Cognitive Behaviour Therapy and Depressive Relapse: Justified Optimism or Unwarranted Complacency?

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Abstract
The magnitude of the problem of relapse and recurrence in depression is outlined and it is contended that this is now the major treatment issue facing clinicians. Studies demonstrating a longer term prophylactic effect of Cognitive Behaviour Therapy (CBT) are briefly reviewed and it is concluded that these methods have significantly impacted on relapse rates in unipolar depression. Nevertheless, it is argued that there is little cause for complacency due to the still significant rate of relapse which is found with CBT. While promising cognitive behavioural methods have been developed in the field of addictive disorders, there is a clear need for similar clinical advances in the area of recurrent depression. Some strategies which may have potential for promoting maintenance and preventing relapse are briefly outlined. The importance of developing a coherent model for assessing relapse risk and guiding decisions regarding treatment and after care strategies is emphasized. Lastly, future research directions in this important area are briefly considered.