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-- by Toronto psychotherapist Beth Mares

When I asked about counselling for depression, I was told that cognitive therapy might clear it up, but if not I will need longer-term psychodynamic or relational psychotherapy. Should I go to a cognitive therapist first?  A better bet would be an integrative therapist who can use whatever methods are needed. The first stage of longer-term psychodynamic work is forming a relationship with the therapist. This will be happening while you are doing the cognitive therapy and will save you time if you need deeper work. Also, people who cannot benefit much from cognitive work at first are usually better able to make use of it after having done some of the deeper work. 

Clinical depression has been diagnosed in [my girlfriend]. Does the term mean that she has a physical problem that a non-medical psychotherapist like yourself would not be able to  help with?  No. It means that it is true depression, not just normal sadness, and that it is severe enough to warrant the diagnosis.  I  help people with clinical depression all the time.  If an antidepressant is required to deal with the physiological aspect of depression it would be prescribed by her doctor or a psychiatrist.

Have you found that an affective disorder such as clinical depression can be overcome through psychotherapy without medication? In most cases. However, if the person is manic or has severe vegetative symptoms of depression he will probably not be in a fit state to do psychotherapy without medication.  It is also worth noting, especially for older people,  that depression can be caused by the effects of some medications and some illnesses on the body chemistry. These problems of course require medical treatment.

What is the difference between psychotherapy and counselling? These are overlapping categories. The term psychotherapy includes counselling about emotional and human relations problems. It also includes work with the unconscious, which falls outside the scope of counselling.

Is it true that some people do their therapy in a few hours?  If so, what is the purpose of long term therapy? Some people can achieve their objectives in short term therapy (up to twenty sessions). Usually they are resolving a specific problem and getting back on  track. Long term therapy is the deluxe method. For some people it is necessary for overcoming chronic depression and/or the effects of childhood trauma  so that they can lead a normal life. However, others are investing in education and personal growth so they can have a richer and more fulfilling life. For many people long term therapy pays off in financial terms also. For example, it can remove blocks to professional and business success, improve health through reducing stress or overcoming unhealthy habits, and make divorce unnecessary by helping clients to build a stable and harmonious marriage. 

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  Copyright © 2000 Beth Mares