Depression & Mood Disorders

Depressive Disorders / Bipolar and Related Disorders (DSM-5-TR)

Persistent low mood, loss of interest, fatigue, sleep/appetite disruption, and cognitive changes. Includes major depressive disorder, persistent depressive disorder (dysthymia), bipolar depression, and perinatal mood disorders. One of the most common reasons people seek therapy.

Prevalence: ~8% of US adults had a major depressive episode in the past year (NIMH, from NSDUH 2021); ~21% lifetime prevalence of major depressive disorder (NESARC-III, Hasin et al., 2018)

Clinical Picture

Depression is not one thing. The flat, leaden immobility of melancholic depression is neurobiologically and experientially different from the agitated, ruminative quality of anxious depression or the irritable emptiness of what's sometimes called 'male-type' depression. Treatment selection depends on which depression you're actually looking at. Behavioral activation works well for the withdrawal-and-avoidance pattern. Cognitive restructuring targets the ruminative loop. Psychodynamic approaches may be essential when depression is rooted in unprocessed grief, chronic self-attack, or relational templates established in childhood. Somatic approaches become relevant when the body itself seems to carry the depression: when the client can articulate no thoughts but reports heaviness, constriction, or numbness.

Treatment Considerations

The assessments below concern specific diagnoses and treatment phases. Adult unipolar-depression recommendations should not automatically be applied to bipolar depression or every perinatal presentation included in this broad topic. NICE recommends choosing treatment with the person according to clinical needs and preferences, considering guided self-help first for less severe new episodes. VA/DoD recommends psychotherapy or medication monotherapy for uncomplicated MDD and weakly suggests combined treatment for severe, persistent or recurrent MDD. These recommendations do not establish that one approach always wins or that combination treatment consistently outperforms either treatment for every treatment-resistant presentation. Ask directly about suicidal thoughts and intent, monitor risk during treatment, and arrange help appropriate to the level of need. Coexisting conditions require their own assessment and treatment considerations.


Approaches and Evidence

Of 80 associated approaches, 17 have completed assessments for this topic, 15 have source checks awaiting assessment, and 48 have neither recorded yet. Each completed assessment states its population and rationale; source checks alone do not establish effectiveness. These categories describe different findings and review stages; they are not a ranking of treatments. 1 framework is shown separately.

Guideline recommendation (9)

These assessments record a guideline recommendation for the stated population. Read the scope and rationale; a broad topic label does not make a recommendation applicable to everyone.

Cognitive-Behavioral

Acceptance and Commitment Therapy

Steven Hayes · 1999

Reviewed population: Adults with major depressive disorder when choosing psychotherapy, within the VA/DoD guideline's recommendations for uncomplicated MDD.

VA/DoD 2022 Recommendation 7 suggests ACT among several psychotherapy options, with a weak recommendation and no ranking among them. In a separate 82-person routine-practice trial, A-Tjak et al. (2018) found improvement with ACT and CBT but no significant between-group differences through six-month follow-up. This qualified recommendation does not establish ACT's superiority, and the trial's nonsignificant superiority comparison does not prove equivalence.

Reviewed

Guidelines and official sources (3)

2 clinical guideline checks · 1 evidence registry check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Acceptance and commitment therapy for depression

    Society of Clinical Psychology (APA Division 12; American Psychological Association) · Current archive, 1998 criteria; 2015 re-evaluation pending · Evidence registry · 1998 EST Status; 2015 EST Status

    Discussed in the source

    The archive lists Modest under 1998 criteria, with 2015 re-evaluation pending. A registry entry does not establish a depression guideline recommendation.

    Scope: ACT for depression

    Source checked

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 7; pp.23,35–36

    Recommendation for the stated population

    VA/DoD suggests acceptance and commitment therapy among seven unranked psychotherapy options (weak for). Treatment strategy also depends on severity, chronicity, prior response and preference.

    Scope: Adults with uncomplicated MDD choosing psychotherapy.

    Source checked

  • Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders

    World Health Organization · Third edition, 20 November 2023 · Clinical guideline · DEP3 and footnote 7, p. 61 (PDF p. 93)

    Discussed in the source

    ACT is named in the reviewed third-wave therapy category. WHO recommends that category alongside other structured therapies; it does not give ACT a separate recommendation or separate certainty rating here.

    Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.

    Source checked

Cognitive-Behavioral

Behavioral Activation

Lewinsohn / Jacobson / Martell · 1974

Reviewed population: Adults with a new episode of unipolar depression/MDD; structured, manual-based behavioral activation, delivered in a format appropriate to severity and preference.

NICE NG222 lists behavioral activation for new adult depressive episodes: structured guided self-help and group or individual BA appear among less severe options, while individual BA is listed for more severe depression. Its advice is to match the intervention to clinical needs and preferences, considering guided self-help first for less severe illness. VA/DoD 2022 weakly suggests behavioral therapy/BA among its unranked psychotherapy options for MDD. These sources support a structured BA treatment, rather than any activity recommendation. They do not establish universal equivalence to CBT, superiority over other treatments, or a relapse-prevention recommendation for BA. This assessment concerns unipolar depression, not bipolar episodes.

Reviewed

Guidelines and official sources (5)

4 clinical guideline checks · 1 evidence registry check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Depression in adults: treatment and management (NG222)

    NICE · 2022 · Clinical guideline · Tables 1 and 2

    Recommendation for the stated population

    Behavioural activation is a named adult depression treatment option.

    Scope: Adults with depression

    Source checked

  • Behavioral activation for depression

    Society of Clinical Psychology (APA Division 12; American Psychological Association) · Current archive, 1998 criteria; 2015 re-evaluation pending · Evidence registry · 1998 EST Status; 2015 EST Status

    Discussed in the source

    The archive lists Strong under 1998 criteria; 2015 re-evaluation is pending.

    Scope: Behavioural activation for depression

    Source checked

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 7; pp.23,35–36

    Recommendation for the stated population

    VA/DoD suggests behavioral therapy/behavioral activation among seven unranked psychotherapy options (weak for). Treatment strategy also depends on severity, chronicity, prior response and preference.

    Scope: Adults with uncomplicated MDD choosing psychotherapy.

    Source checked

  • mhGAP: brief structured psychological treatment for depression

    World Health Organization · 2023 update · Clinical guideline · DEP3, p. 61 (PDF p. 93)

    Recommendation for the stated population

    WHO includes behavioral activation among the structured psychological interventions that should be offered. The recommendation is strong, with moderate-certainty evidence.

    Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.

