Depression
What's the Most Helpful Element of Therapy?
Therapy can be effective due to a mix of elements, but which one matters most?
Posted June 6, 2022 Reviewed by Devon Frye
Key points
- Research has shown that many different types of psychotherapy can be effective to treat depression.
- A major review of studies found that one type of psychotherapy was not more significant in effectiveness among seven different types.
- It may be that the relationship between the therapist and the client, rather than the specific modality, is most closely tied to efficacy.
A common question asked of psychotherapists is whether therapy can truly help a person struggling, or whether the individual simply has to “wait it out” until it passes. Research has found that psychotherapeutic interventions can be significantly effective in treating mental disorders such as depression, and it’s important for patients to know that many different types of psychotherapeutic interventions exist.
In the same way that an experience like psychological trauma can cause different symptoms across individuals, depression may be experienced differently, too. While one individual may feel anxious and restless throughout the course of their depression, another individual may feel apathetic and lethargic over the course of theirs. An important place to begin when one feels depressed is to share their thoughts and feelings honestly with their doctor, or to do an online search for a local mental health clinic and schedule an intake.
The Effectiveness of Different Psychotherapeutic Interventions for Depression
When it comes to treating depression, there is no singular, universal treatment that is effective for every sufferer. In addition to frequently prescribed psychopharmacological treatment (e.g., antidepressants), various types of psychotherapeutic interventions are available to patients.
Barth, Munder, Gerger, Nuesch, Trelle, et al. (2013) conducted a major study of 198 published studies that involved more than 15,000 patients who received one of seven types of psychotherapeutic interventions: interpersonal psychotherapy, behavioral activation, cognitive behavioral therapy (CBT), problem-solving therapy, psychodynamic therapy, social skills training, and supportive counseling.
The results showed that all seven therapies were more effective at reducing depressive symptoms than a control group. Moreover, the research showed that there were no significant differences in positive effects between the types of therapy.
What is it That Made These Interventions Helpful?
Considering the review of 198 studies, what do the research results mean? It may be that what truly helps a depressed patient isn’t so much the specific things the provider says or does, but rather what is most change-inducing for the patient is the relationship with the provider. What is making a difference, then, is the sense that someone is there to care, protect and help them through their emotional struggles.
Because human beings are social creatures, it makes sense intuitively that the human relationship component is a key part of what makes treatment effective. A patient in treatment is listened to, validated, and asked questions—signs of being cared for and valued.
Another factor that is important to note about the clinical relationship is the understanding that the provider is a professional with expertise, and the sense of being cared for by someone who has seen and treated the same condition many times before.
Which Type of Therapeutic Intervention Suits You?
While there are many different types of psychotherapeutic interventions, including the seven listed above, two of the most common types provided in clinics and private practice are CBT and psychodynamic therapy. While CBT is short-term and focused on specific coping techniques, psychodynamic therapy (often the type shown on television and in movies) is more exploratory and longer-term.
One factor that anyone seeking therapy for depression should consider is their own personality preferences regarding what they want from a session. They should ask themselves questions including:
- Do I want a therapist who talks a lot or a little?
- Do I want a highly structured session or one where I can talk about whatever comes up for me?
- Do I want to be assigned “homework” or specific tasks (a practice of CBT) between sessions?
- Do I want to focus more on techniques I can use or on sharing the thoughts and feelings I have?
What to Ask a Prospective Therapist
When seeking help, don’t worry about memorizing or even understanding all the possible types of psychotherapeutic interventions you could receive. Simply start by asking yourself the questions above and share your responses—what you’re looking for—with a prospective therapist. By communicating early on about what you want and need from therapy, you will be better able to determine whether that therapist is a good fit for the work you want to do.
Finally, to reduce anxiety and pressure about the new undertaking, reassure yourself that you can try a session or two and then determine whether the intervention conducted has a chance of working well with you.
References
Barth J., Munder T., Gerger H., Nüesch E., Trelle S., Znoj H., et al. (2013). Comparative Efficacy of Seven Psychotherapeutic Interventions for Patients with Depression: A Network Meta-Analysis. PLoS Med 10(5): e1001454.