Clinical Psychology: Comparative Efficacy of Depression Treatments

This report critically reviews the comparative efficacy of different psychotherapeutic interventions for depression, focusing on Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT), based on the Barth et al. (2016) meta-analysis. The study compares the effectiveness of seven different methods including interpersonal therapy (IPT), behavioral activation (ACT), cognitive behavioral therapy (CBT), problem-solving method (PST), psychodynamic therapy (DYN), social skills training (SST), and supportive counselling (SUP) in treating depression. The report highlights the prevalence of Major Depressive Disorder (MDD) and the preference for psychotherapy over medication, discussing how CBT addresses flawed thinking and IPT resolves interpersonal issues. The report concludes that CBT is more effective than IPT for MDD treatment, though both are viable options, emphasizing the importance of considering individual circumstances when choosing a treatment method.

Running Head: CLINICAL PSYCHOLOGY
CLINICAL PSYCHOLOGY
Name of the Student
Name of the University
Author Note

1CLINICAL PSYCHOLOGY
Introduction
As per the author Barth et al. (2016) there are seven different types of
psychotherapeutic interventions that can be used for the patients who are suffering from
depression. This paper uses meta-analysis the compare the effectiveness of the seven
different methods. The seven different methods include the interpersonal therapy (IPT),
behavioral activation (ACT), cognitive behavioral therapy (CBT), problem-solving method
(PST), psychodynamic therapy (DYN), social skills training (SST), and supportive
counselling (SUP). Depression is a very common disorder that is affected to about one-fifth
in the developed countries. These disorders have the capability to reduce the function of an
individual (Barth et al., 2016).
The different psychotherapies that has been developed are compared and there is
enough supporting evidences that highlight the fact that these methods have a great effect as
controlled to those patients who do not receive any of these mentioned methods (Barth et al.,
2016). IPT can address the various interpersonal causes that give rise to depression in any
patient. While in ACT training is provided to the patient in order to treat the depression. CBT
focuses on the fact that the patient or the client have flawed thinking and the therapy has the
goal to evaluate, challenge, and then modify the flawed belief of the patient (Barth et al.,
2016). PST includes various steps that can be used to solve a single problem. The main aim
of the DYN intervention is to improve the understanding of the patients that is hampered by
the events of the past. SST is a type of behavioral therapy in which skill training is given to
the clients to help them in the buildup of the interpersonal therapy. SUP helps the people in
the ventilation of their thoughts as well as their feelings (Barth et al., 2016).

2CLINICAL PSYCHOLOGY
Discussion
The Major Depression Disorder (MDD) is among the most prevalent that affects
about the 25% of the women and about 12% of the men in their entire lifetime. It impacts the
quality of life, reduces the functioning ability, impacts the quality of life, increases the
psychological strain and also affects the productivity of an individual. The depression
disorders are linked with the use of the health services and also increases the burden over the
healthcare expenses. A large number of patients prefer to use the psychotherapies instead of
using the medications and thus, a huge number of such therapies has been developed. CBT
teaches the patient the various alternative methods that to think and behave (Barth et
al., 2016). It is one of the most commonly used psychotherapies that is supported by a
large number of empirical evidences. As per IPT it has been shown that the treatment
process is able to solve the interpersonal problems of the patients that can ultimately
solve the problems that are related to depression.
Out of the above discussed methods the two type of interventions that is being
focused in this report is the cognitive behavioral therapy (CBT) and the interpersonal therapy
(IPT). The article that has been selected in order to compare and analyze the various
psychotherapies therapies uses meta-analysis which is a method that allows for the
comparison (Zhou et al., 2016). The comparison helps for the identification of the most
effective method that can be used to treat the depression among the patients. This was done
by the pooling of the various therapies that can compare the treatment to other available
treatment process. This method can help in the within-study comparison of two such
interventions out of the seven mentioned psychotherapies (Manber et al., 2016).
Depression can be of several types but, this report considers only MDD because the
treatment of the patients who are suffering from either chronic or non-chronic depression is
same in terms of disease and its symptoms (Barth et al., 2016). Thus, the treatments should be

