Advances in cognitive-behavioural therapy for unipolar depression.

OBJECTIVE: To describe the main innovations in our theoretical understanding of depression and key clinical developments in cognitive-behavioural therapy (CBT). We outline the current status of CBT and discuss how it can respond to the public health problem of depression. METHOD: We undertook a narrative literature review. RESULTS: CBT provides a sophisticated, empirically grounded account of depression and an evidence-based therapeutic approach for people who suffer from depression. Beyond its efficacy in treating acute depression, it has prophylactic effects and is acceptable to various populations in a range of settings. Good theoretical accounts of the emergence of depression in adolescence are forthcoming; to date, however, attempts at primary prevention are unconvincing. Our understanding of factors contributing to positive outcomes is growing, allowing CBT to be tailored to individual client needs. CONCLUSIONS: CBT is a mainstay approach to depression. Significant remaining challenges include tailoring it to different populations and settings and, most importantly, ensuring that it is more readily accessible.