Depression

Therapy for Depression

Medical intervention is certainly not the only path. "Talk" therapy has proven to be highly effective. A variety of therapies are available and are provided by psychiatrists, psychologists, marriage and family therapists, social workers, and pastoral and mental health counselors.

Therapy has historically been thought of as a long-term process, but it is usually completed in 6-10 sessions. Surprisingly, the largest number of people come for only one session! Clients report that changes they receive from therapy peak around 10 sessions with only moderate improvements after that.

Managed Care has also had a hand in modifying the delivery of therapy, requiring therapists to provide shorter term treatment that also shows a high degree of consumer satisfaction. Several effective short-term or "brief therapy" models are available now.

The models of therapy most frequently suggested for the treatment of depression are:

Interpersonal Therapy
A short-term treatment (12 to 16 sessions) developed specifically for treating major depression. It focuses on correcting current social dysfunction rather than unconscious phenomena and on "here-and-now" factors that directly interfere with social relationships.

Cognitive Behavioral Therapy
This form of therapy states that the patient's excessive self-rejection and self-criticism causes major depression. The therapist attempts to help change these negative thoughts or "dysfunctional" attitudes. (Critics of this form of therapy argue that the depressed patient's pessimistic thoughts are a result of the depression, not a cause.)

Family Therapy
The depressed member is viewed as part of a "system" in the overall well being of the whole family. The family or system developed around the problem is the focus of this type of therapy.

Narrative Therapy
The focus in narrative therapy is less on individual pathology and concentrates on the larger socio-cultural factors that have led people into a depressed "lifestyle". This type of therapy helps people "re-author" their lives based on how they prefer to be in the world. A therapist who practices narrative therapy attends to factors such as gender inequality, poverty, racism, corporate stress, the ever-present messages that help people to feel less than worthy (as described in A Pro-Anorexic Culture), as well as the culture of perfectionism, community isolation, and lack of connection.

Solution-Oriented
In solution-oriented therapy, the focus is on what is working or going well in people's lives, and on the times they are not depressed. The therapeutic conversation builds on these problem-free moments, on what factors contribute to these moments, to help the depressed person create more of these times and expand them into other parts of their lives.