ABSTRACT
The prevalence of depression presents a demanding challenge to the mental health professional. The recognition that depression is strongly implicated in some of the most troublesome problems our society faces—from drug abuse to violence against self or others—requires a strong response from clinicians. The message must clearly state that each person has the inherent capacity to make positive changes, however little or great, given the right internal and external environments. The internal world of the depressed client is a finely balanced system that has evolved over time, and before the client can emerge from the “inside out,” he or she must have evolved a new internal frame of reference that permits new and better responses to life situations. Furthermore, the external world of the client (e.g., the relationships he or she has including the one with the clinician) is also an established system that is finely balanced. External situations inevitably require and get a response (since even no response is still a response) from the individual and thus can be used to facilitate changes from the “outside in.”
