Does Therapy Help With Clinical Depression? Quality Of Life, Society

The person might say, “Well, I have clinical depression. We have tried therapy many times, but no result”. Life experience is an important thing to consider when choosing a treatment option. But it is equally important to refer to research results

Can psychotherapy be used to treat serious mental illness, including clinical depression or obsessive-compulsive disorder (OCD)?

The last meta-analysis on this topic was only done last year (Cuijpers, 2017). This analysis begins by saying that "since the 1970s, about 500 randomized controlled trials have examined the effects of psychological therapies on depression." This is a lot. I would dare to say that this is one of the most studied topics in clinical psychology.

Cuijpers and colleagues at the University of Amsterdam have been researching this topic for over a decade, compiling and updating a database of every study on the effects of psychotherapy on a person with depression. They found that the following types of psychotherapy have at least 10 successful control groups:

• cognitive behavioral therapy (CBT) (94 studies),
• behavioral activation therapy (31 studies),
• interpersonal psychotherapy (IPT) (31 studies),
• substandard maintenance therapy (18 studies),
• short-term psychodynamic psychotherapy (10 studies),
• existential-humanistic psychotherapy (10 studies).

Psychotherapy versus drug treatment for depression

How about when you compare psychotherapy with antidepressant medication? Researchers answer:

Our meta-analyzes of trials directly comparing psychotherapy and pharmacotherapy for depression show that there is no significant difference between the two types of treatment

In simple terms, both types of treatments are effective for clinical depression.

Long-term results

“While psychotherapy and pharmacotherapy are likely to be approximately equally effective in the short term,” the researchers note, “it is clear that a combination of the two is more effective than either alone. Combined treatment is significantly more effective than pharmacotherapy alone."

Sometimes critics of psychotherapy argue that most of the research done on therapy and depression is only about "mild anxiety" or mild depression. However, such criticism ignores the evidence.

“We have shown that, contrary to the opinion of many clinicians, the severity of the baseline of the disorder is not a significant predictor of outcome, and CBT or any of the methods on the list is effective for severe depression (Weitz et al., 2015).

We also found that there was no difference in effects between psychotherapy and pharmacotherapy in patients with melancholic depression or atypical depression (Cuijpers et al., Press).”

Other studies confirm that psychotherapy works not only for "mild" depression, but also for severe depression.

Psychotherapy is effective for OCD

People with obsessive-compulsive disorder (OCD) wait an average of 10 years before starting treatment (Pozza & Dettore, 2017). The disorder is characterized by obsessive thoughts or impulses and repetitive behaviors.

A study using randomized groups showed that individualized therapy, including exposure and response prevention (ERP *) and / or cognitive restructuring (CR), resulted in improvement in symptoms in about 70% of patients treated.

* ERP is the most studied and effective treatment for OCD according to McKay et al., 2015.

None of this means that psychotherapy works the same for all people, all the time, and with every therapist.

We don't yet have a great algorithm for predicting success in therapy and answering the question of why some people get more out of it than others.

Over time, I hope such algorithms will become available. This will help patients find a therapist who will be most effective with them in their condition. Until then, please understand that while this is not an ideal process, it is very effective.

Recommendations and sources:

• Aherne D., Fitzgerald A., Aherne C., Fitzgerald N., Slattery M., Whelan N. Evidence for the treatment of moderate depression: A systematic review // Irish Journal of Psychological Medicine. 2017.34 (3). 197-204.
• Cuijpers P. Four decades of outcome research on psychotherapies for adult depression: An overview of a series of meta-analyzes // Canadian Psychology / Psychologie canadienne. 2017.58 (1). 7-19.
• Foa EB, Liebowitz MR, Kozak MJ, Davies S., Campeas R., Franklin ME, Huppert JD, Kjernisted K., Rowan V., Schmidt AB, Simpson HB, Tu X. Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive-compulsive disorder // Am. J. Psychiatry. 2005.162.151-161.
• McKay D., Sookman D., Neziroglu F., Wilhelm S., Stein DJ, Kyrios M., Veale D. Efficacy of cognitive-behavioral therapy for obsessive-compulsive disorder // Psychiatry Res. 2015.225.236–246.
• Olatunji BO, Williams ML, Powers MB, Smits JAJ Cognitive behavioral therapy for obsessive-compulsive disorder: a meta-analysis of treatment outcome and moderators // J. Clin. Psychiatry. 2013. 47. 33–41.

Based on the article: psychcentral.com/blog/psychotherapy-myths-therapy-cant-treat-serious-mental-illness/

Author: John M. Grohol, Psy. D.

Read also:

• The sad triad of depression. When do you need medical attention?
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• Depression already or not yet? And how to be with her