sessions work completed therapy after a relatively short time, leaving me with more and more long-term clients who resisted the CBT techniques I was offering. I was puzzled. What was different about these clients who were fighting me so hard? What was I doing wrong? And the criteria for improvement were sometimes not that stringent. For example, a 50 percent symptom reduction would qualify, but many such individuals were, in fact, still quite depressed.
Their claim to fame was that the effects of short-term treatment with CBT, like other forms of psychotherapy, were comparable to the effects of antidepressants.
But to me this was condemnation through faint praise, because recent research by Irving Kirsch and others suggests that antidepressants are barely better than placebos, if at all. With all the creative proliferation of psychotherapies, both old and new, how could this be the case? And yet the outcome studies, as I read them, have pointed to very few impressive breakthroughs in treatment effectiveness.
But far from being discouraged by this apparent logjam, I find it full of exciting potential—because if we can identify the cause of our failure, the blind spots that prevent us from using our own tools and skills to the best advantage, we might dramatically improve our treatment outcomes.
So what if by discovering the missing link in treatment, that mysterious something that keeps us from being fully effective, we could help even more clients than we already do?
This type of research can help us understand how therapy actually works, thus leading to new and more effective treatment strategies. Jackie Persons, my former student, got me started with this in the s. Since we were both collecting data on depression severity for every person we treated at every session, we decided to pool and analyze our data using statistical modeling techniques to see what we could learn. In one study of hundreds of patients at my Philadelphia clinic, for example, therapeutic empathy, as rated by patients, seemed to have some positive causal effects on recovery from depression, but the size of the effect was small.
I also tested the effects of changes in self-defeating beliefs SDBs , like perfectionism and dependency, on recovery from depression, but once again, the results were disappointing. In two separate studies involving hundreds of people treated at my clinic in Philadelphia, homework compliance appeared to have large and robust causal effects on recovery from depression. In fact, nearly all our clients who did reasonably consistent psychotherapy homework recovered or improved substantially during the first 12 weeks of treatment; in contrast, nearly all the clients who refused to do the homework failed to improve.
Many of them got worse and dropped out of therapy. Next, I developed what I called a Willingness Scale to identify the more resistant clients at the initial evaluation, before therapy even got started. And sure enough, scores on the Willingness Scale did predict homework compliance, as well as the outcome of the treatment—and the causal effect was large.
People with high willingness scores at intake did more psychotherapy homework and recovered rapidly; those with low scores did little or no homework and improved slowly, if at all.
Based on this finding, I decided to make some radical changes in the way I practiced. See sidebar on page 24 for details and examples. And the failure to deal with client resistance might explain why so many of the controlled outcome studies show such disappointing results. The idea is to find the treatment that works the best—which sounds logical. Many therapists say that clients cling to their symptoms because of secondary gains, like support from others or disability income.
And then there are all the old psychoanalytic theories linking resistance with transference, or with the need to suppress certain kinds of erotic or aggressive drives, and so forth. In addition, they implicitly situate the therapist in the role of wise expert trying to fix a broken, dysfunctional client—not a good base for a mutually trusting therapeutic relationship.
Also, thinking about resistance this way can allow the therapist to blame the client for treatment failure. If so, then my first goal as a therapist might be to explore the many good reasons a client might have for not changing. TEAM stands for Testing, Empathy, Agenda setting paradoxical , and Methods—the four most important keys to all psychotherapy, regardless of the approach you might endorse. Eventually, he decided he wanted a divorce and left her.
Years later, even as she was telling her story to the audience, she said she still felt so humiliated and afraid that she simply wanted to run from the stage and hide. Over the years, she said, therapy sessions, no matter what their clinical orientation, usually made her feel better for a short time, but the effects never lasted, and she rarely experienced much progress. I reference the DML during therapy sessions, and encourage clients to work with it between sessions as part of their psychotherapy homework.
This idea, originating from the ancient Greek philosopher Epictetus, can be liberating. So I also had Christine record her negative thoughts on the DML and indicate how strongly she believed each one on a scale from 0 not at all to completely. Here are a few examples:. So where do we begin?
I started out by empathizing with her pain, just as I do with all my clients. Often that works, but sometimes we run into resistance, rendering all our efforts ineffective. In PAS, you bring the outcome and process resistance to conscious awareness and work to reduce them.
If you do a god job of it, the methods phase can be remarkably fast and easy. So after empathizing with Christine as she told her story, I asked her if she wanted some help beyond my listening and providing support; and if so, if this would be a good time to roll up our sleeves and get to work.
She said yes to both. Would you press that button? Like nearly all my clients, she responded to this question with an enthusiastic yes. However, I told her, I was reluctant to use those techniques. I said it was because her negative thoughts and feelings might reveal some really positive things about her, and might even be helpful to her, so maybe we should think twice before making them all disappear, lest we throw the baby out with the bathwater.
I suggested instead that we make a list of the positive aspects about her negative thoughts and feelings. But once therapists get the hang of it, their clients catch on easily too. We use cookies and other tracking technologies to improve your browsing experience on our site, show personalized content and targeted ads, analyze site traffic, and understand where our audiences come from.
To learn more or opt-out, read our Cookie Policy. Can single, minute sessions of therapy help kids struggling with depression? She could use some help from a psychological counselor: someone to teach her how to handle challenging thoughts and behaviors.
But for parents, finding that help can be an ordeal. But even those who are willing face many barriers. Treatment can be costly, and time intensive.
Typically, psychotherapy meaning talk-based therapy takes place over the course of months, and is not often covered by insurance. All of these barriers may be greater for people in minority groups, or in poverty. But only about a third of them receive any help at all. Psychotherapy — a. Three of them are now available, for free, online. Young people can try them out, and help out in evaluating the program. Schleider is just beginning to measure whether this approach is truly effective.
But a pilot study in with 96 participants showed that one minute session decreased symptoms of anxiety and depression in kids compared to kids in a control group. More follow-up is needed. Bite-sized therapy sessions may turn out to be one key way to do that. In the future, the shortage will likely be much greater. By , the US Department of Health and Human Services predicts, the number of school counselors across the country will actually drop by thousands.
Meanwhile, the demand for them is only going to rise. Overall, the HHS finds, that there could be a 10,plus mental health clinician shortage by Here are some online resources to learn more about symptoms, treatment strategies, and how to help. But even those willing and able to get to treatment are often underserved.
Many pediatric clinics have months-long waiting lists.
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