Psychological Therapies for Depression

The purpose of psychoanalysis is to allow the patient to work through their depressive feelings in the safety of the consulting room.

The therapist believes over the course of treatment patients will:

• Cope with loss more effectively 
• Be less dependant on others
• Make appropriate changes to their everyday lives

Treatment of depression involves:

• Uncovering unconscious conflicts that have origins in the past
• Releasing the power these conflicts have over patients - Catharsis
• Includes techniques such as free association

This therapy helps to improve patients internal working models.

This is done through transferance whereby:

• Self directed hostility is projected onto the therapist.
• The therapist points out the similarities between patient-parent and patient-therapist relationship.

• Studies suggest psychoanalysis is as effective as CBT

.

.

• However a criticism is there are too many variables - can't ensure a controlled and statistically valid outcome (Corsini & Wedding)

• Comparisons are made at beginning and end of treatment however:

     - As the treatment is so long there may be other life events that contribute to the patients improvement.

• Furthermore effectiveness is measured by how much the patient feels they have improved- therefore care should be taken when assessing this subjective concept.

Placebo effects

• Grunbaum believed that benefits of psychoanalsis are due to placebo effects
• He suggests it's the action of being treated that improves the patients condition.

This may be because:

• The client is in a powerful relationship with the therapist - part of this power is never being wrong.

    - If the patient challenges the therapist this is interpreted as a symptom of their disorder.

    - Therefore the patient is under pressure to conform to expectations.

• This suggests that care should be taken when assessing the effectiveness of psychoanalysis. 

Not appropriate for everyone

Depressed people are often too:

• Passive
• Withdrawn 
• Fatigued 

To take part in lengthy therapies.

• They're easily disheartened - therefore drop out before the therapy has chance to work.

• Psychoanalysis requires patients to have an interest in the root cause of their depression - therefore those with little interest are unlikely to benefit.
• Not appropriate for everyone.

• Interpersonal psychodynamic therapy is brief and focuses on current problems - may be more suitable for depressed people.