Types of Psychotherapy for Depression

Psychotherapy is often called "talk therapy" because it involves an individual and a psychotherapist sitting in a room talking. But it's much more than that. Psychotherapists are trained in a variety of techniques that they can use to help people recover from mental illness, solve personal problems, and create desired changes in their lives.

 Psychotherapy can be an effective treatment for depression because it can help you delve into the possible underlying reasons for depression and learn new coping skills. Many of the treatment modalities described below have evidence to support their benefit in treating depression.

Cognitive Therapy

At the heart of cognitive therapy is the idea that our thoughts can affect our emotions. For example, if we choose to look for the positive side in each experience, we will be more likely to feel good than if we only focus on the negative.

Negative thoughts can contribute to and exacerbate depression. It's hard to feel good when you're stuck in a constant cycle of negative thoughts. Cognitive therapy helps people learn to identify common negative thought patterns (known as cognitive distortions) and turn those negative thought patterns into more positive ones, thereby improving mood.

Cognitive therapy is usually short-term and goal-focused. The therapy sessions are structured with a specific plan for each session, and there is a "homework" practice to do outside of therapy. Cognitive therapy usually lasts between six and 18 weeks.

Behavioral Therapy

While cognitive therapy focuses on negative thoughts that contribute to depression, behavioral therapy focuses on changing behaviors that affect emotions. A common approach to the behavioral treatment of depression is behavioral activation. This involves helping patients participate in activities that will enhance their feelings of well-being.

Cognitive-Behavioral Therapy 

Because cognitive therapy and behavioral therapy work well together to help depression and anxiety disorders, the two are often combined in an approach called cognitive-behavioral therapy (CBT). CBT focuses on addressing both negative thought patterns and behaviors that contribute to depression.

 Your therapist may ask you to keep a journal to track the events of the week and any negative and counterproductive reactions to those events. Habitual negative responses to events (known as automatic negative reactions) are just one thought pattern that you can address during the course of CBT. Other common response patterns include all-or-nothing thinking and overgeneralization.

 Once you have learned to identify this type of response, you will work with your therapist to learn new thought patterns and ways to respond. You can also practice positive self-talk. Like cognitive and behavioral therapy, CBT is usually brief and goal-oriented. 

It generally involves five to 20 structured sessions focused on addressing specific concerns. CBT sessions are often accompanied by "homework," which can include journaling, practicing relaxation activities, completing readings, and using worksheets focused on specific objectives.

 Research suggests that CBT may be effective in treating depression and may have long-lasting effects that prevent future relapse of depressive symptoms.

Dialectical Behavior Therapy

Dialectical behavior therapy is a type of CBT. Its main objective is to teach people with depression the skills to cope with stress, regulate emotions and improve relationships with others. 2 This type of psychotherapy also incorporates mindfulness practices from Buddhist traditions and the use of crisis coaching, in which a person can call in the therapist for guidance on how to handle difficult situations. 

As the person practices these new skills more and more, their ability to handle these challenging situations on their own will improve. The National Alliance for Mental Health states that DBT has been shown to be effective in treating mental illnesses, including depression.

Psychodynamic Therapy

Psychodynamic therapy, also known as psychoanalytic therapy, assumes that depression can occur due to unresolved, usually unconscious conflicts that often originate in childhood. The goals of this type of therapy are to make the patient more aware of her full range of emotions, including conflicting and disturbing ones, and to help the patient to cope with these feelings more effectively and put them in a more useful perspective. 

Unlike some of the other treatment approaches for depression, psychodynamic therapy tends to be less focused and longer-term. This approach can be helpful in finding connections in past experiences and seeing how those events can contribute to feelings of depression. This approach can also be helpful in developing self-awareness and increasing certain emotional capacities.

Interpersonal Therapy 

Interpersonal conflict and poor social support can also contribute to feelings of depression. Interpersonal therapy is a type of therapy that focuses on these issues by addressing past and present social roles and interpersonal interactions. During treatment, the therapist usually chooses one or two problem areas to focus on.

 This type of therapy is usually brief and involves examining social relationships with important people in your life. This can include your relationships with your partner, friends, family, and coworkers. The goal is to identify the role these relationships play in your life and to find ways to resolve conflicts.\

Your therapist may ask you to role-play different situations to practice and improve communication. By doing this, the hope is that you can implement these strategies in your relationships and build a stronger social support system.

Psychotherapy Formats

Psychotherapy can be administered in different ways. In some cases, your treatment may incorporate two or more ways, such as meeting individually with your therapist followed by an occasional group session in which you can practice new skills. Common formats of psychotherapy include:

 Individual therapy: This modality involves individual work between the patient and the therapist. It allows the patient to have the full attention of the therapist but is limited in that it does not give the therapist the opportunity to observe the patient within social or family relationships.

 Family therapy: this approach is most useful when it is necessary to work on the dynamics within the family group. Family therapy can be especially helpful for children and teens.

 Group therapy: Group therapy usually involves three to 15 people. It offers everyone the opportunity to give and receive group support in coping with their particular problems and gives therapists the opportunity to observe how participants interact in group settings. It can also be a less expensive alternative to individual therapy. 

Couples therapy: this type of therapy is aimed at married couples and people in committed relationships who want to improve their functioning as a couple.

How to Choose a Technique and Therapist

Recommendations from others can often be the best way to find a good therapist. But in the end, it's up to you to decide whether or not the two of you click. It may be helpful to interview a new therapist and, if you feel that things are not working, try a new one.