The Importance of Counseling for Severe Psychotic Depression

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The Importance of Counseling for Severe Psychotic Depression

Psychotic depression is a severe form of major depression characterized by both depressive symptoms and hallucinations and delusions. Without treatment, psychotic depression can be degenerative and will significantly impair the psychosocial functioning of individuals.

Fortunately with the right treatment people with psychotic depression can recover and lead healthy and productive lives. There are a number of different treatment options for individuals with severe psychotic depression. These include pharmaceutical interventions, counseling and alternative therapies such as acupuncture, hypnotherapy and light therapy.

Counseling for severe psychotic depression is particularly effective. There is a vast array of different counseling techniques and the type of treatment received is dependent on a number of factors. Different individuals respond differently and there is no ‘one size fits all’ model of treatment or combination of treatments. Some research has shown counseling is most effective when used in conjunction with pharmaceutical interventions such as anti-depressants and anti-psychotic medication. Counseling for severe psychotic depression is an essential and necessary component for many. This article will detail the three main approaches to counselling, and identify the importance of counseling for severe psychotic depression.

Three Types of Counseling for Severe Psychotic Depression

Behavioral Therapy

Behavioral counseling is a relatively new branch of counseling based on the way an individual thinks or behaves. Behavioral therapists work to change problematic behaviour through rewards, reinforcements and desensitization. Cognitive therapists, in contrast, aim to correct distorted beliefs that exacerbate distress and mental illness. They work with individuals to replace these distorted beliefs with rational and healthy thought patterns. Cognitive behavioral therapy (CBT) combines both approaches by addressing both distorted beliefs and problematic behavior. The counseling process for CBT requires the patient to be actively involved in identifying both the source and solution of their problems. CBT is an effective treatment for severe psychotic depression, particularly when used as an adjunct to pharmaceutical treatment.

Psychoanalytic and Psychodynamic Therapies

Psychoanalytic therapies originate from the belief that the unconsciousness shapes behavior and thinking patterns. Psychodynamic therapy involves increasing an individual’s awareness and understanding about unconscious emotions and motivations that influence behavior.

Increasing awareness, psychotherapists believe, reduces neurotic and maladaptive behavior and thus helps to treat mood disorders. Psychodynamic therapies are usually more intensive and unfold over a longer time frame than other therapies. According to the National Institute of Mental Health research on the effectiveness of psychodynamic theory is mixed, although some studies suggest it can be as effective as other therapies in treating mood disorders.

Humanistic Therapies

Humanistic therapies encompass a broad range of counseling techniques.

  • Person, or client-centered counseling - focuses on unconditional positive regard and aims to increase self-worth and acceptance.
  • Gestalt therapy - aims to reintegrate an individual into being a cohesive, positively functioning whole.
  • Transactional analysis (TA) - aims to recognize three ego states termed the parent, adult and the child. TA aims to modify communication patterns, or transactions, that these ego states create. TA therapists encourage transactions initiated from a mature adult ego state.

These therapies share commonality in that they assume individuals are capable of enacting their own growth and achieving the ultimate goal of self-awareness. Humanistic therapies are as effective as other methods of counseling in treating individuals with severe psychotic depression.


Elkin, I., Shea, T., Watkins, J. (et al) General Effectiveness of Treatments. Archives of General Psychiatry. 1989. 46: 971-982.

Leichsenring, F. Are Psychodynamic and Psychoanalytic Therapies Effective?: A Review of Empirical Data. 2008. 86:3: 841-868.

National Institute of Mental Health: Psychotherapies.