Clinical Depression

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Clinical Depression

Introduction to Clinical Depression

Mental health is an integral part of a person’s wellbeing. Like other health components, such as physical health, our minds give us clues when all is not well. Different mental health disorders present various symptoms used in diagnosis. Clinical depression is a mental health disorder that can happen to anyone regardless of age, gender, or any other characteristic. The main aspect of clinical depression is a profound feeling of deep sadness and low mood that goes on for at least two weeks. The impact on one’s mood and emotional state affects different areas of life.

Clinical depression has several symptoms used in diagnosis according to the DSM-V. One of these symptoms is the persistent feelings of sadness almost all the time. A depressed individual also shows diminished interest or a total lack of interest in everyday activities that they enjoyed before. Another sign of depression is persistent feelings of guilt and worthlessness without explanation. Fourth, an individual is diagnosed with depression when they experience thoughts of suicide recurrently, which may result in an attempt or plan to commit suicide. Other symptoms include excessive fatigue, loss of concentration, indecisiveness, and changes in weight and appetite. Clinical depression negatively affects the patient and the people around them, such as their family, friends, and colleagues. If untreated, clinical depression could lead to dangerous behavior like substance abuse, ruined relationships, sleeping problems, physical illness, and suicide.

Research on Therapeutic Modalities Effectively Treating Clinical Depression in Group Settings

Thimm & Antonsen explored the effectiveness of cognitive-behavioral group therapy for patients with clinical depression. One hundred forty-three patients took part in the study, with 88 of these analyzed during the outcome. It was found that 30% of patients recovered from depression, and 44% showed remarkable improvement (Thimm & Antonsen 2014). The researchers used the Beck Depression Inventory to measure the outcome of the program. CBT has long been recognized as a valuable and effective treatment option for clinical depression; therefore, group CBT was expected to work as well. The study found CBT to be effective due to the significant number of patients who recovered. One of the benefits of group CBT is that it is a cost-effective measure as several patients are treated simultaneously. Patients also feel that their illness is normal and learn from each other’s experience with depression.

Aguilera and colleagues conducted another study to determine the efficiency of GCBT in treating clinical depression among a group of Latinos. The study was conducted in a primary care facility where 96 patients participated in multiple sessions of group CBT. One of the main challenges experienced in the program was a high dropout rate and failure to adhere to the program. The program offered 16 sessions of GCBT, but half of all patients failed to attend 50% of the sessions. It was concluded that the more the sessions attended, the lower the depressive symptoms the patients showed over time (Aguilera et al., 2018). Group CBT was found to be an effective intervention in this case.

Clinical depression tends to be a common issue for women during and after pregnancy. Since pregnancy and childbirth can be challenging experiences, it is imperative that women get the support they need to preserve their mental health through this journey. Group therapy would be helpful for expecting women and new mothers to share experiences and know that they can recover from depression as others have. Oral and Tuncay published their findings on group interpersonal psychotherapy (IPT-G) in the International Journal of Group Psychotherapy. Twenty-two Turkish women diagnosed with clinical depression took part in the study with Social Adaptation Self-Evaluation Scale and Beck Depression Inventory as measures (Oral & Tuncay, 2021). The interventions went on for twelve weeks, and at the end of the study, it was found that group interpersonal therapy decreased depression levels and improved social adaptation of the women in the study. 

Similarly, Monk conducted a study on the effectiveness of group interpersonal therapy to treat women with prenatal depression in a study titled “Effectiveness of Group Interpersonal Psychotherapy in Treating Women with Prenatal Depression.” The findings were published on the US National Library of Medicine website. The article explains that roughly 10-15% of women experience prenatal depression, causing suffering for the women as well as developmental problems for the infants after birth (Monk 2015). Group Interpersonal therapy is one of the most effective treatment options for prenatal depression, as shown in the study. One hundred sixteen pregnant women took part in the twelve-week program. The participants were split into three groups. One was treated with IPT-G, the second received treatment as usual, while the third group received no treatment (Monk 2015). The group that received group therapy with five to eight other women was found to have the highest recovery rate than the other two groups. 

Depression among adolescents is a serious issue as it could lead to lifelong problems if left untreated. Some people think of depression as only affecting adults, but adolescents also suffer from mental health disorders such as clinical depression. Parents, guardians, and teachers need to look out for symptoms of depression among teenagers exhibiting behavioral problems. Keles and Idsoe examined the effects of group cognitive-behavioral therapy on adolescents. They published the results in an article titled “A meta-analysis of group Cognitive Behavioral Therapy (CBT) interventions for adolescents with depression.” The researchers reviewed the literature on the topic and found 23 studies that involved both post-intervention and follow-up comparisons of results (Keles & Idsoe, 2018). The studies involved a control group and treatment group CBT was found to be more effective than control conditions in both comparisons. 

