Whatever the therapy happens to be called, therapy for depression must incorporate the following elements:
- A therapist who has an up-to-date and accurate clinical understanding of what depression is. (You can check this by learning yourself through the Depression Learning Path.
- A therapy which is time-limited, active and focused on learning skills, not personality change.
- There should be a significant improvement in symptoms within 6 sessions, and usually earlier.
- A therapist who you feel you can work with.
There are well over 400 different types of psychotherapy on offer for clinical depression. This can be confusing to say the least.
Luckily, there has been more research into therapy for depression than any other problem, and we know exactly what works, and why.
Therapy that works for depression, and therapy that doesn’t
Well over one hundred thousand separate pieces of research have been carried out into what depression is and the most effective methods for treating it. Findings tell us that the most effective therapies for clinical depression are therapies that aim to teach skills rather than merely attempt to ‘uncover’ origins of and reasons for depression.
The most effective therapies are those that are ‘solution-focussed’ that is they seek to alleviate suffering and teach skills which can prevent future relapse.
According to the international guidelines for the treatment of clinical depression, therapy should be ‘time limited’ – that is to say if no improvements have occurred within six weeks of the start of the therapy the person should be referred on to another practitioner. The best combination for the treatment of depression is a combination of cognitive therapy, behavioral therapy and interpersonal therapy.
- Cognitive therapy looks at how we think and interpret events in our lives.
- Behavioral therapy looks at what we do.
- Interpersonal therapy looks at how we relate to others and how good our communication styles are.
These are all skills based therapies and have been shown to be effective with treating clinical depression. (If it seems difficult to believe that something that feels as awful as clinical depression can be caused by these things, do the Depression Learning Path and see how they affect your body and mind.)
So called psychoanalytical therapies or ‘psycho-dynamic’ approaches which attempt to ‘go back’ and discover reasons for things – focussing on what went wrong rather than building on resources are contraindicated for depression and several therapists in the USA have been successfully sued for using this approach for depression.
Depressed people often look back and mull over past hurts too much anyway, so common sense tells us that any therapy that extends this process is unlikely to be of lasting help. A depressed person may feel better in the short term when seeing a ‘psycho-dynamic’ therapist simply because of the support.
However, thousands of pieces of research show us that lasting symptom relief is unlikely to come from these ‘pathology-focused’ approaches.
Depressed people need hope, new skills and different ways of thinking to prevent future bouts of depression. It may be important to address issues from the past but the client has to become equipped and confident for living in the future.
This type of therapy has been said to cause ‘Paralysis by Analysis’, and will often worsen depression.
Unfortunately, many doctors, therapists and counselors are unaware of this. This may seem hard to believe, but in most countries, information travels slowly through huge health systems, and health professionals are a busy lot!
When seeking help for depression, you must be an enlightened consumer of therapy and counseling!