Psychological Therapies for Depression By Khilan Khimasia

Based on Beck’s cognitive theory Aims to get rid of negative beliefs/dysfunctional behaviour 20 sessions over 16 week (Relatively brief) Active & directive In first session, therapist asks for background info Key Ideas

Behavioural activation (Client identifies pleasurable activities and overcomes obstacles) Graded hwk assignments (Client experiments and progresses for better rewards) Thought-catching (Records their own thoughts and challenges them when they don’t help, using techniques from therapist) Cognitive restructuring Problem solving Main content

Some studies show it’s effective in reducing symptoms of depression, mostly as medication for acute phases, and research has shown it’s better than drug therapy for treating residual symptoms Often effective with antidepressants, as a study found that recovery rates were highest with both combined Difficult to predict which clients respond well to CBT, as research is inconclusive (Although it seems to be suitable for severe and milder depression) A study found that CBT isn’t effective for people who have high stress levels in difficult life circumstances where brief therapy can’t resolve Effectiveness

Client needs to commit themselves, which can be a good thing and help motivate them and lift the depression However the effort involved may be too much for a severely depressed apathetic person It is not physically invasive so there is no difficulty of side effects/addiction On the other hand, clients may become dependent on therapist and the therapy requires cooperation of the client Difficult to get CBT due to availability, and it may take a few weeks before the effects of it show Quicker than psychoanalysis, although medication may be a better solution than both Techniques can help client for future so they can cope long term Appropriateness

Developed by Freud Bring repressed wishes and painful memories from childhood, to consciousness Client is made aware of unconscious causes for their symptoms Client works through intensive & depressive feelings to find more realistic standards for self evaluation, whilst developing more appropriate internal working models for relationships Techniques include free association, dream analysis, projective tests, whilst transference underpins the whole process (Self-directed hostility, criticism & ideas of abandonment and loss of autonomy are projected onto therapist) Therapist helps client to interpret the transference by observing similarities between patient-parent relationship and patient analyst relationship Key Ideas

Evidence that brief psychodynamic psychotherapy is effective but not appropriate for everyone Expensive, long period of time Key clinical characteristics of depression means that some clients may not last the course If client has little/no interest of the origin of their problem, it is unlikely that they will benefit from the therapy Nature of client-therapist relationship may create more dependency which would be bad Claimed that it decreases the likelihood of recovering Study shown people on waiting list were more likely to recover randomly from their symptoms, than those who were actually receiving treatment Effectiveness & appropriateness

Rate of recovery similar to those without treatment Less effective than behavioural therapies Eynsenck (1952) concluded psychoanalysis doesn’t work (However he may have been too selective in his choice of data to analyse) Bergin (1971) re-examined Eynsenck’s data and reached the conclusion that the therapy is twice as effective than having no treatment Effectiveness & appropriateness

Grunbaum (1993) suggested that any benefits of psychoanalysis are due to unintended placebo effects Client-therapist relationship is powerful, as therapist “cannot be wrong” due to any disagreements by patient being counted as symptoms of the disorder He also pointed out that early evidence of it being effective is flawed, as Freud only ever showed 12 cases of it for public scrutiny, which weren’t fully evaluated in terms of outcomes and benefits Traditional forms of psychoanalysis haven’t generally been considered as effective, although research of more modern forms (such as Interpersonal psychotherapy) have been more positive Effectiveness & appropriateness