    Source checked

  • Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders

    World Health Organization · Third edition, 20 November 2023 · Clinical guideline · DEM2, pp. 53–54 (PDF pp. 85–86)

    Recommendation for the stated population

    WHO conditionally recommends considering behavioral activation, with low-certainty evidence. The 2023 edition retains the 2015 recommendation because eligible new evidence was insufficient; suitability requires an individual assessment.

    Scope: People living with dementia and mild-to-moderate depression.

    Source checked

Cognitive-Behavioral

Behavioral Couples Therapy

Neil Jacobson / Gayla Margolin (after Stuart, Weiss) · 1979

Reviewed population: Adults with depression and partner-relationship problems relevant to their depression or treatment.

NICE NG222 1.7.1 says to consider behavioural couples therapy for less or more severe depression when relationship problems may contribute or partner involvement may help treatment. Recommendation 1.7.2 specifies behavioural principles and 15–20 sessions over 5–6 months. This contextual recommendation does not endorse every couples model or depression presentation.

Reviewed

Guidelines and official sources (2)

2 clinical guideline checks

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Depression in adults: treatment and management (NG222)

    NICE · 2022 · Clinical guideline · 1.7.1–1.7.2

    Recommendation for the stated population

    NICE says to consider behavioural couples therapy for this depression and relationship context.

    Scope: Adults with depression and partner-relationship problems contributing to depression or whose partner may help treatment

    Source checked

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 25; pp.25,57–58

    Discussed in the source

    VA/DoD suggests couples-focused therapy as a category (weak for), without preferring a model. Assess partner involvement and safety; this is not a separate endorsement of this named protocol.

    Scope: Adults with mild-to-moderate MDD and significant relationship distress.

    Source checked

Cognitive-Behavioral

Cognitive Behavioral Therapy

Aaron Beck · 1964

Reviewed population: Adults with unipolar depression/MDD receiving a depression-specific CBT protocol; treatment intensity and combination with medication depend on severity, history and preference.

NICE NG222 includes manual-based CBT among options for new episodes of less and more severe adult depression, selected through shared decision-making. For less severe episodes, it advises considering guided self-help first. VA/DoD 2022 recommends psychotherapy or medication monotherapy for uncomplicated MDD and weakly suggests CBT among seven named, unranked psychotherapies. For severe, persistent or recurrent MDD, VA/DoD instead weakly suggests combining evidence-based psychotherapy with medication; NICE also lists combined individual CBT and an antidepressant for more severe depression. These recommendations support depression-specific CBT, without establishing that it is always preferable to other therapies or that every CBT adaptation has equivalent support. This assessment does not cover bipolar depression or children.

Reviewed

Guidelines and official sources (18)

17 clinical guideline checks · 1 evidence registry check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Depression in adults: treatment and management (NG222)

    NICE · 2022 · Clinical guideline · Tables 1 and 2

    Recommendation for the stated population

    CBT is a named adult depression treatment option.

    Scope: Adults with depression

    Source checked

  • Cognitive therapy for depression

    Society of Clinical Psychology (APA Division 12; American Psychological Association) · Current archive, 1998 criteria; 2015 re-evaluation pending · Evidence registry · 1998 EST Status

    Discussed in the source

    The archive rates this specific treatment Strong under 1998 criteria; this is not a universal CBT rating or CPG grade.

    Scope: Cognitive therapy for depression

    Source checked

  • Clinical Practice Guideline for the Management of Pregnancy

    VA/DoD · Version 4.0, July 2023 · Clinical guideline · Recommendation 23; Table 5, p.28

    Recommendation for the stated population

    VA/DoD strongly recommends offering CBT for prevention in this at-risk population. Treatment of an existing depressive episode is addressed separately.

    Scope: Pregnant patients at risk of perinatal depression; individual or group delivery.

    Source checked

  • Clinical Practice Guideline for the Management of Pregnancy

    VA/DoD · Version 4.0, July 2023 · Clinical guideline · Recommendation 25; Table 5, p.28

    Recommendation for the stated population

    VA/DoD weakly suggests CBT for treating perinatal depression.

    Scope: Depression during pregnancy or postpartum.

    Source checked

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 7; pp.23,35–36

    Recommendation for the stated population

    VA/DoD suggests cognitive behavioral therapy among seven unranked psychotherapy options (weak for). Treatment strategy also depends on severity, chronicity, prior response and preference.

    Scope: Adults with uncomplicated MDD choosing psychotherapy.

    Source checked

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 22; pp.25,55

    Recommendation for the stated population

    VA/DoD suggests CBT during continuation treatment to reduce relapse or recurrence (weak for). CBT, IPT and MBCT are not ranked against one another.

    Scope: Remitted MDD with high risk of relapse or recurrence.

    Source checked

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 24; pp.25,56–57

    Discussed in the source

    VA/DoD suggests first-line psychotherapy, including CBT, considering preferences and medication safety (weak for). The recommendation does not establish one psychotherapy as superior.

    Scope: Adults aged 65 or older with mild-to-moderate MDD.

    Source checked

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 28; pp.26,60–61

    Discussed in the source

    VA/DoD suggests CBT-based bibliotherapy as an adjunct, or an alternative when other treatments are declined or inaccessible (weak for). This concerns a specific delivery format.

    Scope: Adults with MDD; CBT-based bibliotherapy.

    Source checked

  • Management of Bipolar Disorder

    VA/DoD · Version 2.0, May 2023; evidence through December 2021 · Clinical guideline · Recommendations 34–35; pp.36,85–88

    Recommendation for the stated population

    VA/DoD suggests CBT alongside pharmacotherapy (weak for). It finds insufficient evidence to prefer CBT over the other listed adjunctive psychotherapies.

    Scope: Adults with bipolar I or II who are not acutely manic.

    Source checked

  • Clinical Practice Guideline for Management of Stroke Rehabilitation

    VA/DoD · May 2024; version 5.0 · Clinical guideline · Recommendation 41; pp.31, 95–97

    Recommendation for the stated population

    VA/DoD weakly recommends psychotherapy and explicitly names CBT as an example. This recommendation concerns treating depression after stroke, rather than preventing stroke or restoring motor function.

    Scope: Depression following stroke.

    Source checked

  • Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts

    American Psychological Association · 2019 · Clinical guideline · Table 1, printed p.7

    Insufficient evidence for or against

    APA found insufficient evidence for a CBT recommendation in this age group. Adolescents have a separate recommendation.

    Scope: Children with depressive disorders; initial treatment.

    Source checked

  • Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts

    American Psychological Association · 2019 · Clinical guideline · Table 2, printed p.8

    Recommendation for the stated population

    APA recommends CBT as one initial psychotherapy option.

