Treating depression with the evidence-based psychotherapies: a critique of the evidence

OBJECTIVE: While Cognitive Behaviour Therapy (CBT) and Interpersonal Therapy (IPT) have been positioned as first-line evidence-based treatments for depression, we suggest that limitations to the 'evidence' deserve wider appreciation. METHOD: A systematic literature search was undertaken, and limitations to the evidence base discussed. RESULTS: The review suggests that the specificity of CBT and IPT treatments for depression has yet to be demonstrated and details likely reasons. CONCLUSION: The superiority of CBT and IPT may well be able to be demonstrated across defined rather than universal circumstances. To achieve this aim, outcome research should move away from testing treatments as if they have universal application for heterogeneous disorder categories. Findings have distinct implications for the clinical management of depressive disorders, and particularly in relation to the utility of psychotherapy.