Not everyone with depression needs or wants analytical forms of therapy where previous feelings and experiences are revisited and explored. Neither do they necessarily connect with time-limited and structured approaches such as cognitive behavior therapy (CBT). In these circumstances counseling and/or supportive psychotherapy may provide a more acceptable and helpful alternative.
During supportive counseling the opportunity to explore and clarify issues that can offer a greater sense of wellbeing will be explored. Counselors will focus on your life as it affects you now, rather than your personal history, but they won’t be immune to reflecting on how your past might be influencing your current situation. Your problems and the way you see things become the real focus of attention.
Supportive therapy is something we’d like to believe is provided to every patient taking antidepressant medication. Many doctors and health workers are trained to conduct supportive therapy but the essence of the approach is the provision of comfort, empathy, reassurance and advice. It’s the immediacy of everyday pressures and troubles that supportive therapists work with. There’s no attempt to analyze unconscious mechanisms and very often the therapist will try to establish the bigger picture by finding out more from family and friends, where this is appropriate.
Supportive therapy uses the practical means at its disposal to help alleviate distress. A skilled therapist can inspire hope even in the darkest moments. They do this by showing patients and their families how to cope with the variety of stressful issues that can arise. They focus on the positive aspects of treatment. They inform patients about the nature and likely course of their depression, how to manage and adjust to it.
It’s not unreasonable to point out that therapeutic boundaries are often less rigid than my attempts at description might suggest. Therapists are usually very flexible and will sometimes attempt to integrate skills acquired from previous therapy. A counselor, for example, might encourage the use of a particular homework task found to be useful during CBT sessions. However, the role of the therapist may also be quite different. A supportive therapist is likely to be far more proactive and even opinionated in the advice and suggestions they provide. The therapist may share their own feelings about the patient and their progress in a way that seems much more natural, but always supportive and always with the welfare of the patient foremost in their mind.