A Review of the Efficacy and Effectiveness of Cognitive-Behaviour Therapy and Short-Term Psychodynamic Therapy in the Treatment of Major Depression: Implications for Mental Health Social Work Practice

Abstract

A systematic review of the literature regarding the efficacy and effectiveness of cognitive-behaviour therapy and short-term psychodynamic therapy in the treatment of major depression in adults was conducted. This search of electronic databases (PsycArticles, PsycINFO, Social Services Abstracts and PsycLIT) was conducted between August and October 2011 and resulted in full text review of 13 publications. On balance the evidence, largely derived from randomised controlled trials, supported cognitive-behaviour therapy as the more efficacious treatment. The evidence for the efficacy of short-term psychodynamic therapy was somewhat fragmented due to the paucity of controlled studies, with the evidence base for short-term psychodynamic therapy relying heavily upon meta-analyses. There was comparable evidence for the effectiveness of cognitive-behaviour therapy and short-term psychodynamic therapy on the basis of standardised clinical outcome measures. More high-quality randomised controlled trials are required to assess the efficacy of short-term psychodynamic therapy for treating major depression, while the methodological challenges of meta-analyses need to be acknowledged where this methodology forms the primary evidence base for efficacy studies.

针对成年重性抑郁症的认知行为疗法和短期心理动力疗法的疗效，我们对有关文献进行了系统的梳理。2011年8月至10月我们搜索电子数据库（“心理文章”、“心理信息”、“社会服务摘要”、“心理文献”），对十三种出版物做了全文考察。总的说，根据得自随机对照测试的证据，认知行为疗法更为有效。支持短期心理动力疗法的证据由于缺少对照研究而支离破碎，其实证严重依赖于元分析。基于标准化临床结果测量的认知行为疗法和短期心理动力疗法的效果，有一些可资比较的证据。需要做更高质量的随机对照测试，以评估短期心理动力疗法对于重性抑郁症的疗效。同时也要承认元分析在方法论上的问题，因为它形成了疗效研究的第一证据基础。

Keywords:

• Cognitive Behaviour Therapy
• Short Psychodynamic Supportive Therapy
• Major Depression
• Efficacy
• Effectiveness
• Evidence-based practice