What influences people who have experienced a major depressive episode to take part in therapy?
Major depression is a common and serious mood disorder which has a high rate of relapse and impacts significantly on individuals, their families and society. Depression is one of the highest contributors to the worlds overall burden of disease. The origin of this mental disorder is complex and multifactorial. Researchers are still working to discover more about causative factors. Given the wide range of contributing factors to depression, it is now recognized there needs to be a holistic approach to treatment. The gold standard for depression treatment, is psychological therapies and medication combined. Currently, medication is readily used and the availability of psychotherapy as treatment is limited. This Masters research thesis took place in the Clinical Research Unit (CRU), Department of Psychological Medicine. The CRU is a clinic which specializes in treating mood disorders. The group of people interviewed were recently discharged from Mental Health Services after being treated for a mood disorder, either Major Depression or Bipolar Disorder, and were entering a study where they would take part in therapy. Semi-structured interviews were completed and analysed using transactional analysis. The aim of this research was to explore what motivated people to take part in therapy as treatment for their depression. People were interviewed prior to starting therapy and were asked a range of questions which sought to build a picture about what made them ready to start therapy, what their expectations were from taking part in therapy and what they wanted over all from therapy as treatment. The findings from this study were summarized into five themes after analysis of the interview transcripts. The first theme ‘Medication was not enough’ encompassed the experience people had about using mediation as treatment for depression. People had varying ideas about medication but mostly agreed medication alone, left their depression largely unaffected. People felt they needed more from medication and needed more support and education around the medication they were prescribed. Theme number two ‘A Turning Point’ arose from people describing the experience of being unable to continue as they were. People talked about feeling desperate, and saw they couldn’t move forward without help, without working to make changes. Often people had attempted suicide, or has significantly impaired functioning in life. This ‘rock bottom’ of sorts was where the motivation for seeking therapy emerged. This first two themes were the beginning of a process that people went through before wanting to start therapy. Beyond the turning point people looked to therapy to meet their needs. The next three themes were under the umbrella of ‘Why Therapy?’ – that is to ask, ‘Why do people want Therapy specifically?’. The first reason people talked about when explaining why they wanted therapy was the connection and support from the relationship with a therapist; being able to talk about their experience. The theme ‘Talking to another; getting it out’ was used to summarize the desire people had to be able to talk to someone who was knowledgeable, objective, professional, consistent and understanding. People saw various benefits would be had from being able to do this. The next theme ‘Making sense of experience’ was one of the main reasons people thought talking therapy would help. People thought if they could make sense of what was happening for them it would give them the direction and power needed to change. The final theme was a common response when people were asked why they were seeking therapy. People wanted to learn new skills to help them cope and thought a therapist would be able to work with them to develop these. In conclusion, people who have experienced a major depressive episode sought psychotherapy as treatment to reach a range of needs for recovery that were not met by medication alone. These findings are supported by current guidelines which recommend a combination of therapy and medication as first line treatment for moderate-severe major depression.
Advisor: Crowe, Marie; Inder, Maree
Degree Name: Master of Health Sciences
Degree Discipline: Department of Psychological Medicine
Publisher: University of Otago
Keywords: New Zealand; mooddisorder; depression; therapy; psychotherapy; qualitative
Research Type: Thesis