Prophylactic cognitive therapy for major depressive disorder

Most people suffering from major depressive disorder experience chronic symptoms, recurrence, or both. We speculate on how the process of diagnosis and cognitive therapy may produce changes that, over time, can affect the view of the self. In clinical practice and research, some of the most challenging questions involve how best to identify and design strategies to help patients and clinicians reduce the chance that depressions recur. Related and equally challenging questions involve how best to increase the time between episodes and how to decrease the length of depressive episodes when prophylactic treatment does not prevent a relapse or recurrence. In this article we describe how we have used the continuation/maintenance phase of cognitive therapy for depression to achieve these goals. We illustrate these concepts and processes with one case history.