Antidepressants,Psychotherapy or their Combination: Weighing Options for Depression Treatments

Psychotherapy and antidepressant medications are the two preeminent treatment choices for depression. This article puts each of these treatments into perspective by presenting an overview of what is currently known about their effectiveness either singly or in combination. Discussion of placebos, common factors among therapies, relapse rates, depression severity, patient treatment preferences and exaggerations in pharmaceutical advertising provide guidance for clinicians in deciding on the best course of treatment. Overall, research reveals the importance of psychosocial factors, no matter what the mode of treatment, and the need for fostering a collaborative bond between clinicians and their patients. We argue that empirical evidence points to making psychotherapy the initial treatment choice for most cases of depression.     

We are not a Healthcare Business: Our Inadvertent Vow of Poverty

Psychology has been fractionated from mainstream healthcare delivery and this schism has resulted in huge costs to psychologists and our intended customers. Psychology has also been naïve economically. The authors suggest three revolutions: (1) for clinical psychology to be better integrated into the healthcare delivery system; (2) for psychologists to better understand healthcare economics and business; and (3) for psychologists to become more entrepreneurial, i.e., see needs in healthcare (such as those of the elderly, obesity, improved access and value through ehealth) and systematically fill these. We note high quality businesses help many individuals (customers, family members, employees) not typically recognized by anti-business psychologists.     

A Study of Religiosity and Psychological Well-being Among African Americans: Implications for Counseling and Psychotherapeutic Processes

This study examined whether a relationship exists between religious orientation as a therapy intervention and the degree of depression, coping behavior and self-esteem among African American adults. In addition, the relationship and predictive power of selected religious and socio-demographic variables and religious orientation as a therapy intervention were studied. African American adults were randomly selected to participate in this empirical study. Age had a significant independent effect on intrinsic religiosity and extrinsic religiosity and a linear relationship was found between extrinsic religiosity and the seven demographic predictor variables at the .05 level of significance.     

Suffering and Spirituality in the Poetry of Emily Dickinson

After a brief review of recent accounts of spirituality in its relation to medicine and psychotherapy, Emily Dickinson’s poetry is considered as a springboard to a more specific account of spirituality. While not conventionally religious, she is arguably among the most spiritual of poets inasmuch as her themes of God, love, beauty, and especially death and suffering all depend upon the jarring juxtaposition of embodied human experience and transcendent human significance. Her poems suggest a complex view of the ambiguous relation of suffering to human action and meaning. Psychotherapy is a spiritual process not because it necessarily involves supernatural beings or destinies, but because it represents the struggle between human will and aspiration on the one hand and acceptance of biological and other realities on the other.     

Positive mental health,positive affect and suicide ideation

Background/ObjectivePositive mental health (PMH) has been shown to confer resilience against suicide ideation. However, the mechanisms underlying the positive effect of PMH on suicide ideation/behavior are largely unknown. The current study aimed to determine whether positive affect mediates the association between PMH and suicide ideation.MethodA total of 150 adult outpatients (65.3%; female; age: M(SD)=37.79(13.50), range:18–77) completed measures on PMH, positive and negative affect, as well as suicide ideation. Data were collected using self-report questionnaires. Linear hierarchical regression analysis was used to analyze the data. Positive affect was considered to mediate the association between positive mental health and suicide ideation.ResultsWhile positive affect fully mediated the significant negative association between PMH and suicide ideation, negative affect did not reveal to be a significant mediator of this relationship.ConclusionsThe protective influence of PMH against suicide ideation is due to heightened positive affect: If positive mental health translates into positive affect, then suicide ideation becomes less likely.     

A healing relationship: Clients’ experiences of the long-term relational significance of the horse in horse assisted psychotherapy

Horse assisted psychotherapy is a type of treatment for mental ill-health in which the client forms a relationship with a horse. Research suggests that the relationship to a horse is very helpful to clients, but how the horse is experienced many years after the end of treatment has not been investigated. The aim of the present study was thus to investigate how former clients from horse assisted psychotherapy experienced the horse several years after treatment was completed. Former clients (n = 5; all females) from one and the same treatment center were interviewed and the data was analyzed with an inductive thematic approach. The analysis showed that many years after completion of treatment, the horses were still remembered as the most important individuals in the informants’ lives during the time of treatment. This was captured by the core category ‘A healing relationship’. These findings are in line with previous research that found that patients in horse assisted psychotherapy and their family members attributed improvements from treatment to the patients’ relationship to the horses, but adds that the clients also keep these views at follow-up several years after termination of treatment.     

Have We Found the Holy Grail? Theory of Mind as a Unifying Construct

Theory of Mind (ToM) refers to a person’s ability to understand that another person has his or her own unique way of thinking and feeling. ToM is a well-known and rapidly expanding field of research in the neurosciences, cognitive, social sciences, evolution, and brain imaging. This review article expands ToM into areas where there has not yet been research. We propose that ToM could illuminate the relationship between religion/spirituality and health, and could provide the lingua franca for the hundreds of schools of psychotherapy. We discern two different kinds of spirituality: personal versus impersonal. Empathy is central to ToM research and is also central to mental health training and practice. ToM illuminates familiar topics in a new light. For example ToM reveals a close link between psychology and spirituality in self-efficacy and locus of control research.     

Interpersonal Psychotherapy for Late Life Depression: Current Status and New Applications

Interpersonal Psychotherapy (IPT) is an empirically-supported treatment for depression and other mental disorders. This article discusses the structure of IPT, its use with older adults, and research that supports its efficacy with depressed older people. Depressed older persons with significant health problems or cognitive impairment present special challenges for those conducting IPT and other psychotherapies. Promising new psychotherapies developed for depressed older adults with cognitive impairment and those living in nursing homes are reviewed. Recommendations are made for use of IPT with older adults in nursing homes.     

Contextual Adult Life Span Theory for Adapting Psychotherapy with Older Adults

Our aging population is growing in size and diversity. To integrate different views on aging and make explicit the role of culture as a contextual factor, we modified Knight’s (Psychotherapy with older adults, 2004) Contextual, Cohort-based, Maturity, Specific Challenge (CCMSC) model of psychotherapy with older adults into the Contextual Adult Lifespan Theory for Adapting Psychotherapy (CALTAP). This article describes various components of the CALTAP, which serves as a meta-theoretical framework in guiding an integrated psychotherapy approach for the aging population. The interaction between environmental factors like cohort differences and socio-cultural contexts and individual factors such as maturation and age-related specific challenges not only shapes the experience and presentation of older adults in clinical settings, but also highlights special considerations in adapting psychotherapy for older adults.