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A comparison of the effectiveness of differing forms of psychotherapy in the treatment of depression

A comparison of the effectiveness of differing forms of psychotherapy in the treatment of depression

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An essay for the 2012 Undergraduate Awards Competition by Shane Curran. Originally submitted for Arts (Psychology) at National University of Ireland Galway, with lecturer Jonathan Egan in the category of Psychology
An essay for the 2012 Undergraduate Awards Competition by Shane Curran. Originally submitted for Arts (Psychology) at National University of Ireland Galway, with lecturer Jonathan Egan in the category of Psychology

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Published by: Undergraduate Awards on Aug 31, 2012
Copyright:Attribution Non-commercial


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This paper reviews the effectiveness of two forms of psychotherapy, specifically the efficacyof Cognitive Behavioural Therapy (CBT) and Short-Term Psychodynamic Psychotherapy(STPP), when utilised in the treatment of depression. Depression was chosen as the focus of this paper as it represents a significant mental health issue worldwide, sometimes referred to
as the “common cold of psychiatry” (Seligman, 1975) in
regard to its prevalence, and canresult in significant impairment causing distress to sufferers and their families (Churchill etal., 2006). As well as commonly occurring comorbidly with other psychological disorders,depression is said to account for 75% of psychiatric hospitalisations (Gilbert, 1992), and, dueto its pervasiveness, can be seen to impact on the wider community, as well as the individual.Depression can, consequently, have wider societal implications and represents a considerableeconomic burden, according to recent cost-of-illness estimates (Sobocki, Jonsson, Angst, &Rehnberg, 2006), Therefore, the importance of finding a treatment that is effective in treatingthis disorder would seem paramount.This paper will firstly give a brief outline of the methods used to find informationabout the two forms of psychotherapy, and to acquire suitable journal articles and publishedworks on which to base this paper. Secondly, the efficacy of CBT in the treatment of depression will be examined, drawing on evidence from the current literature. Thirdly, it willexamine the results of research investigating the outcomes seen with STPP. After examiningthe effects of both treatments individually, the paper will consider research that has examinedboth forms of psychotherapy in contrast to one another, and draw from existent literature andpersonal propositions in an attempt to explain the differences and similarities seen with theeffectiveness of these psychotherapies. In conclusion, attention will be given to assertionsmade on research that aims to find the most effective treatments in an attempt to rationalisecurrent research findings in the literature.
Method for literature search
The literature search used to acquire suitable journal articles and published works forthis paper comprised of online searches of Google Scholar, Science Direct, Psychnet, Ovid,and Google Books, as well as physical searching through personally owned textbooks andbooks from the university library. The author made the decision to focus on large-scale meta-analyses, clinical trials, and reviews of research in order to provide a comprehensiveoverview of the efficacy of the treatments, which requires a broad view of the availableliterature.
CBT is one of many psychotherapeutic approaches developed to addresspsychological problems and treat psychiatric conditions. It assumes that cognitive, emotional,and behavioural variables are functionally interrelated, and, therefore, treatment is aimed at
identifying and modifying the client’s malada
ptive thought processes and problematicbehaviours through cognitive restructuring and behavioural techniques to achieve change(APA, 2009).
 Application to Depression
Therapists commonly refer to manuals such as
Cognitive Therapy of Depression
(Beck, Rush, Shaw, & Emery, 1979) and
 Essential Components of Cognitive Behaviour Therapy for Depression
(Pearson, Davidson, & Tompkins, 2001) for instruction on theapplication of CBT for depression, which essentially comprises of behavioural activation,which helps clients increase the frequency of activities that they enjoy, and cognitive
restructuring, which encourages clients to access and challenge depressive cognitions (Carr,2009).
The efficacy of CBT for the treatment of depression has been the subject of considerable research, with a substantial number clinical trials taking place since the late
1970’s (Gloaguen, Cottraux, Cucherat, & Blackburn, 1998). In light of this interest in CBT’s
effectiveness, there is an astounding supply of information. However, this abundance of information provides a wide variety of conclusions and effect sizes, and a profusion of contradictory evidence.Nonetheless, hailed as the most extensive and methodologically rigorous meta-analysis on CBT for depression (Butler, Chapman, Forman, & Beck, 2006), Gloaguen et al.(1998) investigated the effects of CBT in depressed patients and examined the overall resultsof 48 high-quality controlled trials. The amassed sample, which was essentially exclusivelyadult, took in a wide variety of demographics, which may ensure a comprehensive overviewof CBT effectiveness. In order to establish that placebo effects or demand characteristicswere not confounding results and impacting on the depression of patients, it was found thatCBT was superior to the control conditions with an effect size estimate of 0.82. Overall, incomparison to various other treatments such as antidepressants (0.38), behaviour therapy(0.05), and other psychotherapies (0.24), CBT was demonstrated to be effective in thetreatment of depression. It must be taken into account, however, that studies included in thisreview took place from 1977-1996, and more recent evidence must, therefore, be examined.Recently, Craighead et al. (2007) conducted a review of 13 studies with adultssuffering from depression and found that 50-70% of patients, who completed a course of CBT of approximately 16 weeks, had significant improvements in symptoms of depression

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