Psychological Treatment

There are a wide range of psychological treatments for depression.

 

Some of the main ones are:

 

• Cognitive Behavior Therapy (CBT)
• Interpersonal Therapy (IPT)
• Psychotherapies
• Counseling
• Narrative Therapy

 

CBT, IPT, psychotherapy and counselling all provide either an alternative to medication or work alongside medication. As always, a thorough assessment of the person is needed in order to decide on the best set of approaches.

 

Cognitive Behaviour Therapy (CBT)

 

People suffering from depression - particularly 'non-melancholic depression' - will often have an ongoing negative view about themselves and the world around them. This negative way of thinking is often not confined to depression, but is an ongoing part of how the person thinks about life. Many or all of their experiences are distorted through a negative filter and their thinking patterns become so entrenched that they don't even notice the errors of judgement caused by thinking irrationally.

 

Cognitive behaviour therapy aims to show people how their thinking affects their mood and to teach them to think in a less negative way about life and themselves. It is based on the understanding that thinking negatively is a habit, and, like any other bad habit, it can be broken.

 

CBT is conducted by trained therapists either in one-on-one therapy sessions or in small groups. People are trained to look logically at the evidence for their negative thoughts, and to adjust the way they view the world around them. The therapist will provide 'homework' for between sessions. Between 6-10 sessions can be required but the number will vary from person to person.

 

CBT can be very beneficial for some individuals who have depression but there will be others for whom it is irrelevant.

 

Interpersonal Therapy (IPT)

 

The causes of depression, or our vulnerabilities to developing depression, can often be traced to aspects of social functioning (work, relationships, social roles) and personality .

 

Therefore, the underlying assumption with interpersonal therapy is that depression and interpersonal problems are interrelated.

 

The goal of interpersonal therapy is to help the person understand how these factors are operating in the person's current life situation to lead them to become depressed and put them at risk to future depression.

 

The therapy occurs in three main phases:

 

an evaluation of the patient's history

 

an exploration of the patient's interpersonal problem area and a contract for treatment

 

recognition and consolidation by the patient of what has been learnt and developing ways of identifying and countering depressive symptoms in the future.

 

Usually 12-16 sessions of IPT will be required.

 

Psychotherapies

 

Psychotherapy is an extended treatment (months to years) in which a relationship is built up between the therapist and the patient. The relationship is then used to explore aspects of the person's past in great depth and to show how these have led to the current depression. Understanding this link between past and present - insight - is thought to resolve the depression and make the person less vulnerable to becoming depressed again.

 

Counselling

 

Counselling encompasses a broad set of approaches and goals that are essentially aimed at helping an individual with problem solving - solving long-standing problems in the family or at work; or solving sudden major problems (crisis counselling).

 

Narrative Therapy

 

Narrative Therapy is a form of counselling based on understanding the 'stories' that people use to describe their lives. The therapist listens to how people describe their problems as stories and helps the person to consider how the stories may restrict them from overcoming their present difficulties. It sees problems as being separate from people and assists the individual to recognise the range of skills, beliefs and abilities that they already have (but may not recognise) and that they can apply to the problems in their lives.

 

Narrative Therapy differs from many therapies in that it puts a major emphasis on identifying people's strengths, particularly as they have mastered situations in the past and therefore seeks to build on their resilience rather than focus on their negatives.