The Most Efficient Technique To Treat Depression: Socratic Dialogue

The most efficient technique to treat depression: the Socratic Dialogue

Do you know which is the most effective technique for treating people with depression? Some people with depression expect answers from their therapists. One study suggests that questions might be key.

This study, conducted by researchers from Ohio State University, shows that depressed patients make greater progress when their therapists use a technique called the Socratic Method. The study was published in the journal Behavior Research and Therapy  .

The Socratic Dialogue and Cognitive Therapy

The Socratic Dialogue is a therapeutic instrument of cognitive therapy for cognitive restructuring.

Socratic dialogue consists of a series of questions in which the therapist asks the patient to look at himself and his place in the world from new perspectives.

“People with depression can get stuck in negative thought patterns,” said Justin Braun, co-author of the study and a graduate student in psychology at Ohio State University. “The Socratic Dialogue helps patients to examine the validity of their negative thoughts and to adopt a more realistic and broader perspective.”

Cognitive therapy is based on the assumption that people suffer from depression because of their interpretation of things and not because of the things themselves.  During therapy one tries to achieve that the patient’s giving of meaning becomes more flexible and that he finds more functional and more adaptive interpretations.

The therapy not only curbs the current depression, but also protects against future depression.

“Other studies have focused on finding out how the patient-therapist relationship can promote a positive therapeutic outcome,” said  study co-author Daniel Strunk, assistant professor of psychology at Ohio State University.

“We found that the Socratic Dialogue is predictive of symptom improvement even more than the therapeutic relationship, the most frequently examined variable in previous studies.”

Philosophers statues

Why the Socratic Dialogue is efficient

The study enrolled 55 patients who were undergoing 16-week cognitive therapy for depression at Ohio State University. Before each session, the participants completed a questionnaire. The aim of the questionnaire was to measure the symptoms of their depression.

The researchers evaluated the video recordings of the first three sessions of each individual patient and determined the regularity with which the therapist used the Socratic dialogue.

The researchers observed that after the sessions in which the therapists used the Socratic dialogue more frequently, there was greater improvement in symptoms of depression.

“The patients learn to ask themselves questions and to be skeptical of their own negative thoughts,” explains Braun. “If you do this, you will achieve a significant reduction in your symptoms.”

For example, a patient may tell their therapist that they are a total failure and that their life is no longer worth living because their marriage ended in divorce. The therapist then asks a series of questions that challenge the patient’s assumptions about their situation.

The researchers suggest questions like this:

  • Do you think anyone who’s divorced is a failure?
  • Do you know anyone who doesn’t?
  • Why is your divorce making you a failure?
  • What shows your relationship wasn’t a total failure? Has your relationship been successful in any particular way?
Woman with question mark

“The goal is to teach the patient to ask themselves these kinds of questions,”  explains Strunk.

“We believe that one of the reasons the positive effects of cognitive therapy persist is that patients learn to question their negative thoughts and continue to do so even after they have finished their treatment.”   Strunkt also mentions that patients realize that they are simply ignoring information that contradicts their negative thoughts.”

The researchers are now continuing their studies with new patients being treated for clinical depression. One of the goals of the further investigations is to characterize the patients in order to make the use of the Socratic dialogue even more efficient.

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