See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/230218577 Humanistic therapies versus other psychological therapies for depression Chapter in Cohrane Database of Systematic Reviews · September 2010 DOI: 10.1002/14651858.CD008700 CITATION READS 1 183 7 authors, including: Rachel Churchill Philippa A Davies The University of York University of Bristol 121 PUBLICATIONS 4,394 CITATIONS 23 PUBLICATIONS 525 CITATIONS SEE PROFILE SEE PROFILE Theresa Helen Mazarello Moore University of Bristol 42 PUBLICATIONS 2,466 CITATIONS SEE PROFILE All in-text references underlined in blue are linked to publications on ResearchGate, Available from: Theresa Helen Mazarello Moore letting you access and read them immediately. Retrieved on: 30 June 2016 Humanistic therapies versus other psychological therapies for depression (Protocol) Churchill R, Davies P, Caldwell D, Moore THM, Jones H, Lewis G, Hunot V This is a reprint of a Cochrane protocol, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library 2010, Issue 9 http://www.thecochranelibrary.com Humanistic therapies versus other psychological therapies for depression (Protocol) Copyright © 2012 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. TABLE OF CONTENTS HEADER....................................... 1 ABSTRACT ...................................... 1 BACKGROUND .................................... 1 OBJECTIVES ..................................... 3 METHODS ...................................... 3 REFERENCES ..................................... 10 APPENDICES ..................................... 15 WHAT’SNEW..................................... 16 HISTORY....................................... 16 CONTRIBUTIONSOFAUTHORS . 16 DECLARATIONSOFINTEREST . 17 SOURCESOFSUPPORT . 17 Humanistic therapies versus other psychological therapies for depression (Protocol) i Copyright © 2012 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. [Intervention Protocol] Humanistic therapies versus other psychological therapies for depression Rachel Churchill1, Philippa Davies1, Deborah Caldwell2, Theresa HM Moore1, Hannah Jones3, Glyn Lewis2, Vivien Hunot1 1Academic Unit of Psychiatry, School of Social and Community Medicine, University of Bristol, Bristol, UK. 2School of Social and Community Medicine, University of Bristol, Bristol, UK. 3Cochrane Schizophrenia Group, The University of Nottingham, Nottingham, UK Contact address: Rachel Churchill, Academic Unit of Psychiatry, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK. [email protected]. [email protected]. Editorial group: Cochrane Depression, Anxiety and Neurosis Group. Publication status and date: Edited (no change to conclusions), published in Issue 7, 2012. Citation: Churchill R, Davies P, Caldwell D, Moore THM, Jones H, Lewis G, Hunot V. Humanistic therapies versus other psychological therapies for depression. Cochrane Database of Systematic Reviews 2010, Issue 9. Art. No.: CD008700. DOI: 10.1002/14651858.CD008700. Copyright © 2012 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. ABSTRACT This is the protocol for a review and there is no abstract. The objectives are as follows: 1. To examine the effectiveness and acceptability of all humanistic therapies compared with all other psychological therapy approaches for acute depression. 2. To examine the effectiveness and acceptability of different humanistic therapy models (person-centred, gestalt, process- experiential, transactional analysis, existential and non-directive therapies) compared with all other psychological therapy approaches for acute depression. 3. To examine the effectiveness and acceptability of all humanistic therapies compared with different psychological therapy approaches (psychodynamic, behavioural, humanistic, integrative, cognitive-behavioural) for acute depression. BACKGROUND ture of depression, and people with severe depression may develop psychotic symptoms (APA 2000). Depression is the third leading cause of disease burden world- wide and is expected to show a rising trend over the next 20 years Description of the condition (WHO 2004; WHO 2008). A recent European study has esti- Major depression is characterised by persistent low mood and loss mated the point prevalence of major depression and dysthymia of interest in pleasurable activities, accompanied by a range of at 3.9% and 1.1% respectively (ESEMeD/MHEDEA 2004). As symptoms including weight loss, insomnia, fatigue, loss of energy, the largest source of non-fatal disease burden in the world, ac- inappropriate guilt, poor concentration and morbid thoughts of counting for 12% of years lived with disability (Ustun 2004), de- death (APA 2000). Somatic complaints are also a common