The Treatment and Prevention of Depression: Implications for Counseling and Counselor Training

One of the most common disorders facing people today is depression. By some estimates, roughly 10% to 25% of the population experiences some form of depression. According to Murray and Lopez (1997), depression is the number one cause of disability worldwide. It is clearly the most common disorder experienced by people who see mental health practitioners (Gilroy, Carroll, & Murra, 2002). Also, it may be the most common disorder of mental health workers themselves (Mahoney, 1997; Pope & Tabachnik, 1994), with research suggesting that from one third to more than 60% of mental health professionals had reported a significant episode of depression within the previous year. Depressing? Yes, but there is hope and good news. Depression, by and large, is a problem readily amenable to treatment, and there are many successful approaches, many of which have empirical evidence to support their efficacy. The bad news, however, is that depression has been increasing in epidemic proportions. Data reflect that depression is 10 times as prevalent now as it was in 1960! Seligman (2002) provided a provocative paradox on depression. He stated that while every objective indicator of well-being in the U.S. has been increasing, every indicator of subjective well-being is decreasing. Clearly, the importance of the current knowledge base on depression is obvious. Counselors, from pre-K to adult mental health workers, need to be well-versed on the current state of treatment for depression. For counselors, it is quite likely that for many of their clients, whether they present with problems of mood disturbance or not, depression may be involved. For professionals, who are at high risk for mood disorders by the very nature of their work, the importance of treatment and prevention in self-care is critical. Thus, this topic has considerable value because it is quite likely that counselors will work with clients with depression, and it is quite likely, given the empirical evidence, that counselors are experiencing or will be experiencing some form of depression/mood disturbance themselves. The article "Treatment and Prevention of Depression" (Hollon, Thase, & Markowitz, 2002) reviews the current state of research on various treatment modalities, comparing the effectiveness of the more widely used approaches--psychodynamic therapy, interpersonal psychotherapy, cognitive behavior therapy, marital and family therapy--to antidepressant medication therapy. The results of these comparisons are discussed, together with implications for counselors, counseling, and counselor training. Article Review In a monograph-length article, Hollon et al. (2002) provided a detailed review of the common treatments for depression, together with a summary of the available empirical support for each. They added to that a brief discussion of marital and family therapy for treating depression, approaches that are only now starting to receive empirical scrutiny. Specific research outcomes were presented for medication treatments, psychodynamic treatments, interpersonal psychotherapy, cognitive behavior approaches, and marital and family approaches. The authors discussed the relative effectiveness of various combinations of these treatments as well. Although most of the article was concerned with research-based outcomes for adult outpatients with depressive disorders, the authors also presented examples from the growing body of research on the treatment of bipolar disorders. Hollon et al. (2002) provided a concise primer on the types of mood disorders. The summary should be very helpful for counselors because most will have clients who exhibit some form of mood disorder. The consequences of depression, beyond the disorder itself, are significant. Depression increases the risk of heart disease and diabetes. Also, mood disorders can increase the risk of substance abuse and vice versa. Thus, sensitivity to the occurrence of depression is a critical diagnostic skill for all counselors. …