Couple Therapy for Depression ― A Clinician's Guide to Integrative Practice

Depression is second after heart disease as the most damaging health condition in the world. The NHS has devoted huge resources to training thousands of psychological therapists to work in 'Improving Access to Psychological Therapies' services specifically to treat depression in adults and couple therapy has been identified as one of the effective ways of treating it.

Couple Therapy for Depression is an integrative 20-session couple therapy designed to treat depression in couples where there is also relationship distress. Following the recommendations of the UK's National Institute for Clinical Excellence for a behaviourally-based couple therapy treatment, it draws on RCT studies of efficacy as well as 'best practice' in behavioural, cognitive, emotionally-focused, systemic, and psychodynamic couple therapies. Sticking closely to the competencies identified for the treatment of depression and relationship distress in couples, it outlines the ways in which couple therapists can reduce damaging interactions between couples, build emotional openness and closeness, improve communication and behaviour, change unhelpful cognitions and perceptions, and help the couple cope with the ordinary and not-so ordinary stresses that arise in the course of everyday relating.

Written by couple therapists who understand deeply the unique challenges of doing therapy with couples, it is based on the training programme for Couple Therapy for Depression commissioned by the NHS for use in its Improving Access to Psychological Therapies services. It begins by describing the causes and consequences of depression, and then focuses on its impact on the adult couple. Highlighting the particular techniques needed in safe and effective work with distressed couples, it goes through the different ways in which the couple's feelings, thoughts, and behaviours need to be understood and worked with in order to reduce relationship distress. It outlines the treatment of 4 different couples to illustrate the therapy in action and will be helpful for any therapist wanting to enhance their work with couples.

David Hewison, Head of Research & Consultant Couple Psychoanalytic Psychotherapist Project manager, trainer & supervisor, Couple Therapy for Depression Training, Tavistock Centre for Couple Relationships, London UK,Christopher Clulow,Couple Psychotherapist, Tavistock Centre for Couple Relationships, London UK,Harriet Drake,Senior couple and psychosexual therapist Lead trainer and supervisor, Couple Therapy for Depression Training, The Tavistock Centre for Couple Relationships, London, UK

David Hewison D.Cple.Psych.Psych is head of research and a consultant couple psychotherapist at the Tavistock Centre for Couple Relationships. He has a background in adult mental health, training, and individual and couple psychotherapy and research. He was part of the Expert Reference Group that agreed the competencies for the treatment of depression by couple therapy, as recommended by the UK's National Institute of Clinical Excellence. He developed the clinical model of treatment from these that became the basis for Couple Therapy for Depression in the UK National Health Service and is responsible for the professional training and supervision that leads to accreditation in this modality. He has supervised practitioners, supervisors, and trainers in Couple Therapy for Depression, revising the model in response to its experience in practice. Author of many papers and chapters on individual and couple therapy, he teaches internationally.

Christopher Clulow PhD is a Senior Fellow of the Tavistock Centre for Couple Relationships, London, where he works as a visiting lecturer and researcher. He has published extensively on marriage, partnerships, parenthood and couple psychotherapy, most recently from an attachment perspective. He has a long history of contributing to thinking about the processes involved in ending relationships, and his most recent work has involved heading up a project identifying competences for treating depression through couple therapy under the Department of Health's Improving Access to Psychological Therapies initiative. He has also recently consulted to and evaluated interventions provided by a mental health agency to reduce depression in parents of young children. He is a founding member and past Deputy Chair of the British Society of Couple Psychotherapists and Counsellors and a member of the editorial board for Couple and Family Psychoanalysis.

Harriet Drake worked in a health psychology research unit at Guy's hospital before training as a psychodynamic couple therapist and psychosexual therapist at The Tavistock Centre for Couple Relationships. As well as practicing there as a clinician she is the lead trainer and supervisor in TCCR's Accredited Couple Therapy for Depression Training for practitioners working in Improving Access to Psychological Therapies services in the NHS.