Depressed? Ohio State researchers test different therapies to see which works best

When faced with depression during the holidays, or any other time, many people understandably want to fix what they think is wrong in their lives.

But, so far, there has been little effort to see if another approach might work better for some people.

"It's often been assumed that therapists should focus on fixing problems, but we believe there may be another way of helping depressed people, by concentrating on improving what they are already doing well," said Jennifer Cheavens, assistant professor of psychology at Ohio State.

Cheavens said traditional psychotherapies for depression tend to use a general approach without many clear ideas about how to match people with the therapeutic approaches that are most likely to benefit them.

Psychotherapies often work to remedy specific psychological deficits people with depression are likely to experience. For example, people with depression who hold negative views of themselves and their futures may be especially likely to benefit from therapy that helps them to reconsider these negative views.

Daniel Strunk, assistant professor of psychology at Ohio State, said that it could be that psychotherapy developers have been on to something – that the best way to treat depression is to focus on particular psychological deficits that are more common among people with depression. But, he noted that this is a largely untested assumption.

"For some people, the best way to battle depression may be to capitalize on things they're already good at – that may be what really fosters improvement," Strunk said.

Cheavens and Strunk are starting a new research project to test these competing theories.

For the study, they will bring in 60 people who meet diagnostic criteria for depression. All participants will get 16 weeks of individual psychotherapy for one to two hours a week.

Half will get cognitive therapy that focuses on the patients' beliefs and thoughts, and which teaches them strategies for improving mood. The other half of the participants will receive treatment focused on their interpersonal relationships. They will learn how to be more effective when dealing with others, and how to increase levels of social support to combat depressive symptoms.

However, rather than focusing on whether one therapy will outperform the other, the researchers are focused on evaluating whether the treatments work better for people with a strength or deficit in these two areas (thinking optimistically and interpersonal relationships and skills).

The researchers will assess the participants during the 16 weeks of the treatment, and then every three months afterwards for a year to see how they are doing.

The question will be whether patients do better when they are treated with the type of therapy that matches their own personal strengths.

In earlier work, Strunk evaluated cognitive therapy, which is often thought to work by remedying deficits. His work has shown that patients who learn to use the cognitive skills tend to stay well following treatment.

Cheavens tested one way to help depressed people build on their strengths: hope therapy.

"Hope therapy seeks to build on strengths people already have, or teach them how to develop those strengths. We focus not on what is wrong, but on ways to help people live up to their potential."

Cheavens and Strunk said the new study will provide more evidence on the best ways to treat depressed people.

"There are a lot of different kinds of treatment for depression, and each of them has some level of success," Strunk said. "But they have plenty of room for improvement. Maybe if treatment was more individualized, it could be more successful."

The holiday season, when many people feel high levels of stress and sadness, is a good time for people to assess their own psychological health, Strunk said.

"Stress around the holiday season is pretty normal," he said. "So, people should consider whether their difficulties are just related to the holiday season and temporary stress. But, if problems persist for a couple of weeks or more, it may be a good idea to be evaluated for depression."