Multimodal Therapy of Treatment Resistant Depression: A Study and Analysis

Abstract

Objective: To demonstrate through the use of a case study, the application of cognitive psychotherapy in the treatment of resistant depression. Method: The case of a woman with an 18-month history of resistant depression associated with low self-esteem, guilt and shame, who failed to respond to three therapeutic trials of antidepressants is described. A detailed description of a CBT intervention over 12 sessions is given. Result: Clear improvements on assessments of mood and hopelessness, along with overall improvements in social and occupational functioning were noted. Conclusion: These improvements were attributed to a combination of CBT and pharmacotherapy, where pharmacotherapy alone failed to alleviate symptoms. A concise literature review revealed relatively few published trials of psychological treatments, and a lack of clear guidelines on pharmacological treatments. More research is needed to explore the efficacy of psychological therapies for treatment resistant depression.