    Scope: Adolescents with depressive disorders; initial treatment, excluding psychotic depression.

    Source checked

  • Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts

    American Psychological Association · 2019 · Clinical guideline · Table 3, printed p.10

    Recommendation for the stated population

    For combined treatment, APA recommends CBT plus a second-generation antidepressant. It does not identify a superior psychotherapy monotherapy.

    Scope: Adult depressive disorders, excluding psychotic depression; bipolar disorder is outside scope.

    Source checked

  • Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts

    American Psychological Association · 2019 · Clinical guideline · Table 4, printed p.13

    Recommendation for the stated population

    APA recommends group CBT over no treatment.

    Scope: Adults aged 60 or older with MDD; group CBT, alone or added to usual care.

    Source checked

  • mhGAP: brief structured psychological treatment for depression

    World Health Organization · 2023 update · Clinical guideline · DEP3, p. 61 (PDF p. 93)

    Recommendation for the stated population

    WHO strongly recommends structured psychological interventions including CBT for this population, based on moderate-certainty evidence.

    Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.

    Source checked

  • Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders

    World Health Organization · Third edition, 20 November 2023 · Clinical guideline · DEM2, pp. 53–54 (PDF pp. 85–86)

    Recommendation for the stated population

    WHO conditionally recommends considering CBT, with low-certainty evidence. The 2023 edition retains the 2015 recommendation because eligible new evidence was insufficient; suitability requires an individual assessment.

    Scope: People living with dementia and mild-to-moderate depression.

    Source checked

  • Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders

    World Health Organization · Third edition, 20 November 2023 · Clinical guideline · CAMH2.2, pp. 30–31 (PDF pp. 62–63)

    Discussed in the source

    WHO strongly recommends psychosocial interventions incorporating CBT, psychoeducation and family-focused approaches, with low-certainty evidence. This is a prevention recommendation for a defined group, rather than a general child-disorder treatment recommendation.

    Scope: Children whose parents have mental health conditions; prevention of depression and anxiety.

    Source checked

  • Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders

    World Health Organization · Third edition, 20 November 2023 · Clinical guideline · PSY12, pp. 105–107 (PDF pp. 137–139)

    Recommendation for the stated population

    WHO conditionally recommends individual CBT and other listed psychological interventions as adjuncts to pharmacological treatment, with low-certainty evidence. This concerns maintenance in remission, not acute mania or a blanket depression recommendation.

    Scope: Adults with bipolar disorder in remission.

    Source checked

Cognitive-Behavioral

Internet-Delivered Cognitive Behavioral Therapy

Various (Andersson / Titov) · 2000

Reviewed population: Adults with mild-to-moderate MDD receiving clinician-guided internet CBT.

VA/DoD 2022 recommendation 10 weakly supports clinician-guided computer/internet CBT as initial treatment or alongside medication, according to preference. It does not extend to unguided apps or establish equivalence to in-person therapy.

Reviewed

Guidelines and official sources (5)

5 clinical guideline checks

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Depression in adults: treatment and management (NG222)

    NICE · 2022 · Clinical guideline · Table 1: guided self-help

    Discussed in the source

    NICE includes supported printed or digital structured self-help, including CBT. The programme and support requirements matter.

    Scope: Adults with depression choosing guided self-help

    Source checked

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 10; pp.23,38–39

    Recommendation for the stated population

    VA/DoD suggests clinician-guided computer/internet CBT as first-line treatment or alongside medication, according to preference (weak for). This does not endorse every app or unguided programme.

    Scope: Adults with mild-to-moderate MDD; clinician-guided delivery.

    Source checked

  • Management of Bipolar Disorder

    VA/DoD · Version 2.0, May 2023; evidence through December 2021 · Clinical guideline · Recommendation 38; pp.36,92–93

    Discussed in the source

    VA/DoD finds insufficient evidence for any particular app or computer/web intervention. This broader technology finding is not a specific assessment of every iCBT programme.

    Scope: Adults with bipolar disorder; digital interventions.

    Source checked

  • Clinical Practice Guideline for Management of Stroke Rehabilitation

    VA/DoD · May 2024; version 5.0 · Clinical guideline · Recommendation 41 discussion; p.96

    Discussed in the source

    The guideline discusses computerized CBT under its broader weak recommendation for psychotherapy after stroke. It does not separately establish a preferred digital program or equivalence of all delivery formats.

    Scope: Computerized CBT studied for depression following stroke.

    Source checked

  • Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders

    World Health Organization · Third edition, 20 November 2023 · Clinical guideline · DEP3 justification and remarks, p. 61 (PDF p. 93)

    Discussed in the source

    The review includes internet CBT. WHO notes that guided internet CBT was more effective than unguided delivery for this population; its clinical recommendation is for structured psychological interventions, rather than every digital program.

    Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.

    Source checked

Integrative

Interpersonal Psychotherapy

Klerman / Weissman · 1984

Reviewed population: Adults with unipolar depression/MDD receiving manual-based interpersonal psychotherapy; separately, people in remission at high risk of relapse or recurrence receiving continuation-phase IPT.

NICE NG222 includes individual, manual-based IPT among treatments for both less and more severe new episodes of adult depression. VA/DoD 2022 weakly suggests IPT among seven unranked psychotherapy options for MDD. It separately weakly suggests a course of IPT, CBT or MBCT after remission for people at high risk of relapse or recurrence, without preferring one of those three. Initial treatment and relapse prevention therefore have different populations and phases. This supports IPT for the stated adult depression contexts, not a universal ranking alongside CBT as the only two leading treatments. The assessment does not cover bipolar depression or interpersonal approaches that do not follow an IPT protocol.

Reviewed

Guidelines and official sources (11)

11 clinical guideline checks

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Depression in adults: treatment and management (NG222)

    NICE · 2022 · Clinical guideline · Tables 1 and 2

    Recommendation for the stated population

    IPT is a named adult depression treatment option.

    Scope: Adults with depression

    Source checked

  • Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts

    American Psychological Association · 2019 · Clinical guideline · Table 3, page 10: General adult population

    Recommendation for the stated population

    APA does not select one adult psychotherapy monotherapy as superior. It includes IPT and specifically recommends IPT or CBT plus a second-generation antidepressant when combined treatment is chosen.

    Scope: Adult depressive disorders excluding psychotic depression; bipolar disorder is outside the guideline scope. Initial monotherapy choice or combined treatment.

    Source checked

  • Clinical Practice Guideline for the Management of Pregnancy

    VA/DoD · Version 4.0, July 2023 · Clinical guideline · Recommendation 23; Table 5, p.28

    Recommendation for the stated population

    VA/DoD strongly recommends offering IPT for prevention in this at-risk population. Treatment of an existing depressive episode is addressed separately.

