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January 22, 1992

Psychotherapy for Depression

Author Affiliations

Greenville, NC

JAMA. 1992;267(4):579. doi:10.1001/jama.1992.03480040131047

T. Byram Karasu, professor of psychiatry at Albert Einstein College of Medicine, is the chairman of the American Psychiatric Association's Commission on Psychiatric Therapies and the APA Task Force on the Treatment of Psychiatric Disorders. In this book he presents the three predominant psychotherapeutic approaches to depression: psychodynamic, cognitive-behavioral, and interpersonal.

Karasu views depression as a spectrum of disorders requiring a flexible model of treatment. There is a shared element to all therapies, ie, the benign human relationship, which includes empathy and a positive regard. The goal of therapy is to establish an alliance whereby affective, cognitive, and/or behavioral change may be produced. Selective system variables may be addressed differently by each mode of therapy. These psychotherapeutic approaches also interact with pharmacological treatment.

Each conceptual approach to depression is addressed in its theoretical and technical dimensions. In psychodynamic psychotherapy the core conceptualization of the ideology and pathogenesis of depression is