3CLINICAL PSYCHOLOGY
same that becomes comparable. Then the next reason is that both the depression can be
compared in terms of severity that makes it easy for the researcher to compare the patients
with the two types of depression. As the presence of comorbidity is same in the patients who
suffer from depression thus, this report will focus on the MDD and the application of CBT
and IPT in its treatment (Thornicroft et al., 2017).
Here the two of the discussed interventions include CBT and IPT. IPT is a short and
structured psychotherapy that is manual-based. This therapy addresses the various
interpersonal issues that can be directly or indirectly linked to CBT. This method also
excludes the other clinical reasons or causes that can lead to depression. CBT on the other
hand, focuses on the impact of the various broken thoughts that can impact the mind of the
patient. These broken or flawed thoughts have a strong influence on the recent attitude and
behavior of the patient. The future functioning of the various cognitive activities are also
affected (Thornicroft et al., 2017). This treatment method has the central goal to evaluate,
challenge and modify the flawed or broken thoughts. The therapist in this type of treatment
emphasizes on the fact that the client or the patient should perform certain activities in their
home and also some activities that are outside the session. The therapists exert an influence
on the over the various therapeutic interactions and the topics of the discussion, uses an
educational approach that is psychosocial in its treatment process and also teaches the patient
about the various ways to cope with the conditions that are stressful (Zhou et al., 2016).
The practice guidelines suggest that CBT and IPT are the two major choices of
treatment for the major depression disorder (MDD). Despite the direct comparison of the
various treatment methods there were few articles that conducted the direct analysis. The
meta-analysis results showed that CBT is supposed to be more effective than the IPT for the
treatment of MDD (Barth et al., 2017). This observation was further supported by the
analysis of the sub-groups. As the application of CBT is done in order to correct the views of

4CLINICAL PSYCHOLOGY
the patients that are flawed or distorted and the maladaptive beliefs which can lead to the
depression in the patient and thus, the therapy will help them to reduce their feeling of
depression. This can ultimately lead to relieving of the depression in the patients (Rosenblat,
Lee &McIntyre, 2017).
On the other hand, IPT focuses on the fact that the patent is socially isolated and helps
in the establishment of the social connect with the patient. This will help them to improve
their quality of relationships that can be linked to the depressing thoughts and symptoms.
This will help in the solving of the interpersonal relationships of the patients (Keyloun et al.,
2017). The patient might feel more confident and comfortable for the establishment of the
various social relation and also on the improvement in the social connect. Thus, as per the
experience which is subjective there are certain differences among the two therapies but these
changes are not significant according to the observer (Manber et al., 2016).
Reflection
The results of the study show that the two psychotherapies are use of the two
therapies are useful for the analysis and treatment of the patients who are suffering from
depression. As depression is an umbrella term for a number of disorders that can cause
serious complications in the life of an individual (Ekeblad et al., 2016). This is related to the
various reasons that actually lead to the condition of the patient. Thus, depending on the
condition of the patient it is important that the therapist analyses the situation and
circumstances and also considers the various reasons that can lead to depression before
prescribing the medicine or the treatment process (Bockting et al., 2015).
The results of the meta-analysis in the paper show that in the large, medium and small
trials CBT is considered as the treatment method that can be used for the treatment. This
means that the success rate for the treatment of the patient is high in case of CBT as

5CLINICAL PSYCHOLOGY
compared to that of IPT (van der Velden et al., 2015). The differences in the effectiveness of
the treatment method varies as per the different measures of the outcomes. It is clearly shown
that the CBT has an added advantage over the IPT for the treatment of MDD. The
interpretation of these results should be done carefully (Fitzpatrick, Darcy &Vierhile, 2017).
The meta-analysis of the two therapies showed that there are no significant
differences among the two applied interventions. Thus, the results of those interpretations
should be considered carefully. At first the analysis of the various sub-groups among the
patients who were treated with the psychotherapy and the subsequent studies showed that the
there was no observable difference between CBT and IPT (Kessler et al., 2017). IPT has an
added clinical advantage however the changes require a lot of time. Out of the various
psychotherapeutic therapies IPT and CBT are the most recommended line of treatment for the
adults who are suffering from depression. It is very difficult to favor any one of them and the
choice of treatment should be done by the use of the various circumstances that are specific
for each individual (Gajic-Veljanoski et al., 2018).
As a single effective therapy IPT is considered to treat depression among the patients.
However, the meta-analysis shows that the use of a monotherapy for the adults with
depression is not useful or beneficial.The results showed that the CBT and IPT are the
effective methods of treatment for depression (van Bronswijk et al., 2019). Each of the
treatment component is linked with the greater amount of advantage. This shows that the
CBT has an extra advantage over IPT. After the treatment the assessment shows that about
68.5% of patients who are treated with the CBT showed a large amount of improvement
while the patients treated with IPT have an improvement rate of 42.1% (Kontunen et al.,
2016).