    Scope: Pregnant patients at risk of perinatal depression; individual or group delivery.

    Source checked

  • Clinical Practice Guideline for the Management of Pregnancy

    VA/DoD · Version 4.0, July 2023 · Clinical guideline · Recommendation 24; Table 5, p.28

    Recommendation for the stated population

    VA/DoD strongly recommends IPT for treating perinatal depression.

    Scope: Depression during pregnancy or postpartum.

    Source checked

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 7; pp.23,35–36

    Recommendation for the stated population

    VA/DoD suggests interpersonal therapy among seven unranked psychotherapy options (weak for). Treatment strategy also depends on severity, chronicity, prior response and preference.

    Scope: Adults with uncomplicated MDD choosing psychotherapy.

    Source checked

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 22; pp.25,55

    Recommendation for the stated population

    VA/DoD suggests IPT during continuation treatment to reduce relapse or recurrence (weak for). CBT, IPT and MBCT are not ranked against one another.

    Scope: Remitted MDD with high risk of relapse or recurrence.

    Source checked

  • Management of Bipolar Disorder

    VA/DoD · Version 2.0, May 2023; evidence through December 2021 · Clinical guideline · Recommendation 34; pp.36,85–87

    Discussed in the source

    VA/DoD suggests interpersonal and social rhythm therapy alongside medication (weak for). That combined protocol is distinct from IPT alone.

    Scope: Adults with bipolar I or II who are not acutely manic.

    Source checked

  • Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts

    American Psychological Association · 2019 · Clinical guideline · Table 2, printed p.8

    Recommendation for the stated population

    APA recommends IPT-A as an initial psychotherapy option.

    Scope: Adolescents with depressive disorders; the adolescent adaptation IPT-A, excluding psychotic depression.

    Source checked

  • Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts

    American Psychological Association · 2019 · Clinical guideline · Table 4, printed p.13

    Recommendation for the stated population

    APA recommends combined treatment, favoring a second-generation antidepressant on tolerability grounds.

    Scope: Adults aged 60 or older with MDD; combined medication and IPT versus IPT alone.

    Source checked

  • mhGAP: brief structured psychological treatment for depression

    World Health Organization · 2023 update · Clinical guideline · DEP3, p. 61 (PDF p. 93)

    Recommendation for the stated population

    WHO strongly recommends structured psychological interventions including IPT for this population, based on moderate-certainty evidence.

    Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.

    Source checked

  • Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders

    World Health Organization · Third edition, 20 November 2023 · Clinical guideline · DEM2, pp. 53–54 (PDF pp. 85–86)

    Recommendation for the stated population

    WHO conditionally recommends considering IPT, with low-certainty evidence. The 2023 edition retains the 2015 recommendation because eligible new evidence was insufficient; suitability requires an individual assessment.

    Scope: People living with dementia and mild-to-moderate depression.

    Source checked

Cognitive-Behavioral

Mindfulness-Based Cognitive Therapy

Segal / Williams / Teasdale · 2002

Reviewed population: Adults with uncomplicated MDD, or remitted MDD with high relapse risk.

VA/DoD 2022 weakly includes MBCT for initial psychotherapy selection (recommendation 7) and separately for continuation after remission in patients at high relapse risk (22). Neither recommendation establishes superiority; acute treatment and relapse prevention are distinct scopes.

Reviewed

Guidelines and official sources (7)

6 clinical guideline checks · 1 evidence registry check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Depression in adults: treatment and management (NG222)

    NICE · 2022 · Clinical guideline · 1.8.5–1.8.6

    Recommendation for the stated population

    NICE lists group MBCT as a relapse-prevention option, with or without continuing antidepressants according to preference.

    Scope: People remitted on antidepressants alone and at higher relapse risk

    Source checked

  • Mindfulness-based cognitive therapy

    Society of Clinical Psychology (APA Division 12; American Psychological Association) · Current archive, 1998 criteria; 2015 re-evaluation pending · Evidence registry · 1998 EST Status; 2015 EST Status

    Discussed in the source

    The archive lists Strong under 1998 criteria and pending 2015 re-evaluation.

    Scope: MBCT; depression/relapse prevention evidence

    Source checked

  • Depression in adults: treatment and management (NG222)

    NICE · 2022 · Clinical guideline · Recommendation 1.5.2; Table 1: group mindfulness and meditation

    Recommendation for the stated population

    NICE includes group mindfulness and meditation using a programme such as MBCT among treatment options. This is separate from its relapse-prevention recommendations.

    Scope: Adults with a new episode of less severe depression; depression-specific group programme.

    Source checked

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 7; pp.23,35–36

    Recommendation for the stated population

    VA/DoD suggests mindfulness-based cognitive therapy among seven unranked psychotherapy options (weak for). Treatment strategy also depends on severity, chronicity, prior response and preference.

    Scope: Adults with uncomplicated MDD choosing psychotherapy.

    Source checked

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 22; pp.25,55

    Recommendation for the stated population

    VA/DoD suggests MBCT during continuation treatment to reduce relapse or recurrence (weak for). CBT, IPT and MBCT are not ranked against one another.

    Scope: Remitted MDD with high risk of relapse or recurrence.

    Source checked

  • Clinical Practice Guideline for Management of Stroke Rehabilitation

    VA/DoD · May 2024; version 5.0 · Clinical guideline · Recommendation 42; pp.31, 97–99

    Discussed in the source

    VA/DoD weakly recommends mindfulness-based therapies and specifically reviews MBSR and MBCT. The recommendation is for the therapy family in this post-stroke population.

    Scope: Depression following stroke.

    Source checked

  • Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts

    American Psychological Association · 2019 · Clinical guideline · Table 3, printed p.10

    Discussed in the source

    APA includes MBCT among broadly comparable models; it cannot recommend a superior monotherapy.

    Scope: Adults with depressive disorders, excluding psychotic depression; initial monotherapy selection.

    Source checked

Cognitive-Behavioral

Problem-Solving Therapy

D'Zurilla / Goldfried / Nezu · 1971

Reviewed population: Adults with uncomplicated MDD choosing psychotherapy.

VA/DoD 2022 recommendation 7 weakly suggests PST among unranked options. This treatment recommendation does not establish superior efficacy or address depression prevention across other clinical populations.