Moore et al. examined whether cognitive behavioral therapy is as effective as it is made out to be in the treatment of clinical depression. The study focused on research articles published on various sites such as PubMed, Cochrane, PsycInfo, and EMBASE. The common factor in the reports analyzed is that they all used the Beck Depression Inventory as a measure of outcomes. The studies compared two groups, control groups and those receiving CBT. The study found that CBT is a viable intervention for treating clinical depression in adults, given the significant effect of the therapy on depressive symptoms among patients (Moore et al., 2017). Similarly, group CBT was shown to be effective among a group of patients with autism. Patients showing signs of depression were split into two groups, one receiving group CBT and the other individual treatment. The Depression Anxiety Stress Scales was used to measure the outcomes of treatment (McGillivray & Evert, 2014). The patients who received CBT showed lower scores on the scale compared to those who did not.

Barth et al. compared the efficiency of various treatment therapies for patients with clinical depression. These treatments include cognitive behavioral therapy and interpersonal therapy in group settings. The researchers, in this case, examined previous studies done on seven psychotherapeutic interventions. These interventions include short-term psychodynamic therapy, behavioral activation, and problem-solving therapy, in addition to CBT and interpersonal therapy. The study’s main aim was to find out the efficiency of the different treatments in individual and group settings (Barth et al., 2016). It was concluded that interpersonal therapy was most effective in treating clinical depression compared to the other interventions.

Challenges of the Therapeutic Modalities

One of the main challenges that the researchers experienced in their studies is the significant dropout rate among participants. The length of the intervention varied, with most of them lasting twelve weeks. For many people, twelve weeks is a long time to attend treatment, especially when one is already feeling better. Many of the studies cited patients dropping out as one of the challenges in measuring the intervention program’s efficacy. When patients who complete the study show high recovery rates, it indicates that the treatment would have been even more effective had all the patients remained with the treatment schedule. A perfect example of this is the study conducted by Thimm & Antonsen, in which 17.5% of participants dropped out (Thimm & Antonsen, 2014).

Another challenge in the studies is homogeneity. Most of the studies involve participants with different characteristics. These include pregnant women, individuals with autism, adolescents, and adults. All of these groups respond differently to therapy, meaning that efficiency will vary from one group to another. The procedure of treatment also tends to be different. For example, group therapy involves a different number of individuals, meaning it is challenging to find the best number of people for group therapy. The number may affect the efficacy of the intervention.

Implications to Social Work Practice in Group Settings.

One of the significant implications of the study is the use of control measures. Some of the control measures in the studies include the use of waitlist controls and control groups (Barth et al., 2016). Such measures should be considered unethical as they could adversely affect patients who need treatment for clinical depression. Proving the efficiency of group therapy should take a backseat to the patient’s wellbeing. Future practitioners should find a different way of measuring the efficiency of group treatment without putting patients at risk. 

The dropout rate for patients with clinical depression is another concern during the study. One way to address this is to assess patients’ suitability to group therapy to reduce patient dropout rates. Some of the characteristics that should be analyzed include attachment style, chronicity of problems, personality disorders, among others (Thimm & Antonsen, 2014). All these should be considered indicators of how suited a patient will be to group therapy instead of other forms of treatment. 

Conclusion

In summary, clinical depression is a serious mental disorder that should be treated as soon as possible. The DSM-V elaborates on the symptoms, diagnosis, and treatment of patients with clinical depression. If left untreated clinical depression will have severe adverse effects on individuals and those around them. Various studies have been carried out to examine the effectiveness of cognitive-behavioral therapy and interpersonal therapy in treating clinical depression in group settings. Group therapy offers advantages such as the feeling of support and cohesion among patients, giving them hope of recovery. These studies show that the two interventions are effective in treating clinical depression among different groups of people. Mental health is a crucial part of a person’s wellbeing, so people should treat the best treatment in case of mental illness. 

References

Aguilera, A., Bruehlman-Senecal, E., Liu, N., & Bravin, J. (2018). Implementing group CBT for depression among Latinos in a primary care clinic. Cognitive and behavioral practice, 25(1), 135-144.

Barth, J., Munder, T., Gerger, H., Nüesch, E., Trelle, S., Znoj, H., … & Cuijpers, P. (2016). Comparative efficacy of seven psychotherapeutic interventions for patients with depression: a network meta-analysis. Focus, 14(2), 229-243.

Keles, S., & Idsoe, T. (2018). A meta-analysis of group cognitive behavioral therapy (CBT) interventions for adolescents with depression. Journal of adolescence, 67, 129-139.

McGillivray, J. A., & Evert, H. T. (2014). Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD. Journal of autism and developmental disorders, 44(8), 2041-2051.

Monk, C. (2015) “Effectiveness of Group Interpersonal Psychotherapy in Treating Women With Prenatal Depression.” ClinicalTrials.gov.

Moore, L. M., Carr, A., & Hartnett, D. (2017). Does group CBT for depression do what it says on the tin? A systemic review and meta-analysis of group CBT for depressed adults (2000–2016). Journal of Contemporary Psychotherapy, 47(3), 141-152.

Oral, M., & Tuncay, T. (2021). Effectiveness of group interpersonal psychotherapy among women with major depression in Turkey. International Journal of Group Psychotherapy, 71(1), 180-202.

Thimm, J. C., & Antonsen, L. (2014). Effectiveness of cognitive behavioral group therapy for depression in routine practice. BMC psychiatry, 14(1), 1-9.