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Deborah Tang

Jan. 05/15
Approaches to Treatment of Depression
Biomedical The use of drugs to treat chemical imbalances of depression; is based
on the assumption that if the disorder is characterized by malfunction on a
biological basis, drugs can be used for restoration.
Example: selective serotonin reuptake inhibitors (SSRIs), such as Prozac and Zoloft,
increase levels of serotonin by preventing its reuptake in the synaptic gap.
- Is 60-80% effective for short term
- Is not equally effective in all
treatment (Bernstein et al. 1994)
cases, and may not be more
- Provides effective long term
effective than psychotherapy in
control for mood disorders
the long term (Kirsch and
- Cannot be given without consent
Sapirstein 1998)
when possible, so it satisfies this
- Reduction in number of hospital
ethical consideration
inpatients may also be reflective
of changing policies towards
- Side-effects raise important
ethical issues
- Does not constitute a cure
although reduce symptoms
- Placebo effect
Individual Therapy The replacement of negative cognitions with more realistic and
positive ones is assumed to be effective in helping a depressed person, as a
symptom of the disorder is distorted cognitions (ex: self-defeating thoughts); based
on the theory of cognitive restructuring. Principles include: identifying automatic
negative and self-critical thoughts; noting the connection between the negative
thought and depression; examining each negative thought and deciding whether it
can be supported; replacing distorted negative thoughts with realistic
interpretations of each situation.
Example: cognitive-behavioural therapy (CBT) is a brief form of psychotherapy
which is concerned with a persons past history, and focuses on current issues and
symptoms in order to identify and correct faulty cognitions and unhealthy
behaviours and encourage participation in rewarding activities. It consists of around
12-20 weekly sessions, combined with daily practice exercises designed to help use
new skills on a daily basis.
- Are effective in treating
- Focuses on symptoms rather
depression, especially milder
than causes
- The therapist is still making value
ones (Rush et al. 1977)
- Are superior to no treatment or
judgements as to which thoughts
to a placebo
are acceptable (ethical concerns)
- Are cost-effective because they
- Combination of individual
do not usually involve prolonged
approach with drugs (biomedical)
increase effectiveness of
- No negative effects have been

Deborah Tang
Jan. 05/15

By providing clients with
strategies for self-help, they are
less manipulative than other
Cognitive and behavioural
techniques help to manage
negative thoughts and feelings
that could trigger substance
More holistic approach
Empowers the client
Addresses patterns of behaviour

Can be costly if it continues for a

prolonged period of time (12-20
weekly sessions)
May be difficult to build rapport

Group Therapy The use of consultations with a (usually small) group and a
therapist. Factors to consider include: group cohesion (should be no one person
different from the rest); exclusion (should be no one with outstanding
characteristics); confidentiality (people must trust that they can speak freely in the
group); relationship with therapist (therapist must show empathy for the members
and try to understand their reality)
Example: Marital therapies for depression focus on teaching couples to
communicate and problem-solve more effectively, while increasing positive,
pleasurable interactions and reducing negative interchanges
- Is more effective than other
- Ethical consideration of
forms in improving the quality of
Potential social desirability effect
a marital relationship and is
in speaking in a group and to a
equally effective in treating
symptoms of depression
Lack of high quality studies
(Jacobsen et al. 1989)
- Conformity effects
- Is recognized for having
- High drop-out rates
beneficial effects on an individual
(Toseland and Siporin 1986)
- Therapist is a guide on their side
- Builds a support system
- Financially advantageous