6CLINICAL PSYCHOLOGY
In certain studies it has been highlighted that when the therapists use different types of
therapies they might get different outcomes. When they combine the short-time
psychodynamic psychotherapy and the CBT, the results showed that there are no such
differences among the two type of treatment measures (Blanco et al., 2019). However, this
can be showed that the CBT had a superior value for the treatment of anxiety, depression and
worry. Thus, the results show that the difference in the treatment efficiencies for CBT and
IPT for MDD might be different as per the results of the various methods. However, it can
also be said that the use of the different treatment process should be as per the situation of the
patient. (Karyotaki et al., 2016)
Conclusion
Thus, it can be concluded that for the treatment of MDD or Major Depressive
Disorder CBT or IPT can be applied by the therapists.As depression is a common but have
affects the way in which the individual gets affected at the time of performing the daily
activities like eating, working, or sleeping. Thus, the treatment of the disorder requires either
medicines, psychotherapy or a combination of both the processes. As this report focuses on
the CBT in which the therapists try and influence the fact that the patients should be
trained in such a manner that their cognitive thinking is improved. Along with this the
other therapy is the IPT which emphasizes on the interpersonal relations of the patients.
This makes them socially connected and is also effective in the treatment of the
patients who are suffering from social awkwardness.Both these treatment methods can
be applied to different patients as per their specific needs and demands. However, the
report shows that there is no such significant difference in both the treatment process.
Thus, the treatment process that should be selected will be as per the needs and
demands of the patients as both the types of treatment showed no significant difference.
This report also shows that the CBT has an added advantage over the other treatment

7CLINICAL PSYCHOLOGY
method and hence the use of the CBT is superior in comparison to the other treatment
method.

8CLINICAL PSYCHOLOGY
References
Barth, J., Munder, T., Gerger, H., Nüesch, E., Trelle, S., Znoj, H., ...&Cuijpers, P. (2016).
Comparative efficacy of seven psychotherapeutic interventions for patients with
depression: a network meta-analysis. Focus, 14(2), 229-243.DOI:
10.1371/journal.pmed.1001454
Blanco, C., Markowitz, J. C., Hellerstein, D. J., Nezu, A. M., Wall, M., Olfson, M., ...&
Okuda, M. (2019). A randomized trial of interpersonal psychotherapy, problem
solving therapy, and supportive therapy for major depressive disorder in women with
breast cancer. Breast cancer research and treatment, 173(2), 353-
364.doi.org/10.1007/s10549-018-4994-5
Bockting, C. L., Hollon, S. D., Jarrett, R. B., Kuyken, W., & Dobson, K. (2015). A lifetime
approach to major depressive disorder: The contributions of psychological
interventions in preventing relapse and recurrence. Clinical psychology review, 41,
16-26.doi.org/10.1016/j.cpr.2015.02.003
Ekeblad, A., Falkenström, F., Andersson, G., Vestberg, R., &Holmqvist, R. (2016).
Randomized trial of interpersonal psychotherapy and cognitive behavioral therapy for
major depressive disorder in a community‐based psychiatric outpatient
clinic. Depression and anxiety, 33(12), 1090-1098.doi.org/10.1002/da.22495
Fitzpatrick, K. K., Darcy, A., &Vierhile, M. (2017). Delivering cognitive behavior therapy to
young adults with symptoms of depression and anxiety using a fully automated
conversational agent (Woebot): a randomized controlled trial. JMIR mental
health, 4(2), e19.doi:10.2196/mental.7785

