Treatment history and its relationship to outcome in psychotherapy for depression
Patients with major depression can expect an average of four depressive episodes in their lifetime, meaning most clients presenting to therapy have had multiple prior episodes of treatment. These psychotherapy careers have as yet received only minimal study and there is little data regarding the relationship of these prior treatments on responsiveness to psychotherapy. Aim: To explore prior treatment history and its relationship to psychotherapy outcome in people with major depression. Method: 48 individuals with major depression presented to an Australian community-based psychotherapy facility. Structured diagnostic and treatment history interviews were taken and outcomes monitored. Results: 90% had received some form of prior psychotherapy or counselling with on average 3.5 previous episodes of care (range 1-7). This Australian sample was less likely to have received group, family or couples therapy than international samples. Those receiving psychotherapy at the time of intake showed higher levels of improvement over the following 12 months, although a more chronic subsample remained symptomatic and were seeking further therapy at followup. Discussion: Those actively engaged in some therapy experience at intake benefited more than those with an interrupted psychotherapy career. Enhancing recent episodes of care may be helpful in achieving better long-term outcomes.