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Psychological Treatment
There are a wide range of psychological treatments for
depression.
Some of the main ones are:
CBT, IPT, psychotherapy and counselling all provide either an
alternative to medication or work alongside medication. As
always, a thorough assessment of the person is needed in order
to decide on the best set of approaches.
Cognitive Behaviour Therapy (CBT)
People suffering from depression - particularly
'non-melancholic depression' - will often have an ongoing
negative view about themselves and the world around them. This
negative way of thinking is often not confined to depression,
but is an ongoing part of how the person thinks about life.
Many or all of their experiences are distorted through a
negative filter and their thinking patterns become so
entrenched that they don't even notice the errors of judgement
caused by thinking irrationally.
Cognitive behaviour therapy aims to show people how their
thinking affects their mood and to teach them to think in a
less negative way about life and themselves. It is based on
the understanding that thinking negatively is a habit, and,
like any other bad habit, it can be broken.
CBT is conducted by trained therapists either in one-on-one
therapy sessions or in small groups. People are trained to
look logically at the evidence for their negative thoughts,
and to adjust the way they view the world around them. The
therapist will provide 'homework' for between sessions.
Between 6-10 sessions can be required but the number will vary
from person to person.
CBT can be very beneficial for some individuals who have
depression but there will be others for whom it is irrelevant.
Interpersonal Therapy (IPT)
The causes of depression, or our vulnerabilities to developing
depression, can often be traced to aspects of social
functioning (work, relationships, social roles) and
personality
.
Therefore, the underlying assumption with interpersonal
therapy is that depression and interpersonal problems are
interrelated.
The goal of interpersonal therapy is to help the person
understand how these factors are operating in the person's
current life situation to lead them to become depressed and
put them at risk to future depression.
The therapy occurs in three main phases:
-
an evaluation of the patient's history
-
an exploration of the patient's interpersonal problem area
and a contract for treatment
-
recognition and consolidation by the patient of what has
been learnt and developing ways of identifying and
countering depressive symptoms in the future.
Usually 12-16 sessions of IPT will be required.
Psychotherapies
Psychotherapy is an extended treatment (months to years) in
which a relationship is built up between the therapist and the
patient. The relationship is then used to explore aspects of
the person's past in great depth and to show how these have
led to the current depression. Understanding this link between
past and present - insight - is thought to resolve the
depression and make the person less vulnerable to becoming
depressed again.
Counselling
Counselling encompasses a broad set of approaches and goals
that are essentially aimed at helping an individual with
problem solving - solving long-standing problems in the family
or at work; or solving sudden major problems (crisis
counselling).
Narrative Therapy
Narrative Therapy is a form of counselling based on
understanding the 'stories' that people use to describe their
lives. The therapist listens to how people describe their
problems as stories and helps the person to consider how the
stories may restrict them from overcoming their present
difficulties. It sees problems as being separate from people
and assists the individual to recognise the range of skills,
beliefs and abilities that they already have (but may not
recognise) and that they can apply to the problems in their
lives.
Narrative Therapy differs from many therapies in that it puts
a major emphasis on identifying people's strengths,
particularly as they have mastered situations in the past and
therefore seeks to build on their resilience rather than focus
on their negatives.
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