Reviewed

Guidelines and official sources (6)

5 clinical guideline checks · 1 evidence registry check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Depression in adults: treatment and management (NG222)

    NICE · 2022 · Clinical guideline · 1.5.2/Table 1 and 1.6.1/Table 2

    Recommendation for the stated population

    NICE includes problem-solving among treatment options. The format and choice depend on depression severity, clinical needs and patient preferences.

    Scope: Adults with depression; guided self-help or individual problem-solving options.

    Source checked

  • Problem-Solving Therapy for Depression

    Society of Clinical Psychology (American Psychological Association Division 12) · Archived Chambless treatment page; checked 2026-09-06 · Evidence registry · EST status / archive

    Discussed in the source

    The archive records a 1998 strong rating and a 2015 status awaiting re-evaluation. These are evidence-registry classifications, separate from NICE’s recommendations.

    Scope: Depression; historical Division 12 treatment ratings.

    Source checked

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 7; pp.23,35–36

    Recommendation for the stated population

    VA/DoD suggests problem-solving therapy among seven unranked psychotherapy options (weak for). Treatment strategy also depends on severity, chronicity, prior response and preference.

    Scope: Adults with uncomplicated MDD choosing psychotherapy.

    Source checked

  • Clinical Practice Guideline for Management of Stroke Rehabilitation

    VA/DoD · May 2024; version 5.0 · Clinical guideline · Recommendation 38; pp.30, 90–91

    Insufficient evidence for or against

    VA/DoD finds insufficient evidence for or against solution-focused psychological interventions, explicitly including problem-solving therapy. The finding is specific to post-stroke depression prevention.

    Scope: Preventing the onset of depression following stroke.

    Source checked

  • Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts

    American Psychological Association · 2019 · Clinical guideline · Table 4, printed p.15: cognitive impairment/dementia

    Recommendation for the stated population

    APA conditionally suggests the specified individual problem-solving treatments for these populations.

    Scope: Older adults with MDD and executive dysfunction, or minor/MDD depression with dementia.

    Source checked

  • mhGAP: brief structured psychological treatment for depression

    World Health Organization · 2023 update · Clinical guideline · DEP3, p. 61 (PDF p. 93)

    Recommendation for the stated population

    WHO includes problem-solving therapy among the structured psychological interventions that should be offered. The recommendation is strong, with moderate-certainty evidence.

    Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.

    Source checked

Psychoanalytic

Short-Term Psychodynamic Psychotherapy

Davanloo / Sifneos / Malan · 1968

Reviewed population: Adults with uncomplicated major depressive disorder choosing psychotherapy.

VA/DoD 2022 recommendation 7 weakly suggests STPP among unranked psychotherapy choices. This source-specific treatment recommendation does not establish superiority or transfer to every brief psychodynamic variant, including ISTDP.

Reviewed

Guidelines and official sources (4)

4 clinical guideline checks

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Depression in adults: treatment and management (NG222)

    NICE · 2022 · Clinical guideline · Tables 1 and 2; 1.5.2 and 1.6.1

    Recommendation for the stated population

    STPP is a named option using empirically validated depression protocols.

    Scope: Adults with less or more severe depression

    Source checked

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 7; pp.23,35–36

    Recommendation for the stated population

    VA/DoD suggests short-term psychodynamic psychotherapy among seven unranked psychotherapy options (weak for). Treatment strategy also depends on severity, chronicity, prior response and preference.

    Scope: Adults with uncomplicated MDD choosing psychotherapy.

    Source checked

  • Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts

    American Psychological Association · 2019 · Clinical guideline · Table 3, printed p.10

    Discussed in the source

    APA lists psychodynamic therapies among comparable models; this does not separately grade every short-term protocol.

    Scope: Adults with depressive disorders, excluding psychotic depression; the broad psychodynamic-therapy category.

    Source checked

  • mhGAP: brief structured psychological treatment for depression

    World Health Organization · 2023 update · Clinical guideline · DEP3, p. 61 (PDF p. 93)

    Recommendation for the stated population

    WHO includes brief psychodynamic therapy among the structured psychological interventions that should be offered. The recommendation is strong, with moderate-certainty evidence.

    Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.

    Source checked

Randomized studies (8)

These assessments describe randomized studies in the stated population. Randomized studies may include pilot or null findings; this label alone does not establish benefit.

Integrative

Cognitive Behavioral Analysis System of Psychotherapy

James McCullough · 2000

Reviewed population: Adults with chronic nonpsychotic major depression; trials distinguish initial treatment, medication nonresponse and early-onset chronic depression without antidepressants.

Keller et al. (2000) randomized 681 adults: CBASP combined with nefazodone produced more responses than either alone after 12 weeks. In REVAMP (2009), adding CBASP to optimized medication for 491 initial nonremitters did not significantly improve depression outcomes over medication alone or supportive-therapy augmentation. A separate 268-person trial (2017) found CBASP superior to supportive psychotherapy on the 20-week primary depression measure in unmedicated early-onset chronic depression. These different treatment settings support randomized evaluation with mixed comparative results, not universal augmentation benefit or an assessment of every depressive presentation.

Reviewed

Guidelines and official sources (2)

1 clinical guideline check · 1 professional reference check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Depression in adults: treatment and management, short version DRAFT

    NICE · July 2017 consultation draft, not final guidance · Professional reference · Draft 1.9.9 and 1.10.1–1.10.2; pp.26–27

    Discussed in the source

    The draft named CBASP. Consultation material is not final guidance, and the final NG222 recommendations do not name CBASP.

    Scope: Chronic depression and inadequate response in NICE’s July 2017 consultation draft.

    Source checked

  • Depression in adults: treatment and management (NG222)

    NICE · 2022 · Clinical guideline · Final recommendations; exact-name search and chronic-symptoms section 1.10

    Discussed in the source

    CBASP is not named in the final recommendation text inspected here. This does not establish its absence from all guideline evidence reviews or other organizations’ documents.

    Scope: Final adult-depression recommendations in NG222.

    Source checked

Humanistic

Emotion-Focused Therapy

Leslie Greenberg · 1990

Reviewed population: Adults with MDD receiving Greenberg's individual EFT in Goldman et al. (2006).

This 42-person randomized comparison analyzed 38 completers. EFT had better depressive and general symptom outcomes than relational client-centered therapy, without a significant recovery-rate difference. Small sample, exclusions and possible researcher allegiance limit inference. This concerns individual EFT, not Johnson's couples therapy or tapping.

Reviewed

Guidelines and official sources (1)

1 evidence registry check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Emotion-focused therapy for depression

    Society of Clinical Psychology (APA Division 12; American Psychological Association) · Current archive, 1998 criteria; 2015 re-evaluation pending · Evidence registry · 1998 EST Status; 2015 EST Status

    Discussed in the source

    The archive rates this treatment Modest under its 1998 criteria, with 2015 re-evaluation pending. This is an evidence-registry rating.

