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Psychological Therapies
for Depression
By Khilan Khimasia
Key Ideas
Based on Beck’s cognitive theory
 Aims to get rid of negative
beliefs/dysfunctional behaviour
 20 sessions over 16 week (Relatively
 Active & directive
 In first session, therapist asks for
background info
Main content
Behavioural activation (Client identifies
pleasurable activities and overcomes
 Graded hwk assignments (Client
experiments and progresses for better
 Thought-catching (Records their own
thoughts and challenges them when they
don’t help, using techniques from therapist)
 Cognitive restructuring
 Problem solving
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
 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
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
 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
Key Ideas
Developed by Freud
 Bring repressed wishes and painful memories from childhood, to
 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
Effectiveness & appropriateness
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
 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
 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
 Bergin (1971) re-examined Eynsenck’s data
and reached the conclusion that the therapy
is twice as effective than having no
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