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INTEGRATING CBT & HYPNOSIS

vented suicide in tens of thousands of patients around the world. Although these medications are readily available, many people refuse or are not eligible to take them. Some are wary of long-term side effects. Women of childbearing age must protect themselves against the possibility of conceiving while taking antidepressants, because they can damage the fetus. In addition, 40%50% of patients do not respond adequately to these drugs, and a substantial number of the remainder are left with residual symptoms of depression (Barlow & Durand, 2005, p. 238). Electroconvulsive therapy (ECT) is often given to patients who dont respond to drug therapies. ECT is known to relieve depression in 50%60% of depressives (Fink, 2001). ECT, however, remains a controversial treatment for several reasons, including causing cognitive and memory impairments, and the idea of passing electrical current through a persons brain appears primitive to some. And it is still not known how ECT works. Although antidepressant medications and ECT work well for many depressed persons, they obviously do not alleviate the problems that may have caused the depression in the first place. Pills cannot improve the bad marriage, unhappy work situation, or family conflict that precede depression. Therefore, many depressed people benefit from psychotherapies designed to help them cope with the difficult life circumstances or personality vulnerabilities that put them at risk for depression. Psychotherapy is also sometimes the recommended treatment for people who have medical conditions (such as pregnancy and some heart problems) that preclude the use of prescribed medications.

CBT for Treating Depression

Cognitive behavior therapy (CBT) is the most extensively tested psychosocial treatment for depression. It has been studied in over 80 controlled trials (American Psychiatric Association, 2000), it has been found to be effective in the reduction of acute distress, and it compares favorably with pharmacological treatment among all but the most severely depressed patients. Moreover, CBT reduces relapse (Hollon & Shelton, 1991) and can prevent the initial onset of first episodes or the emergence of symptoms in persons at risk who have never been depressed (Gillham, Shatte, & Freres, 2000).