    Scope: Emotion-focused therapy for depression

    Source checked

Psychoanalytic

Intensive Short-Term Dynamic Psychotherapy

Habib Davanloo · 1980

Reviewed population: Adults with persistent major-depression symptoms despite at least six weeks of antidepressant treatment, in the 60-person secondary-care Halifax trial.

Town et al. (2017) randomized 20-session ISTDP against secondary-care treatment as usual. ISTDP improved the primary six-month observer-rated depression outcome more, with benefits on self-reported depression and remission measures. The small trial and routine-care comparator limit generalization to other providers, settings and active psychotherapies. This does not validate the catalogue's archived numerical estimates.

Reviewed

Cognitive-Behavioral

Metacognitive Therapy

Adrian Wells · 2009

Reviewed population: Adults with major depressive disorder in a Danish primary-care outpatient clinic, in Callesen et al.'s 2020 MCT-versus-CBT trial.

The trial randomized 174 adults; 155 remained after withdrawals of consent. MCT improved the self-reported BDI-II co-primary outcome more than CBT, but the observer-rated HDRS co-primary outcome did not differ significantly. The same pattern held at six-month follow-up. Only two therapists delivered treatment, and the MCT originator's involvement and post-randomization exclusions limit inference. The results support randomized evaluation with outcome-dependent findings, not unqualified superiority over CBT.

Reviewed

Guidelines and official sources (2)

2 clinical guideline checks

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 7 discussion, p.35; reference 89, p.150

    Discussed in the source

    VA/DoD discusses a metacognitive-therapy trial within CBT-package comparisons, without issuing a separate recommendation for Wells’s protocol or establishing its superiority.

    Scope: Adults with MDD; Wells metacognitive therapy compared with CBT.

    Source checked

  • Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders

    World Health Organization · Third edition, 20 November 2023 · Clinical guideline · DEP3 and footnote 7, p. 61 (PDF p. 93)

    Discussed in the source

    Metacognitive therapy is named in the reviewed third-wave therapy category. WHO recommends that category alongside other structured therapies; it does not give metacognitive therapy a separate recommendation or separate certainty rating here.

    Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.

    Source checked

Humanistic

Person-Centered Therapy

Carl Rogers · 1951

Reviewed population: Adults with MDD receiving manualized relational client-centered therapy in Goldman et al. (2006).

The trial randomized 42 people and analyzed 38 completers. Both arms improved; EFT produced greater symptom reductions. This small active-comparator study does not establish client-centered therapy's equivalence to other therapies. Concurrent depression treatment and several complex presentations were excluded.

Reviewed

Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Depression in adults: treatment and management (NG222)

    NICE · 2022 · Clinical guideline · Tables 1 and 2: counselling

    Discussed in the source

    NICE names protocol-based counselling for depression. It does not name every Rogerian/person-centred approach, and its current categories are less and more severe depression.

    Scope: Adults with less or more severe depression; validated depression counselling protocols

    Source checked

Cognitive-Behavioral

Radically Open Dialectical Behavior Therapy

Thomas Lynch · 2018

Reviewed population: Adults with refractory or chronic major depression despite an adequate antidepressant trial, in the 250-person UK RefraMED trial.

RefraMED compared RO-DBT plus usual care with usual care alone. The primary 12-month observer-rated depression outcome did not differ significantly; neither did the 18-month outcome. Depression favored RO-DBT immediately after treatment at seven months, and psychological flexibility and emotional coping improved. Fewer participants were analyzed than planned, reducing power. This records a randomized add-on trial with a null primary endpoint, not sustained superiority or evidence for every depressive population.

Reviewed

Cognitive-Behavioral

Rumination-Focused Cognitive Behavioral Therapy

Edward Watkins · 2016

Reviewed population: Adults with medication-refractory residual depression receiving individual RFCBT, and adult outpatients with major depression receiving group RFCBT alongside routine medical management.

Watkins et al. (2011) randomized 42 people to usual care with or without individual RFCBT; residual symptoms and remission favored the add-on, but the trial lacked an attention control. Hvenegaard et al. (2020) randomized 131 outpatients to group RFCBT or group CBT, both added to routine medical management. The primary post-treatment observer-rated depression outcome favored RFCBT, while post-treatment rumination and six-month depression did not differ significantly. These phase II findings do not establish a durable advantage or isolate the specific rumination mechanism.

Reviewed

Cognitive-Behavioral

Schema Therapy

Jeffrey Young · 1990

Reviewed population: Adults with major depression in Carter et al.'s 100-person schema-therapy-versus-CBT trial; chronic depression and comorbid personality disorder were additional subgroup analyses.

Carter et al. (2013) randomized participants to weekly schema therapy or CBT for six months, followed by monthly sessions for six months. The therapies did not differ significantly on key depression, remission or recovery outcomes; additional analyses did not identify differential effects for chronic depression or comorbid personality disorder. This preliminary active-comparator trial supports randomized evaluation, while a nonsignificant difference does not establish formal equivalence or specific superiority for chronic depression.

Reviewed

Source checks available — assessment pending (15)

Sources have been checked for this topic, but a condition-specific assessment has not been completed. Open the source notes to read each document’s population, recommendation and limitations.

Somatic

Biofeedback

Various (Neal Miller / Kamiya / Green / Sterman / Schwartz) · 1960

Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 31; pp.26,63–64

    Insufficient evidence for or against

    VA/DoD finds insufficient evidence for or against adjunctive biofeedback. The discussion evaluates heart-rate-variability biofeedback; this is not a positive recommendation.

    Scope: Adults with MDD; biofeedback added to usual treatment.

    Source checked

Contemplative

Buddhist Psychology / Contemplative Psychotherapy

Chögyam Trungpa / Jack Kornfield / Mark Epstein · 1974

Guidelines and official sources (2)

2 clinical guideline checks

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 32; pp.26,64–65

    Discussed in the source

    VA/DoD finds insufficient evidence for or against adjunctive meditation. The reviewed meditation programmes do not establish a recommendation for this broad contemplative psychotherapy approach.

    Scope: Adults with MDD; adjunctive meditation.

    Source checked

  • Management of Bipolar Disorder

    VA/DoD · Version 2.0, May 2023; evidence through December 2021 · Clinical guideline · Recommendation 36; pp.36,88–89

    Discussed in the source

    VA/DoD finds insufficient evidence for or against adjunctive meditation. This does not establish a recommendation for a specific contemplative psychotherapy or for bipolar I.

