Topics Covered in This Depression Treatment Article:
- Electroconvulsive Therapy (ECT) and Repetitive Transcranial Magnetic Stimulation (rTMS)
- Psychotherapy, Medication or Both?
Psychotherapy for Depression Continued…
Interpersonal therapy is another short-term therapy utilized in the treatment of depression. Focus of this treatment approach is usually on an individual’s social relationships, and specifically on how to improve them. It is thought that good, stable social support is imperative to a person’s overall well-being and health within this framework. When relationships falter, a person directly suffers from the negativity and unhealthiness of that relationship. Therapy seeks to improve a person’s relationship skills, working on communication more effectively, expressing emotions appropriately, being properly assertive in social and occupational situations, etc. It is usually conducted, like cognitive-behavioral therapy, on an individual basis but can also be used within a group therapy
Most individual psychotherapy approaches, whether they are cognitive-behavioral, interpersonal, behavioral, rational-emotive, or what-not, will emphasize the importance of the client taking a pro-active approach in therapy. That is, the patient is encouraged to do daily or weekly homework assignments in-between therapy sessions which are imperative to the success of the treatment approach. Therapy is an active collaboration between therapist and client. If the client is not yet able to participate actively in therapy, then a supportive environment should be provided until medication helps energize the individual further.
Psychoanalytic or psychodynamic approaches in the treatment of depression have little research to support their use at this time. While many therapists may make use of psychodynamic theoretical constructs to help conceptualize an individual’s personality or specific case, it is likely that applied approaches in these areas are ineffective and should be avoided.
Family or couples therapy should be considered when the individual’s depression is directly affecting family dynamics or the health of significant relationship. Such therapy focuses on the interpersonal relationships shared amongst family members and seeks to ensure that communications are clear and without double (hidden) meanings. The roles played by various family members in reinforcing the depression within the patient are often examined as well. Education about depression in general can also be an important role of such therapy. 
Individuals who suffer from seasonal affective disorder, a form of depression which is related to the change of the seasons within their geographic location, may benefit from bright light phototherapy. 
Hospitalization of an individual is necessary when that person has attempted suicide or has serious suicidal ideation or plan for doing so. Such suicidal intentions must be carefully and fully assessed during an initial meeting with the client. The individual must be imminent danger of harming themselves (or another). Daily, routine daily functioning will likely be negatively affected by the presence of a clear and severe major depression. Most individuals who suffer from major depression, however, are usually only mildly suicidal and most also often lack the energy or will (at least initially) to carry out any suicidal plan.
Care must be taken with regards to any hospitalization procedure. When possible, the patient’s consent and full understanding should first be obtained and the client encouraged to check him or herself in. Hospitalization is usually relatively short, until the patient becomes fully stabilized and the therapeutic effects of an appropriate antidepressant medication can be realized (3 to 4 weeks). A partial hospitalization program should also be considered.
Suicidal ideation should be assessed during regular intervals throughout therapy (every week during the therapy session is not uncommon). Often, as the individual who suffers from a depressive disorder is beginning to feel the energizing effects of a medication, they will be at higher risk for acting on their suicidal thoughts. Care should be used at this time and hospitalization may need to be again considered.
Grohol, J. (2006). Depression Treatment. Psych Central. Retrieved on March 12, 2014, from http://psychcentral.com/lib/depression-treatment/000646
Last reviewed: By John M. Grohol, Psy.D. on 22 Jan 2014
Published on PsychCentral.com. All rights reserved.