ABSTRACT
Chapter 8 reviews the emergence of psychotherapies specifically developed for treatment of depression, epitomised by cognitive behavioural therapy (CBT) based on the rationale that depression is a disorder of negatively biased thinking. Typically, effective therapies are relatively brief and require active efforts to identify and change dysfunctional patterns of thought and behaviour. Patients are taught exercises that can be applied for symptom reduction and to identify contributory behaviours and life circumstances to alter and practice new skills to prevent future depression. Similarly, interpersonal psychotherapy (IPT) helps identify an interpersonal problem contributing to the depression, and develops problem-solving skills and strategies for resolving it. Extensive research has verified the effectiveness of such treatments; they are as effective as antidepressant medications in symptom reduction, and superior to medications in relapse prevention if medications are withdrawn. For some individuals the combination of drug and psychotherapy treatments works best. Unfortunately, both forms of treatment suffer from lack of widespread availability, limited success in preventing recurrences and elevated rates of nonresponse. Accordingly, efforts to better understand mechanisms of treatment effectiveness, and make therapy more accessible and affordable by use of trained nonprofessionals, self-help materials and computerised protocols are topics of ongoing study. Also, research on efforts to prevent depression in those at risk is continuing.