    Scope: Adults with bipolar II; adjunctive treatment of depressive episodes or symptoms.

    Source checked

Cognitive-Behavioral

Dialectical Behavior Therapy

Marsha Linehan · 1993

Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders

    World Health Organization · Third edition, 20 November 2023 · Clinical guideline · DEP3 and footnote 7, p. 61 (PDF p. 93)

    Discussed in the source

    DBT is named in the reviewed third-wave therapy category. WHO recommends that category alongside other structured therapies; it does not give DBT a separate recommendation or separate certainty rating here.

    Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.

    Source checked

Somatic

HeartMath

Doc Childre · 1991

Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 31; pp.26,63–64

    Discussed in the source

    VA/DoD finds insufficient evidence for adjunctive biofeedback, discussing HRV studies. It does not issue a HeartMath-specific recommendation or establish branded coherence claims.

    Scope: Adults with MDD; adjunctive heart-rate-variability biofeedback.

    Source checked

Humanistic

Interpersonal Process Group Therapy

Irvin Yalom · 1970

Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Depression in adults: treatment and management (NG222)

    NICE · 2022 · Clinical guideline · Tables 1–2; recommendation 1.8.6

    Discussed in the source

    NICE includes group CBT, behavioral activation and related structured approaches. Group format alone does not establish a recommendation for interpersonal process group therapy.

    Scope: Specific structured group interventions for adult depression.

    Source checked

Psychedelic

Ketamine-Assisted Psychotherapy

Various (Wolfson, Bennett) · 2010

Guidelines and official sources (4)

3 clinical guideline checks · 1 regulatory source check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • SPRAVATO (esketamine) original prescribing information

    US Food and Drug Administration · Revised March 2019; Reference ID 4399464 · Regulatory source · Section 1; original label page 3

    Not a treatment recommendation

    The historical drug indication is verified. It does not establish approval or guideline endorsement of KAP. This original label is not current prescribing information.

    Scope: Esketamine nasal spray plus an oral antidepressant for adult TRD in 2019

    Source checked

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 19

    Discussed in the source

    VA/DoD weakly suggests ketamine or esketamine augmentation. The recommendation concerns medication, not a named KAP psychotherapy protocol.

    Scope: MDD after several adequate pharmacological trials have failed

    Source checked

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 12; pp.24,39–41

    Discussed in the source

    VA/DoD suggests against ketamine/esketamine as initial pharmacotherapy (weak against). Its separate augmentation recommendation concerns prior treatment failure; neither recommendation endorses a named KAP psychotherapy protocol.

    Scope: Adults choosing initial medication treatment for MDD.

    Source checked

  • Management of Bipolar Disorder

    VA/DoD · Version 2.0, May 2023; evidence through December 2021 · Clinical guideline · Recommendation 16; p.34

    Discussed in the source

    VA/DoD finds insufficient evidence for ketamine/esketamine alone or as adjuncts. The recommendation concerns medication and does not endorse KAP psychotherapy.

    Scope: Adults with acute bipolar depression.

    Source checked

Humanistic

Life Review Therapy

Robert Butler · 1963

Guidelines and official sources (4)

4 clinical guideline checks

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts: older adults

    American Psychological Association · 2019 · Clinical guideline · Table 4, p.13: initial treatment—major depressive disorder

    Recommendation for the stated population

    APA recommends group life review, alone or added to usual care, over no treatment, with treatment selected through shared decision-making.

    Scope: Adults aged 60 or older receiving initial treatment for major depressive disorder; group life review.

    Source checked

  • Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts

    American Psychological Association · 2019 · Clinical guideline · Table 4, printed p.15: subthreshold/minor depression

    Recommendation for the stated population

    APA conditionally suggests the group course for this comparison.

    Scope: Older adults with subclinical depression; group life-review course versus an educational video.

    Source checked

  • Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts

    American Psychological Association · 2019 · Clinical guideline · Table 4, printed p.15: individual treatment

    Insufficient evidence for or against

    APA reports insufficient evidence for this comparison; the separate group-treatment recommendation does not transfer automatically.

    Scope: Older adults with subclinical depression; individual life review versus usual care.

    Source checked

  • Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders

    World Health Organization · Third edition, 20 November 2023 · Clinical guideline · DEP3 justification, p. 61 (PDF p. 93)

    Discussed in the source

    Life review therapy was reviewed but explicitly omitted from the therapies recommended in DEP3 because of limited-certainty findings. This is not a formal recommendation against life review in every population.

    Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.

    Source checked

Integrative

Mindfulness-Based Stress Reduction

Jon Kabat-Zinn · 1979

Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Clinical Practice Guideline for Management of Stroke Rehabilitation

    VA/DoD · May 2024; version 5.0 · Clinical guideline · Recommendation 42; pp.31, 97–99

    Discussed in the source

    VA/DoD weakly recommends mindfulness-based therapies and specifically reviews MBSR and MBCT. The recommendation is for the therapy family in this post-stroke population.

    Scope: Depression following stroke.

    Source checked

Psychedelic

Psilocybin-Assisted Therapy

Griffiths / Carhart-Harris · 2016

Guidelines and official sources (2)

1 clinical guideline check · 1 regulatory source check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • FDA accelerates action on treatments for serious mental illness following Executive Order

    US Food and Drug Administration · 2026-04-24 · Regulatory source · National priority voucher announcement

    Not a treatment recommendation

    FDA announced priority vouchers for psilocybin studies in April 2026. This establishes development activity, not approval or psychotherapy endorsement.

    Scope: Companies studying psilocybin for TRD and MDD

    Source checked

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 35

    Recommendation against the stated use

    VA/DoD strongly recommends against psilocybin for MDD outside research. This 2022 guideline used evidence through January 2021 and does not review subsequent trials.

    Scope: Psilocybin for MDD outside research settings

    Source checked

Psychoanalytic

Psychoanalysis

Sigmund Freud · 1895

Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Depression in adults: treatment and management (NG222)

    NICE · 2022 · Clinical guideline · Tables 1 and 2

    Discussed in the source

    NG222 names STPP, not classical long-term psychoanalysis. The distinction in the current text is supported.

    Scope: Adults with depression; empirically validated short-term protocols

    Source checked

Cognitive-Behavioral

Rational Emotive Behavior Therapy

Albert Ellis · 1955

Guidelines and official sources (2)

2 clinical guideline checks

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Depression in adults: treatment and management (NG222)

    NICE · 2022 · Clinical guideline · Sections 1.5–1.6; treatment tables

    Discussed in the source

    NICE lists CBT with specified delivery characteristics. This category-level recommendation does not separately identify REBT.

