Q&A

CBT for Depression and Medication

CBT for Depression and Medication

Steven Hollon compares Cognitive Behavior Therapy with medication in the treatment of moderate to severe depression.

Q
I’m interested to know if there are any misconceptions about depression that you’ve noticed in your work?
A
pdf
hollon 2019 (behav therapy)
Q
What makes CBT such an effective intervention with depression?
A
pdf
2013 Cuijpers, Long term effects CBT antidepressants, BMJ Open
Q
What is the latest research on effectiveness of CBT for depression vs. medication plus CBT? What about other somatic treatments for depression, including TMS, Direct Current Stimulation, Pulsed Electromagnetic Field Therapy, with vs without CBT?
A
pdf
derubeis 2014 (plos1)
pdf
2013 Cuijpers, Long term effects CBT antidepressants, BMJ Open
Q
Do you think people are being overprescribed medication to treat depression?
A
Q
Do you have a preference for a particular type of antidepressant? (i.e. SSRIs, SNRIs?)
A
pdf
hollon 2014 (cpt3 recovery new)
pdf
2013 Cuijpers, Long term effects CBT antidepressants, BMJ Open
Q
I've worked with children experiencing depression and there's been pressure to start them on medication. What are your views on this?
A
Q
What areas of research in the field of clinical depression would you love to see explored more?
A
pdf
derubeis 2014 (plos1)
pdf
2009 andrews (rumination)
pdf
hollon 2019 (behav therapy)
Q
Do medications interfere with the process and outcome of CBT for depression?
A
pdf
cpt1 acute (hollon et al 1992)
pdf
hollon 2014 (cpt3 recovery new)
pdf
derubeis 2020 (recurrence)
pdf
2013 Cuijpers, Long term effects CBT antidepressants, BMJ Open
Q
Don’t anti-depressants just suppress symptoms and stop people from making the necessary changes to improve their lives?
A
pdf
fournier et al 2010 (jama sev mod)
pdf
2009 andrews (rumination)
pdf
cpt2 employment (fournier 2014 bjpsych)
pdf
2013 Cuijpers, Long term effects CBT antidepressants, BMJ Open
pdf
hollon 2019 (behav therapy)
Q
I often hear that people need anti-depressants to 'dial down' the symptoms of depression to enable engagement in CBT or psychotherapy. Does the literature support this?
A
pdf
hollon 2014 (cpt3 recovery new)
pdf
cpt1 acute (hollon et al 1992)
pdf
derubeis 2014 (plos1)
pdf
derubeis 2020 (recurrence)
pdf
2013 Cuijpers, Long term effects CBT antidepressants, BMJ Open
Q
Do you need to change CBT protocol if someone has commenced medication?
A
pdf
derubeis 2020 (recurrence)
pdf
2013 Cuijpers, Long term effects CBT antidepressants, BMJ Open
Q
Does medication vs CBT target different symptoms of depression e.g., suicide ideation, anhedonia?
A
pdf
cpt2 symptom change (fournier 2013)
pdf
2013 Cuijpers, Long term effects CBT antidepressants, BMJ Open
pdf
derubeis 2014 (plos1)
Q
What are the morbidity and mortality stats for the long-term (or even short-term) use of SSRIs?
A
pdf
maslej 2017 (PPS all cause mortality article)
Q
What is the best way to prevent the recurrence of a depressive episode?
A
pdf
cpt2 relapse (hollon et al 2005)
pdf
seattle ba relapse (dobson et al 2008)
pdf
2013 Cuijpers, Long term effects CBT antidepressants, BMJ Open
Q
Why do some patients not benefit from CBT?
A
pdf
derubeis 2014 (plos1)
Q
What is 'treatment resistant' depression?
A
Q
Does antidepressant medication induce neuronal growth in the hippocampus?
A
pdf
duman 1997 (agp neurogenesis)
pdf
duman monteggia neurotrophic model stress biol psychiatry 2006
Q
Under what circumstances should psychotherapists (not doctors) recommend to clients that they see their GP for anti-depressant medication?
A
Q
I've had many clients present stating that they don't want CBT. It does seem that CBT has fallen out of favour with some therapists and clients. What do you think is going on here?
A
Q
When people present with depression that includes sleep disturbance, what do you target first - e.g., mood or sleep?
A
Q
How much does the therapeutic relationship matter in CBT?
A
pdf
feeley derubeis gelfand 1999 (jccp dep process)
pdf
2013 Cuijpers, Long term effects CBT antidepressants, BMJ Open
Q
What are some of the research findings on the long term impact a) on the brain from long term (i.e. years+) treatment with SSRIs, and b) on the ability to successfully stop taking SSRIs after long term treatment?
A
pdf
maslej 2017 (PPS all cause mortality article)
pdf
hollon 2019 (behav therapy)
Q
CBT may be misunderstood as regimented (almost calloused) in it's approach - both to clients and other professionals. How do you navigate conversations with clients who have had negative past experiences with this therapy?
A
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