What does neuroscience offer us in understanding cognitive therapy and person-centred therapy for depression? A realist synthesis review

Abstract

A need for increased access to effective therapies for depression has been identified in the United Kingdom. There has been significant investment in Cognitive Therapy but a perceived lack of funding for alternatives. This study takes a pluralistic perspective in enquiring into what neuroscience offers us in understanding Cognitive Therapy and Person-Centred Therapy for Depression. This realist synthesis review provides a background of the theories, mapped for commonality in causality and therapy for depression. It examines neuroscience theory of depression and fMRI evidence of the effects of Cognitive Therapy and Person-Centred therapeutic concepts on the brain. This review highlights some of the limitations of scanning technology and the way that research within ‘schools’ interprets evidence from the perspective of a particular theory. This has led to evidence being presented for the case of cognitive control of emotion. The alternate hypothesis for emotional regulation was not tested in the studies reviewed despite being observed as the mechanism of change in drug therapy for depression. Since all disciplines and theories reviewed suggest the involvement of both cognitive and affective processes further research is suggested to clarify their interaction.