Which Therapy is Best for Depression?

Several different treatment modalities are used to treat Major Depressive Disorder. Rather than using the word “best,” the term “evidenced-based” is preferred. If a treatment modality is evidence-based, there have been studies showing that it is effective (rather than anecdotal evidence). The most evidence-based treatment modality for the treatment of Depression today is Cognitive Behavioral Therapy.

You probably have seen movies depicting a therapy session in which the client lays on a couch, and the clinician analyzes the client’s dreams or has the client recount in great detail memories from childhood. Today, most clinicians focus more on the here-and-now, which leads to better outcomes more quickly. Whereas it used to be common for people to attend therapy for years upon end, for most people (there are exceptions), it is expected that eight to twelve sessions of Cognitive Behavioral Therapy should produce some positive results.

Just because Cognitive Behavioral Therapy is effective for Depression does not mean that it is a passive process. Clinicians will often assign homework to be completed between sessions or even daily. While there is some exploration of past events, particularly how they affect current cognition, the focus is on recognizing and challenging thoughts (cognitive restructuring), psychoeducation (learning new skills), and coping skills. Your therapist may role-play with you in a session.

While Cognitive Behavioral Therapy is commonly used, most therapists actually using an eclectic approach today, borrowing from narrative therapy, reality therapy, solution-focused therapy, and other modalities. Many clients with Major Depressive Disorder find great benefits from taking psychotropic medications in addition to participating in therapy. Even if you have not had a positive outcome from taking psychotropic medication in the past, it may be worth talking with a psychiatrist about other options, as several different types of antidepressant medications are available. The same is also true for therapy—regardless of what treatment modality is used, if you do not notice progress after several sessions or do not feel comfortable with your clinician, consider changing counselors, as other approaches may be a better fit for you. Ultimately, your relationship with the clinician is an important component, and the best therapy for Depression is the one that works best for you.