Types of Therapy for Depression
There are many different types of therapy. Learning a little about each can help you decide which approach will likely work best for you.
You may see a therapist say they practice “Eclectic” or “Integrative” therapy. This simply means that they use more than one type of therapy in their practice, combining them in some way.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) has been around for over 30 years and has the most evidence supporting its effectiveness. For depression in particular, it’s considered the gold standard in psychotherapy, and is beneficial for a multitude of other mental health issues.
CBT is largely focused on the present, as opposed to the past. It has the following characteristics:
- CBT uses ‘homework.’ Because CBT is about teaching the client skills, rather than relying on the skills of the therapist, CBT utilizes extensive out-of-session assignments, asking the client to apply and practice concepts and follow through on plans made in-session.
- CBT is short. Compared to other therapies, CBT is usually remarkably short, usually between 10 and 20 sessions. This is partly because of CBT’s goal and skill-oriented nature, and partly because of its reliance on homework.
- CBT believes healthier habits can be learned. CBT follows the principle that behaviors, thoughts, and emotional responses are learned, and therefore, healthier methods can be learned through specific techniques and activities.
- CBT is more focused on the client than on the client-therapist relationship. While a good relationship is necessary for CBT, CBT is more focused on helping the client learn the skills to overcome their challenges themselves, and therefore the relationship with the therapist is of secondary importance. (This is one reason CBT is such an excellent therapy for use in online depression apps, like UpLift.)
Therapies Closely Related to CBT
Interpersonal Psychotherapy (IPT) IPT focuses on your relationships with others, which can include difficulties with communication or coping with bereavement. There’s some evidence that IPT can be as effective as antidepressants or CBT, but research is still in the early stages.
Behavioral Activation (BA) BA focuses on the activities and behaviors that worsen your depression (like avoidance) and others that improve your mood. BA is also a central component of CBT.
Problem-solving Therapy (PST) PST helps you generate and apply creative solutions to your problems. CBT treatments often include problem-solving strategies.
Acceptance and Commitment Therapy (ACT) ACT helps you improve thoughts, feelings, memories, and physical sensations that are feared or avoided. Acceptance and mindfulness strategies are used to teach people to focus on the present and engage in positive behaviors even in the midst of difficult thoughts or situations.
Mindfulness-Based Cognitive Therapy (MBCT) MBCT is similar to ACT in that it incorporates mindfulness practices to help you become more aware and accepting of your emotional reactions. In MBCT, formal meditation practices are a much larger focus.
Humanistic therapy believes that humans are essentially good and positive, and focuses on the struggle to become your ‘real, true self.’ It emphasizes responsibility for one’s choices in terms of thoughts, behaviors, and emotions, and pays less attention to outside influences. (This is in contrast to psychoanalysis, below, which tends to see people as shaped by influences from their past.)
Humanistic therapy tends to focus on questions such as acceptance of various parts of one’s self, and being authentic in one’s relations with others.
There are several sub-branches of humanistic therapy:
- Gestalt Therapy, with a special focus on being in the here-and-now.
- Existential Therapy, with a focus on free-will and the search for meaning.
- Client-Centered Therapy, which emphasizes that the client is the greatest source of knowledge about themselves, and sees the therapist as more of a guide for the client in their journey towards solving their own problems. (The word “non-directive” is used to describe this concept of a therapist’s role.)
When many people think of “therapy,” as represented in popular culture, they are actually thinking of psychoanalysis. This type of therapy is one of the oldest forms and was developed by Freud.
Psychoanalysis focuses on:
- The role of the unconscious Unlike humanistic therapy, which believes humans are essentially good and positive and tries to achieve one’s ‘true nature,’ psychoanalysis believes that mental well-being comes from controlling unconscious desires, many of which are negative or destructive.
- The origin of a person’s thoughts, behaviors, and personality in early childhood experiences Psychoanalysis believes that many of the problems a person encounters in their adult life are the result of early childhood trauma.
- The importance of the skill of the therapist The success of psychodynamic therapy is thought to largely rest on the ability of the therapist to listen to the client extensively, and then interpret what they hear to derive insights about a client, which allows the client to see their behavior in a new light.
The term “psychodynamic therapy” is basically a more modern term for psychoanalysis.