Systemic family and couple therapy for mood disorders
Behaviourally-inspired couple therapy approaches have been used for some time and have proved to be effective with patients suffering from depression. A number of RCTs of marital therapy as a treatment for depression have been conducted (e.g. O'Leary & Beach, 1990; Jacobson et al, 1991; Emanuels-Zuurveen & Emmelkamp, 1996; Baucom et al, 1998). Interpersonal systems therapy (Gottlieb & Colby, 1987) and conjoint interpersonal therapy (Klerman et al, 1984) have also been shown to be effective with couples when one of the partners has depression. At the more severe end of the spectrum, family interventions, in addition to ongoing traditional treatments, have been found to significantly reduce relapse rates of patients suffering from bipolar disorder (Miklowitz & Goldstein, 1990), confirming similar findings by Clarkin et al (1990). A recent RCT (Leff et al, 2000) has confirmed the efficacy of systemic couple therapy with people with depression living with a partner. This study, with an unusually long 2-year follow-up, is described in more detail below. The London Depression Intervention Trial (Leff et al, 2000) was set up to compare the effectiveness of antidepressants, individual CBT and systemic couple therapy. Patients diagnosed by psychiatrists as having depression and who were in a stable relationship with a partner were randomly assigned to one of these three treatment modalities. The trial involved an initial baseline assessment of patients with depression and their partners, followed by an intervention (treatment) phase. Patients were assessed at the end of treatment and again after a period of no treatment lasting 12–15 months. The treatment phase consisted of a maximum of 9 months or 20 sessions for couple therapy and CBT and 1 year for antidepressant medication. Patients allocated to one of the treatments were not permitted to receive any other treatment simultaneously. Patients had to meet criteria...
Please join StudyMode to read the full document