An official website of the United States government
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Warnick SJ Jr, Van Harrison R, Parikh SV, et al. Unipolar Depression [Internet]. Ann Arbor (MI): Michigan Medicine University of Michigan; 2021 Feb.
| Modality | Brief Description | Evidence of Effectiveness | Questions to Ask Patients |
|---|---|---|---|
| Cognitive behavioral therapy (CBT) | Identifies and attempts to modify negatively-biased cognitions. Behavioral component includes activity scheduling and social skills training. This therapy is usually brief (8–16 weeks) and occurs weekly. | Acute and maintenance phases of depression treatment. [A] Effective in severe or treatment resistant depression. [A] Evidence supports use in a group setting, computer-based, and via tele-video. [A] | How often do you see your therapist? How long have you been seeing your therapist? What homework are you doing with your therapist? What skills are you working on? |
| Interpersonal therapy (IPT) | Focuses on clarification and resolution of interpersonal difficulties. Explores interpersonal losses (complicated bereavement), role disputes (struggle with a significant person), role transitions (life change), and social skill deficits (no current interpersonal issue but struggling with depression). This therapy is usually brief (8–16 weeks) and occurs weekly. | Acute phase and maintenance phase (with medications) of depression treatment. [A] Evidence supports use in a group setting and internet-based. [A] | How often do you see your therapist? How long have you been seeing your therapist? Are you working on bereavement, a role transition, a role dispute, or an interpersonal deficit? Do you talk about your relationships? Have you ever role-played relationships? |
| Behavioral activation (BA) | Uses the behavioral components of CBT, particularly by focusing on daily activities, either through monitoring activities, identifying pleasurable activities, assigning daily activities, and working through problems and potential solutions. This is often used in collaborative care by care managers, and may not be identified as therapy per se by the patient. | Acute phase and maintenance phase (with medications) of depression treatment. [A] Evidence supports use in collaborative care settings for the management of mild to moderate depression. [A] | How long are your sessions with your therapist? What do you call your therapist? Are they your care manager? What goals have you set? What pleasurable activities are you working on increasing right now? |
| Mindfulness-based cognitive therapy (MBCT) | Uses techniques from mindfulness meditation and CBT, with homework, including mindfulness exercises. A focus is often on being aware of one’s affect, rather than trying to change affect. This can be alone or in a group setting. | Acute depression that is mild to moderate in severity. [A] Maintenance therapy in adjunct to medications. [A] Relapse prevention method after remission of depression. [A] | What type of homework are you doing? Are you working on mindfulness, meditation, or imagery? Are you working on changing your mood or on becoming more aware of it? |
| Problem-solving therapy (PST) | Focuses on solving the current problems affecting the patient, usually in a brief therapy lasting from 6–10 sessions, which can last from 30 minutes to 1 hour. This is often used in collaborative care by care managers, and may not be identified as therapy per se by the patient. | Acute treatment for mild to moderate depression in the primary care population, particularly in older adults. [A] Evidence supports use in collaborative care settings for the management of mild to moderate depression. [A] | How long are your sessions with your therapist? Which specific problems in your life are you working on right now? What goals are important to you in your therapy? |
| Cognitive behavioral analysis system of psychotherapy (CBASP) | A combination of CBT and IPT that was created to help treat chronic depression. This model also puts more of the ownership for depression on the patient, and there are less rigid boundaries between the therapist and patient during sessions. | A second-line psychotherapy for the treatment of acute and chronic depression with or without pharmacotherapy. [B] | Are you working on situational analysis of difficult events? Do you talk to your therapist about how you react to other in your life compared to how you react to your therapist? Do you have homework? |
| Acceptance and commitment therapy (ACT) | A mindfulness based therapy without specific guidelines, differentiating it from MBCT. The focus is on recognizing depression and rather than trying to get rid of depression, to recognize it and commit to making the changes the patient wants in life. | First-line acute treatment for mild to moderate depression, although it does not have the breadth of evidence of CBT, IPT, PST, or MBCT. [A] | Do you have homework? What are you working on? Are you working on changing your emotions or accepting them? Have you worked on defusing emotions or knowing your values? |
| Short-term psychodynamic psychotherapy (STPP) | A time-limited form of psychodynamic therapy that pays careful attention to the patient-therapist interaction, including interpretations of the transference between the patient and therapist. This can encompass 25–40 sessions. | A second-line treatment for acute depression in patients who decline pharmacology treatment or a first-line evidence-based psychotherapy. [A] | Do you have homework? (if answering yes, unlikely to be STPP) Do you have a goal for your therapy? Does your therapist offer interpretations of your thoughts and interactions? |
From: Unipolar Depression
Except where otherwise noted, this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-sa/4.0/
Your browsing activity is empty.
Activity recording is turned off.
See more...
