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David Baxter

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New specialized treatment for depression developed
Wednesday, 31 May 2006

Researchers led by a Duke University psychologist have developed a new type of psychotherapy that is optimally designed to treat a particular type of depression.

The new self-system therapy (SST) targets patients whose depression is linked to difficulty identifying and pursuing goals involving advancement, growth and achievement, according to Timothy J. Strauman, a co-developer of SST who is professor and co-chair of the Duke Department of Psychology and Neuroscience. About one-fifth of depressed patients fit this profile, Strauman said.

The researchers found that SST was more effective for such individuals than cognitive therapy, a common treatment for depression.

"The advantage of the new treatment is that it was designed in advance to be optimal for this particular subset of depressed people," Strauman said. "Even though cognitive therapy is generally effective, for these patients SST was significantly better."

The researchers reported their findings in the Journal of Consulting and Clinical Psychology. The research was funded by the National Institute of Mental Health.

The new therapy also may help therapists choose the best treatment for individual patients, Strauman said.

Typically, when patients seek treatment for depression, their doctors and therapists must experiment with different forms of psychotherapy and medication to find one that works for that individual.

Even the most successful interventions - such as cognitive therapy, interpersonal therapy and the use of drugs called selective serotonin reuptake inhibitors - lead to complete remission of symptoms only about 60 to 70 percent of the time. The treatment process can be frustrating and time-consuming.

But SST offers a method that is specifically tailored for one particular group of depressive individuals, and hence therapists might make it their first choice for treating such patients, Strauman said.

"Until now, there has been no way to predict in advance which treatment will be best for a particular person, even though a number of treatments for depression can be effective," he said.

SST is based on what psychologists call regulatory focus theory, which defines two types of goals: prevention goals and promotion goals. Prevention goals involve "keeping bad things from happening," while promotion goals involve "making good things happen." SST is designed to treat patients who have not learned how to attain promotion goals and so cannot experience the positive motivation and self-esteem boost that accompanies making such progress.

"Many people are better able to take a prevention approach to life - keeping bad things from happening," he said. "Being prevention-oriented has advantages, but it does not make you happy."

Self-system therapy draws on techniques used in other types of therapy, including cognitive therapy, which focuses on reversing the effects of depression on how the patients think. But SST sessions focus on helping patients develop skills and strategies to answer four critical questions:

  • What are your promotion and prevention goals?
  • What are you doing to attain them?
  • What is keeping you from making progress?
  • What can you do differently?

Forty-five patients who met diagnostic criteria for depression took part in the study. Half were treated with self-system therapy, while the other half received cognitive therapy. Both groups received about 20 sessions of therapy, at no cost.

Although patients in both treatments improved, patients lacking the ability to pursue promotion goals who received SST made much more significant progress than similar patients receiving cognitive therapy, Strauman said, adding, "For those patients, the difference between SST and cognitive therapy was substantial."

"The emphasis in SST on the distinction between promotion and prevention, each of which involves specific strategies for goal pursuit, may have provided a perspective and skill set that allowed these individuals to instigate a self-reinforcing process of pursuing promotion goals," the researchers said in their report.

Therapists who now use cognitive therapy and other treatment approaches should be able to learn self-system therapy easily, said Strauman, who is a fellow of the Academy of Cognitive Therapy. In fact, the therapists who participated in the study were trained through a manual and weekly discussion sessions, a process that could be replicated so that therapists could add SST screening and treatment to the battery of treatment options they offer.

Strauman TJ, Vieth AZ, Merrill KA, Kolden GG, Woods TE, Klein MH, Papadakis AA, Schneider KL, Kwapil L. Self-system therapy as an intervention for self-regulatory dysfunction in depression: a randomized comparison with cognitive therapy. J Consult Clin Psychol. 2006 Apr;74(2):367-76. [Abstract]
 

Halo

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I think that anytime a new treatment option is discovered and used it is a great thing. The more options available to a therapist the better.
 

sister-ray

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Sounds good to me :) I would love to be involved in some of these studys, trying new therapies out.
 

Halo

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Same here. I also think that it would be interesting to try new medication studys as well. Anything that would help.
 

foghlaim

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while it sounds goood. i don't think i'd like to be a guinea pig for any study... i'm a coward.lol




nsa
 

sister-ray

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I dont think I like the idea of trying new medications out just in case there where strange side effects.
 

Halo

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The way I figure it, there may be strange side effects but to be honest I am not sure if they are much worse than the side effects of some of the meds that I have been on. Also, what if it was the "miracle" med that worked???

I think that I would have to give it a try. I have been a guinea pig before for doctors....no big deal for me.
 

Banned

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I would love to be a guinea pig - not for meds (too chicken as well!) but I'm game for anything else...
 

Kanadiana

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I'm already a guinea pig for meds (all for physical stuff) and new ones keep getting added, and more to come, am already on 3 different things to deal with side effects of the main meds ... argh. Always six of one half a dozen of the other when it comes to benefits/drawbacks. At this point I need the benefits more than I need to avoid the side-effects.
 

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