Depression-Focused Psychotherapies

Introduction

Michael E. Thase, M.D.

This research was supported in part by Grants MH-41884, MH-58397, and MH-30915 (MHCRC) from the National Institute of Mental Health. Thanks to Ms. Christine Johnson for her assistance in preparation of the manuscript for this chapter.

The term depression-focused psychotherapy was chosen for use in this volume to group together a variety of time-limited psychosocial treatments that have been studied in depression. Models of psychotherapy within this domain include various forms of behavior therapy, cognitive therapy (CT), and interpersonal psychotherapy (IPT). Each model of psychotherapy draws its name principally from the objectives of treatment. One feature that these therapies hold in common is that they neither rely on psychodynamic formulations of depressive psychopathology nor emphasize more traditional methods centering around the therapeutic relationship to guide the process of therapy. Rather, each type of therapy emphasizes the use of model-specific formulations, psychoeducation, and procedurally guided interventions to help patients learn to cope with and, it is hoped, recover from depression. Another feature in common is that each of these psychotherapies has been subjected to empirical study using the methods of randomized clinical trials. In fact, these therapies are the best-studied nonsomatic treatments of major depressive disorder.

Depression-Focused Psychotherapies Introduction Historical Overview Shared Features of Depression-Focused Psychotherapies Interpersonal Psychotherapy Behavior Therapy Cognitive Therapy Treatment Efficacy

• Interpersonal Psychotherapy
• Behavior Therapy
• Cognitive Therapy Depression-Focused Psychotherapies in the Treatment of Severe Depression: Are They Contraindicated? Conclusions

In this chapter I briefly describe the conceptual and pragmatic underpinnings for the major forms of depression-focused psychotherapy and summarize evidence concerning their efficacy in the treatment of major depressive disorder. The latter endeavor builds on and updates the comprehensive review published by the Agency for Health Care Policy and Research and the chapter in the second edition of this volume.