fea- pression is associated with marked personal, social and economic Humanistic therapies versus other psychological therapies for depression (Protocol) 1 Copyright © 2012 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. morbidity, loss of functioning and productivity and creates signif- termined by events, and implying a lack of free will) and towards icant demands on service providers in terms of workload (NICE client choice and responsibility (Pilgrim 2002). Key psychological 2009). Depression is also associated with a significantly increased therapies considered as humanistic in approach include Gestalt risk of mortality (Cuijpers 2002). The strength of this association, therapy (Perls 1976), existential therapy (Deurzen 1997), trans- even taking account of confounders such as physical impairment, actional analysis (Berne 1961), person-centred therapy (Rogers health-related behaviours and socio-economic factors, has been 1951), and process-experiential therapy (a manualised humanistic shown to be comparable to, or greater than, the strength of the intervention combining person-centred therapy and emotion-fo- association between smoking and mortality (Mykletun 2009). cused therapy) (Greenberg 1998).To date, person-centred therapy remains the most commonly used psychotherapeutic approach in UK health care settings (Stiles 2008) (see Types of interventions Description of the intervention section for a detailed description of each type of therapy). Clinical guidelines recommend pharmacological and psycholog- ical interventions, alone or in combination, in the treatment of moderate to severe depression (NICE 2009). Antidepressant pre- How the intervention might work scribing has increased dramatically in many Western countries over Humanistic psychological therapies are based on the premise that the last 20 years, mainly with the advent of selective serotonin people are ‘self-actualizing’, that is, they have an inherent tendency reuptake inhibitors and newer agents such as venlafaxine. Antide- to develop their potential (Rogers 1951; Maslow 1970). Other pressants continue to be the mainstay of treatment for depression defining characteristics of humanistic therapies include the belief in health care settings (Ellis 2004, NICE 2009). that people are self-aware, are free to choose how they will live, Whilst antidepressants are of proven efficacy for the acute treat- are responsible for the choices they make, and are unique entities ment of depression (Guaiana 2007; Arroll 2009; Cipriani 2009a; that need to be understood in the context of their individual ex- Cipriani 2009b; Cipriani 2009c), adherence rates remain very low periences and characteristics (Cain 2002). (Hunot 2007; van Geffen 2009), due in part to patients’ concerns In clinical practice, manualised or highly specific treatments for about side effects and possible dependency (Hunot 2007). Fur- psychological disorders are largely avoided by humanistic thera- thermore, surveys consistently demonstrate patients’ preference pists, on the basis that therapy should be individualised to fit with for psychological therapies over that of antidepressants (Churchill the personal goals, preferences and values of each client. Whilst 2000; Riedel-Heller 2005). Therefore, psychological therapies contemporary models of humanistic therapies may differ some- provide an important alternative intervention for depressive dis- what from a conceptual perspective and in terms of strategies/tech- orders. niques, all emphasise the ‘growth-inducing power’ (Cain 2002) of A diverse range of psychological therapies is now available for the therapeutic relationship. Therapist ‘core conditions’ of empa- the treatment of common mental disorders (Pilgrim 2002). Psy- thy, genuineness and unconditional positive regard, described by chological therapies may be broadly categorised into four sepa- Rogers 1951 as ‘the definable climate of facilitative psychological rate philosophical and theoretical schools, comprising psychoana- attitudes’, are considered as cornerstones of therapy. Creation of lytic/dynamic (Freud 1949; Klein 1960; Jung 1963), behavioural an optimal interpersonal environment to facilitate client insight, (Watson 1924; Skinner 1953; Marks 1981), humanistic (Maslow leading to acceptance, change and personal growth with resulting 1943; Rogers 1951; May 1961) and cognitive approaches (Lazarus potential for a reduction in depression symptoms (Cain 2002). 1971; Beck 1979). Each of these four schools contains a num- Presenting problems are person rather than disorder-focused, and ber of differing and overlapping psychotherapeutic approaches. individuals are treated as experts