Which Types of Therapy Are Best for Treating Depression?

A Close Look at a Variety of Therapeutic Modalities

Teenage girl (16-17) talking to therapist
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Psychotherapy is often called "talk therapy" because it involves a patient and a psychotherapist sitting in a room talking, but it is much more than that. Psychotherapists have training in a variety of techniques that may be employed in order to help patients to recover from mental illness, resolve personal issues, and create desired changes in their lives.

Psychotherapy can be an effective treatment for depression, because it can help you delve into the underlying reasons for your depression and learn new coping skills.

Many of the therapeutic modalities described below have evidence supporting their benefit in treating depression. Several studies suggest, however, that the combination of an antidepressant and psychotherapy is the best approach, because of the biopsychosocial origins of most mood disorders.

The Most Common Types of Psychotherapy Used for Treating Depression

Cognitive Therapy. At the heart of cognitive therapy is the idea that our thoughts can affect our emotions. For example, if we choose to look for the silver lining in every experience, we will be more likely to feel good than if we only focus upon the negative. Cognitive therapy helps patients to learn to identify common patterns of negative thinking, called cognitive distortions, and to turn those negative thought patterns into more positive ones, thus improving the patient's mood.

Behavioral Therapy. Behavioral therapy is a type of psychotherapy that focuses on changing undesired behaviors.

It uses the principles of classical and operant conditioning in order to reinforce wanted behaviors while eliminating unwanted behaviors.

Cognitive-Behavioral Therapy. Because cognitive therapy and behavioral therapy work well together to help depression and anxiety disorders, the two are often combined in an approach called cognitive-behavioral therapy (CBT).

Dialectical Behavior Therapy. Dialectical behavior therapy is a type of CBT. Its main goal is to teach the patient skills to cope with stress, regulate emotions, and improve relationships with others. Dialectical behavior therapy is derived from a philosophical process called dialectics. Dialectics is based upon the concept that everything is composed of opposites, and that change occurs when one opposing force is stronger than the other. This type of psychotherapy also incorporates mindfulness practices from Buddhist traditions.

Psychodynamic Therapy. Psychodynamic therapy is based upon the assumption that depression can occur because of unresolved—usually unconscious—conflicts, often originating from childhood. The goals of this type of therapy are for the patient to become more aware of their full range of emotions, including contradictory and troubling ones, and to help the patient more effectively bear these feelings and put them in a more useful perspective.

Interpersonal Therapy. Interpersonal therapy is a type of therapy that focuses on past and present social roles and interpersonal interactions.

During treatment, the therapist generally chooses one or two problem areas in the patient's current life to focus on. 

Various Types of Psychotherapy Formats

Individual Therapy. This modality involves one-on-one work between patient and therapist. It allows the patient to have the full attention of the therapist, but is limited in that it does not allow the therapist an opportunity to observe the patient within social or family relationships.

Family Therapy. This approach is most useful when it is necessary to work on dynamics within the family group.

Group Therapy. Group therapy generally involves anywhere from three to fifteen patients. It offers patients the opportunity to give and receive group support in coping with their particular issues, and gives therapists the chance to observe how they interact in group settings. It may also be a less expensive alternative to individual therapy.

Couple's Therapy. This type of therapy is geared toward married couples and those in committed relationships who desire to improve their functioning as a couple.

How Can You Find the Best Technique and/or Therapist for You?

Recommendations from others can often be the best way to find a good therapist but, in the end, it's up to you to decide whether or not the two of you click. It's well within your rights to "interview" a new therapist and, if you feel that things are not working, to try a new one.

Sources:

"DBT Resources: What is DBT?" Behavioral Tech, LLC. 2003. Behavioral Tech, LLC. Accessed: December 3, 2015.

Ferri, Fred F. "Depression, Major." Ferri's Clinical Adviser. Ed. Mitchell D. Feldman. 10th ed. Philadelphia: Mosby Elsevier, 2008.

"Interpersonal Therapy - An Overview." International Society for Interpersonal Psychotherapy Web Site. International Society for Interpersonal Psychotherapy. Accessed: December 3, 2015.

Jacobson, James L. and Alan M. Jacobson. Psychiatric Secrets. 2nd ed. Philadelphia, PA : Hanley & Belfus, Inc., 2001.

Pampallona S. et. al. "Combined pharmacotherapy and psychological treatment for depression: a systematic review." Archives of General Psychiatry 61.7 (2004) : 714-9.

Rupke, Stuart J., David Blecke, Marjorie Renfrow. "Cognitive Therapy for Depression." American Family Physician. 73.1 (January 2006):83-6.

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