9CLINICAL PSYCHOLOGY
Gajic-Veljanoski, O., Sanyal, C., McMartin, K., Xie, X., Walter, M., Higgins, C., ...& Ng, V.
(2018). Economic evaluations of commonly used structured psychotherapies for
major depressive disorder and generalized anxiety disorder: A systematic
review. Canadian Psychology/psychologiecanadienne, 59(4),
301.doi.org/10.1017/S2045796016000020
Karyotaki, E., Smit, Y., de Beurs, D. P., Henningsen, K. H., Robays, J., Huibers, M. J., ...
&Cuijpers, P. (2016). The long‐term efficacy of acute‐phase psychotherapy for
depression: A meta‐analysis of randomized trials. Depression and anxiety, 33(5), 370-
383.doi.org/10.1002/da.22491
Kessler, R. C., Van Loo, H. M., Wardenaar, K. J., Bossarte, R. M., Brenner, L. A., Ebert, D.
D., ... &Schoevers, R. A. (2017). Using patient self-reports to study heterogeneity of
treatment effects in major depressive disorder. Epidemiology and psychiatric
sciences, 26(1), 22-36.doi.org/10.1037/cap0000155
Keyloun, K. R., Hansen, R. N., Hepp, Z., Gillard, P., Thase, M. E., & Devine, E. B. (2017).
Adherence and persistence across antidepressant therapeutic classes: a retrospective
claims analysis among insured US patients with major depressive disorder
(MDD). CNS drugs, 31(5), 421-432.doi: 10.1007/s40263-017-0417-0
Kontunen, J., Timonen, M., Muotka, J., &Liukkonen, T. (2016). Is interpersonal counselling
(IPC) sufficient treatment for depression in primary care patients? A pilot study
comparing IPC and interpersonal psychotherapy (IPT). Journal of affective
disorders, 189, 89-93.doi.org/10.1016/j.jad.2015.09.032
Manber, R., Buysse, D. J., Edinger, J., Krystal, A., Luther, J. F., Wisniewski, S.
R., ...&Thase, M. E. (2016). Efficacy of Cognitive-Behavioral Therapy for Insomnia
Combined With Antidepressant Pharmacotherapy in Patients With Comorbid

10CLINICAL PSYCHOLOGY
Depression and Insomnia: A Randomized Controlled Trial. The Journal of clinical
psychiatry, 77(10), e1316-e1323.DOI: 10.4088/JCP.15m10244
Rosenblat, J. D., Lee, Y., & McIntyre, R. S. (2017). Does pharmacogenomic testing improve
clinical outcomes for major depressive disorder? a systematic review of clinical trials
and cost-effectiveness studies. The Journal of clinical psychiatry, 78(6), 720-
729.DOI: 10.4088/JCP.15r10583
Thornicroft, G., Chatterji, S., Evans-Lacko, S., Gruber, M., Sampson, N., Aguilar-Gaxiola,
S., ...&Bruffaerts, R. (2017). Undertreatment of people with major depressive disorder
in 21 countries. The British Journal of Psychiatry, 210(2), 119-
124.doi.org/10.1192/bjp.bp.116.188078
vanBronswijk, S. C., Lemmens, L. H., Keefe, J. R., Huibers, M. J., DeRubeis, R. J.,
&Peeters, F. P. (2019). A prognostic index for long‐term outcome after successful
acute phase cognitive therapy and interpersonal psychotherapy for major depressive
disorder. Depression and anxiety, 36(3), 252-261.doi.org/10.1002/da.22868
van der Velden, A. M., Kuyken, W., Wattar, U., Crane, C., Pallesen, K. J., Dahlgaard, J., ... &
Piet, J. (2015). A systematic review of mechanisms of change in mindfulness-based
cognitive therapy in the treatment of recurrent major depressive disorder. Clinical
psychology review, 37, 26-39.doi.org/10.1016/j.cpr.2015.02.001
Zhou, S. G., Hou, Y. F., Liu, D., & Zhang, X. Y. (2017). Effect of Cognitive Behavioral
Therapy Versus Interpersonal Psychotherapy in Patients with Major Depressive
Disorder: A Meta-analysis of Randomized Controlled Trials. Chinese medical
journal, 130(23), 2844–2851. doi:10.4103/0366-6999.219149