Other types of psychological therapy

Interpersonal therapy (IPT)

Interpersonal therapy (IPT) focusses on current (not past) relationships and may be appropriate if difficult relationships with other people are a major factor in your depression. The therapy aims to help you understand the link between mood and interpersonal relationships, including grief and conflicts, and helps you explore different ways of managing these.

How does IPT compare with antidepressants?

Only a few studies have compared IPT with antidepressants for depression, but it appears they are about as effective as each other. However, antidepressants are recommended if you have severe depression; psychological therapies may be helpful once you start to feel better.

How does IPT compare with other types of psychotherapy?

Only a few studies have compared IPT with cognitive behavioural therapy (CBT), but the results showed they were about as effective as each other for treating depression. There have not been enough studies to judge how IPT compares with other kinds of psychotherapy.

Is there a benefit in combining IPT and antidepressants?

Combining IPT with an antidepressant is more effective than either IPT or an antidepressant alone. IPT may also increase your chances of staying well after you stop taking an antidepressant.

Psychodynamic therapy

Psychodynamic therapy aims to explore feelings and conscious and unconscious conflicts from the past. We don’t really know if it helps in depression because there have not been many trials of it — while CBT and IPT have convincing evidence of benefit from trials. Psychodynamic therapy involves a long period of treatment.

How does psychotherapy compare with CBT?

Counselling

Counselling is a broad term covering a range of approaches. It aims to support you to find resolution, personal growth and self-healing.

It’s difficult to say if counselling is effective for depression, because there haven’t been enough trials of it. In contrast, trials of CBT and IPT have shown convincing evidence of benefit. However, counselling may be a useful option for people with mild depression who do not want to have CBT or IPT or take an antidepressant.

How does counselling compare with CBT?

Professor Gavin Andrews, Director of the UNSW School of Psychiatry at St Vincent’s Hospital, and head of the Anxiety and Depression Clinic and Clinical Research Unit for Anxiety and Depression (CRUfAD), St Vincent’s Hospital, Sydney, talks about CBT.

Therapies for problems related to depression

Sometimes there may be other problems that contribute to depression, which may benefit from specific treatments.

Couples therapy

Couples therapy or relationship therapy may be useful for couples when the relationship is a significant factor in a person’s depression. It appears to be about as effective as individual CBT or IPT in this situation. Couples therapy is also often used when neither person in the relationship has depression.

Problem-solving therapy

Problem-solving therapy focusses on breaking problems down into specific, manageable tasks, and developing appropriate coping behaviours for problems. It is usually done over six sessions. It may be effective in depression, but the evidence is not as convincing as it is for CBT and IPT. It may be helpful when used with other treatments.

Drug or alcohol counselling

Many people turn to drugs or alcohol as a way of dealing with depression. If you are dependent on alcohol or drugs, specific counselling can help. It may be more difficult for you to recover from depression if you don’t get help for your drug or alcohol problem. You can have this counselling at the same time as other treatments, such as CBT.

Find more information

Reference
  • National Collaborating Centre for Mental Health. Depression: the NICE guideline on the treatment and management of depression in adults (updated edition). London: National Institute for Health and Clinical Excellence, 2010. www.nice.org.uk/nicemedia/live/12329/45896/45896.pdf (accessed 9 February 2012).