    Scope: CBT options for adults with depression.

    Source checked

  • Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts

    American Psychological Association · 2019 · Clinical guideline · General Adult Population; page 38; references, page 66

    Discussed in the source

    The guideline discusses these therapy categories and cites a REBT trial. This does not establish a separate REBT recommendation for every condition associated with the approach.

    Scope: Cognitive and cognitive-behavioral therapies for adults with depression.

    Source checked

Psychoanalytic

Relational Psychoanalysis

Stephen Mitchell / Lewis Aron · 1988

Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Depression in adults: treatment and management (NG222)

    NICE · 2022 · Clinical guideline · Treatment tables 1–2; short-term psychodynamic psychotherapy

    Discussed in the source

    The recommendation concerns a specified treatment format. It does not separately identify relational psychoanalysis.

    Scope: Short-term psychodynamic psychotherapy for adults with depression.

    Source checked

Postmodern

Solution-Focused Brief Therapy

de Shazer / Insoo Kim Berg · 1985

Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Clinical Practice Guideline for Management of Stroke Rehabilitation

    VA/DoD · May 2024; version 5.0 · Clinical guideline · Recommendation 38 discussion; pp.90–91

    Discussed in the source

    The guideline discusses SFBT among pooled psychological interventions and makes a neutral recommendation for the broader prevention category. It does not separately grade SFBT as a treatment for established depression.

    Scope: SFBT included in the review of interventions to prevent depression following stroke.

    Source checked

Psychoanalytic

Supportive Psychotherapy

Various (Rockland, Winston) · 1950

Guidelines and official sources (2)

2 clinical guideline checks

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 14; pp.24,42–43

    Recommendation for the stated population

    VA/DoD suggests considering non-directive supportive therapy in this defined situation (weak for). The recommendation does not make it the default first-line treatment.

    Scope: Mild-to-moderate MDD; medication declined and first-line psychotherapy declined or inaccessible.

    Source checked

  • Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts

    American Psychological Association · 2019 · Clinical guideline · Table 3, printed p.10

    Discussed in the source

    APA includes supportive therapy among broadly comparable models without selecting a superior monotherapy.

    Scope: Adults with depressive disorders, excluding psychotic depression; initial monotherapy selection.

    Source checked

Somatic

Trauma-Sensitive Yoga

David Emerson / van der Kolk · 2005

Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 27; pp.26,59–60

    Discussed in the source

    VA/DoD suggests adjunctive exercise, including yoga as an example (weak for). It does not name or separately recommend trauma-sensitive yoga.

    Scope: Adults with MDD; exercise as adjunctive care.

    Source checked

Assessment not yet completed (48)

No completed assessment or source check for this topic is recorded yet.

Family Systems

Circle of Security

Glen Cooper / Kent Hoffman / Bert Powell / Robert Marvin · 1998

Psychedelic

EMBARK

Brennan / Belser · 2022

Somatic

Neurofeedback

Joe Kamiya / Barry Sterman / Joel Lubar · 1968

Associated Frameworks (1)

These are conceptual or research frameworks. They are not ranked as treatment evidence.

Additional Source References (6)

These source checks also address this topic. They are listed separately from the catalogue associations above. Read each source’s scope and direction; a mention may concern a related intervention or a neutral recommendation.

Integrative

Clinical Hypnotherapy

Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 9 discussion; pp.37–38

    Discussed in the source

    The review discusses adding hypnotherapy to CBT under insufficient evidence for combining psychotherapy components. It does not recommend hypnotherapy alone or establish an added benefit.

    Scope: Adults with MDD; hypnotherapy added to CBT.

    Source checked

Attachment

Emotionally Focused Therapy for Couples

Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 25; pp.25,57–58

    Discussed in the source

    VA/DoD suggests couples-focused therapy as a category (weak for), without preferring a model. Assess partner involvement and safety; this is not a separate endorsement of this named protocol.

    Scope: Adults with mild-to-moderate MDD and significant relationship distress.

    Source checked

Cognitive-Behavioral

Integrative Behavioral Couple Therapy

Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 25; pp.25,57–58

    Discussed in the source

    VA/DoD suggests couples-focused therapy as a category (weak for), without preferring a model. Assess partner involvement and safety; this is not a separate endorsement of this named protocol.

    Scope: Adults with mild-to-moderate MDD and significant relationship distress.

    Source checked

Psychedelic

MDMA-Assisted Therapy

Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Management of Major Depressive Disorder

    VA/DoD · Version 4.0, February 2022; evidence through January 2021 · Clinical guideline · Recommendation 35; pp.26,67–68

    Recommendation against the stated use

    VA/DoD strongly recommends against MDMA for MDD outside research. This 2022 guideline used evidence through January 2021; it does not assess later trials or every diagnosis.

    Scope: MDMA for MDD outside research settings.

    Source checked

Humanistic

Motivational Interviewing

Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.

  • Clinical Practice Guideline for Management of Stroke Rehabilitation

    VA/DoD · May 2024; version 5.0 · Clinical guideline · Recommendation 38; pp.30, 90–91

    Insufficient evidence for or against

    VA/DoD finds insufficient evidence for or against solution-focused psychological interventions, explicitly including MI. This neutral finding concerns prevention, not treatment of established depression.

    Scope: Preventing the onset of depression following stroke.

    Source checked

Humanistic

Play Therapy

Guidelines and official sources (1)

1 clinical guideline check

Read the recommendation and its scope. A source may discuss an approach without recommending it.


Cases Featuring Associated Approaches

These teaching cases share approach links with this topic. They may illustrate a different presenting concern.


Reading This Page

Why are these approaches listed with Depression & Mood Disorders?

The catalogue associates 80 approaches and 1 frameworks with this topic. These links support learning and comparison; association alone is not a treatment recommendation or evidence of effectiveness.

How should I read the evidence assessments?

Assessments are specific to the population and scope stated on each card. They include a rationale, source links, and a review date. An overall review of an approach does not automatically apply to this condition, and a randomized-study label does not by itself mean that a study found benefit.

What does "Assessment not yet completed" mean?

A condition-specific assessment has not been recorded. Approaches with checked sources appear in a separate assessment-pending group; a checked source can support, oppose, or discuss an intervention without recommending it. Neither pending group means that no research exists or that the approach is ineffective. Frameworks are shown separately.


Sources and Review Scope

Source links and dates on assessment cards apply to the stated population and rationale. The clinical overview and prevalence text above are separate authored content; an approach's evidence label does not verify those statements. Recorded narrative notes and citations remain available on individual modality pages, with their review status identified. The bibliography provides further reading.