Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Evidence-based counselling approaches for managing anxiety and depression in adults include:
- Cognitive Behavioural Therapy (CBT): Recommended as a high-intensity psychological intervention for generalized anxiety disorder (GAD) and social anxiety disorder, CBT is effective and should be delivered by trained practitioners using treatment manuals. It can be offered individually and is preferred over group CBT for social anxiety disorder due to better clinical and cost effectiveness NICE CG113,NICE CG159.
- Low-intensity psychological interventions: For GAD, low-intensity options such as individual non-facilitated self-help, guided self-help, and psychoeducational groups are appropriate early steps in a stepped-care model NICE CG113.
- Counselling: For depression, individual counselling delivered by practitioners with therapy-specific training is effective. It usually involves 12 to 16 sessions focusing on emotional processing, empathic listening, and helping individuals develop coping mechanisms without giving specific behavioural advice. It is particularly useful for those with psychosocial, relationship, or employment problems contributing to depression and for those who prefer individual over group therapy NICE NG222.
- Short-term Psychodynamic Psychotherapy (STPP): Also for depression, STPP involves 16 sessions focusing on recognizing difficult feelings in relationships and stressful situations, with an insight- and affect-oriented approach. It suits people with emotional and developmental difficulties in relationships but may be less suitable for those unwilling to explore close relationships NICE NG222.
- Interpersonal Psychotherapy (IPT): IPT is another evidence-based individual therapy for depression, delivered according to treatment manuals, focusing on current interpersonal issues NICE NG222.
These psychological interventions should be delivered by competent practitioners with appropriate training and supervision, and treatment adherence and outcomes should be monitored NICE CG113,NICE CG159.