Psychotherapy to Treat Depression
Cognitive Behavioral Therapy for Depression
Cognitive behavioral therapy (CBT) includes several different approaches to therapy, all of which focus on how thinking affects the way a person feels and acts. The idea of cognitive behavioral therapy is that you can change your way of thinking about a situation, and when you do, you also change the way you feel and act. As a result, you can feel better, and behave differently in response to life stresses, even when the situation stays the same.
While other approaches to therapy rely heavily on analyzing and exploring people's relationship with the world around them, the focus of CBT is on learning. The therapist functions in many ways similar to a teacher. He or she guides the client through the process of learning how to change his or her way of thinking and then how to act on that learning. Because there is a specific goal and a process for arriving at it, CBT is often more narrowly focused. It also is typically completed in less time than other therapies.
Two examples of different types of CBT are:
- Rational emotive behavior therapy or REBT. REBT focuses on the way emotions affect thinking and actions. It helps the client recognize that the intensity of negative emotions can change the quality of his or her thinking. The result is often overreaction and loss of perspective. The emphasis of therapy then is on learning how to restore emotional balance by thinking more realistically about situations.
- Dialectical behavior therapy or DBT. DBT emphasizes the validity of a person's behavior and feelings and reassures the individual that those feelings and behaviors are understandable. At the same time, it encourages the individual to understand that the responsibility for changing unhealthy or disruptive behavior is his or her own.
Therapy works best when you attend all of your scheduled appointments and participate actively in the work of treatment. The effectiveness of therapy comes from the fact that it is not a passive process but one that depends on your active participation. It requires time, effort, and consistency.
As you begin therapy, establish some goals with your therapist. Then spend time periodically reviewing your progress with your therapist. If you don't like your therapist's approach or if you don't think the therapist is helping you, talk to him or her about it or seek a second opinion, but don't discontinue therapy abruptly.
Tips to Help You Get Started With Therapy
- Identify sources of stress: Try keeping a journal and note stressful as well as positive events.
- Restructure priorities: Emphasize positive, effective behavior.
- Make time for recreational and pleasurable activities.
- Communicate: Explain and assert your needs to someone you trust; write in a journal to express your feelings.
- Try to focus on positive outcomesand finding methods for reducing and managing stress.
Remember, therapy involves evaluating your thoughts and behaviors, identifying stresses that contribute to depression, and working to modify both. People who actively participate in therapy recover more quickly and have fewer relapses. Therapy is treatment that addresses specific reactions to depression as an illness; it is not a "quick fix." It can take longer to begin to work than antidepressants, but there is evidence to suggest that its effects may sometimes last longer, depending on the type of depression being treated. Antidepressants may be needed immediately in cases of severe depression, but the combination of therapy and medicine is very effective.