Toward a clinical model of psychotherapy for depression, II: An integrative and selective treatment approach

Integrative dimensions of psychotherapy training

This paper investigates the influence of integrative factors on psychotherapy education. The broad relevance of integrative psychotherapy to residency training and continuing mental health education is discussed. Following a review of the existing literature on the education of integrative psychotherapists, the article systematically examines the integrative and pedagogic issues to be considered in planning psychotherapy training informed by integrative principles. The integrative issues are organized into 5 categories: attitudinal set, knowledge base, clinical techniques and skills, developmental tasks and challenges, and systemic institutional factors. The educational issues can be divided into 4 categories: content, format and process, sequence, and faculty development. Brief descriptions of actual educational interventions illustrate the implementation of such ideas. Specific recommendations are made regarding the development of integrative educational initiatives and future study of unresolved questions.

Knowledge of depression and application to practice: a program evaluation

The purposes of this program were to determine whether participants gained more comprehensive knowledge about depression and if that knowledge was applied in practice following attendance at a 3-day educational workshop. Twelve programs were conducted in three southwestern states. The majority of the 363 participants were Anglo-White female registered nurses whose ages ranged from 23 to 74 years and who worked in general medical-surgical units, nursing homes, or community health settings. This study was a repeated-measures design to evaluate the effects of depression education on depression knowledge and its clinical application. Participants demonstrated increased depression knowledge and practice application following the program. Knowledge of depression remained stable across postprogram measures. Although application of interventions decreased between 6 weeks and 6 months, assessment skills remained stable. Mental health nurses can improve patient outcomes through programs such as the one described by educating nurses in the detection and management of depression.

Formulation: a multiperspective model

This paper presents a model of formulation that can be used by psychiatrists and other mental health professionals. A review of the literature indicates a need for a more comprehensive approach that can accommodate a variety of perspectives, suggest treatment and can be easily recalled. These issues are addressed by the multiperspective grid presented in this paper.

Antidepressants in group psychotherapy

This article alerts us to consider depression as a relatively frequent cause of impasse in the course of group psychotherapy. The authors recommend the combined use of antidepressant medication along with group psychotherapy when such depression is confirmed independently outside the group. Common obstacles and pitfalls preventing successful combined treatment are reviewed; the depressive logjam is differentiated from common resistance; and profiles of responders versus nonresponders are described. A rationale of the combined treatment, its results, and implications for group therapists are all delineated.