Psychotherapy of Depression: A Self-Confirmation Model

• Published in: Psychological review 1989-10, Vol.96 (4), p.576-607
• Main Author: Andrews, John D. W
• Format: Article
• Language: English
• Subjects: Behavior; Biological and medical sciences; Depressive Disorder - psychology; Depressive Disorder - therapy; Feedback; Human; Humans; Interpersonal Relations; Major Depression; Medical sciences; Mental depression; Models, Psychological; Personality; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapies. Psychological and clinical counseling; Psychotherapy; Self Concept; Therapy; Treatments
• ISSN: 0033-295X; 1939-1471
• DOI: 10.1037/0033-295X.96.4.576

The concepts of self-confirmation, interpersonal diagnosis, and prototype construction are used to integrate research and clinical findings concerning depression. The person is conceptualized as sustaining his or her self-concept through a feedback loop that provides both interpersonal and intrapsychic confirmation. The personality styles specified in interpersonal diagnosis are viewed as prototypes that characterize the self-confirmation strategies used by different sorts of individuals. It is argued that various theories of depression reflect distinct segments of the depressive self-confirmation feedback cycle, and hence the stages of that cycle provide a systematic basis for deriving prototype features at both descriptive and causal levels. Various interventions are targeted toward different links in the self-confirmation cycle, and all effective interventions can lead, in different ways, to rechanneling the cycle as a whole. For this reason, combinations of interventions will often be particularly valuable. The therapeutic relationship also helps to redirect the depressive client's self-confirmation patterns and should be coordinated with target-specific interventions in order to attain maximum therapeutic impact.