Depression

Does therapy work?

That therapy can work (compared to having no treatment) is clear in the research. Certainly, 31 out of 38 people we talked to said that talking therapies had helped them. Despite the costs in money and time, people we saw considered talking therapies to be one of the most helpful approaches in depression. In particular, people were very positive about cognitive behaviour therapy (CBT), which many had had (see 'Depression - Managing the mind'). People were also positive about a range of other talking therapies, including person-centred counselling, psychosynthesis, systemic consultation, psychodynamic approaches, psychoanalysis, art therapy, group therapy and Gestalt therapy.

The range of talking therapies available is bewildering, but it was clear that a respectful and safe client-professional relationship - which helped people to sort out their problems - was more important than the kind of therapy they had.

The talking cure

Many people found that just being given the freedom to talk about their feelings and thoughts helped them to unburden themselves and work out what was at the root of their problems. Many were also surprised about the topics that arose through talking. One woman found herself talking about things she would not even tell a best friend. She discovered she had kept up a façade with other people all her life. Therapeutic discussions also worked by helping people to think about their problems in different ways. Practitioners commonly guided people to address their own issues, helping them to think of their problems in more helpful ways, rather than providing solutions. Through talking therapies, people became more insightful and could frequently make changes to improve their lives (see 'Gaining insights about depression').

The past and present

Some people found it helpful to talk about their past, including childhood. They were very much helped by discovering through therapy that they had an 'inner child' who needed comforting. For instance, one man was surprised by his 'reservoirs of pain' and described how he found it therapeutic to reconnect with himself at age ten to listen to and 'comfort' that self. Others found going over their past unhelpful and even traumatic. Such people benefited more from talking therapies that focused on overcoming present-day difficulties e.g. work stresses, relationship problems.

Ending therapy

At some stage, people thought about ending therapy. With more open-ended therapy, people made their own decisions about when they felt they had finished therapy. Some felt they needed to finish because they were consuming resources that others in more distress could be using. But as one therapist explained to a client, it is part of depression itself that some people do not feel entitled to talking therapies. One man mistrusted a particular therapist, and suspected they were prolonging therapy for financial gain. Some women were clear that people should negotiate the ending of open-ended therapy, since like the end of any relationship, there is grieving work to be done. When one woman's long-term therapist was off sick for 6 months she suffered a strong grief reaction.

With NHS or other therapy that is short-term, enduring relationships are not built, and so less grieving work has to be done. The downside of short therapy courses is that the depth of the relationship is limited, and this may decrease the benefit of therapy. A few people were inspired by their own experiences of therapy to go on to learn how to become counsellors themselves. Their courses also helped them to further cope with their own issues.

Last reviewed September 2017.

Last updated September 2017.