The philosophical basis for the humanistic approach was phenomenology. According to this philosophical perspective, subjective perceptions, feelings, cognitions, experience are more important than objective facts. For example, two people can see the same movie but every person will have a unique subjective perception of this movie. Therefore, humanistic psychologists also believed that every person`s experience is unique and that an individual`s psychology cannot be studied by objective, scientific method such as tests. Also, because of phenomenological ideas humanists believe that one of the main tasks of a therapy is to explore the subjective experiences of a client (Hjelle& Ziegler, 1992).
Behavioristic ideas were developed, on the other hand, on the basis of positivism and mechanistic philosophical theory of Descartes. According to main ideas of positivism, only that knowledge which was obtained through objective scientific methods can be considered as true. This philosophical theory excluded introspection as the scientific method. Therefore, on the basis of these philosophical ideas behaviorists indicated that psychology should be a science of a behavior because a behavior is visible and accessible for studying, measuring with objective scientific methods.
Descartes tried to apply a mechanistic principle of functioning to humans. He believed that those principles of functioning which are applicable for mechanisms are also applicable for human beings. Because of these mechanistic ideas, behaviorist developed their theoretical assumptions that human`s reactions, behaviors can be shaped, fully controlled by using certain stimuli and totally predicted. Founders of behaviorism believed that, like machines, individuals can be programmed by different schedules of reinforcements (Hjelle& Ziegler,1992).
The philosophical origin of psychodynamic approach is philosophical ideas of Freud. Freud was a founder of the psychoanalysis. He was the first theoretic who state the existence of unconscious forces which are beyond the awareness and understanding of humans. Freud elaborated his assumptions on the base of his clinical practice with patients and his ideas became the base not only for the development of psychoanalytic therapeutic approach but also psychoanalysis as the influential philosophical perspective. Freud believed that human`s mind include ID, Ego and Alter Ego. Libido (sexual instincts) and Thanatos (death drive) are two powerful unconscious drives which influence our life (Hjelle& Ziegler,1992).
The philosophical ideas which became the base for development of family system approach included ideas of the theory of systems and constructivism. Bertalanffy, the author of the general theory of systems, indicated that a system is a unit which cannot be measured only by the sum of its elements. The author stated that it is very important how elements of a system interact with each other and with other systems.
Goals of different approaches
The cognitive-behavioral approach is one of the most popular modern approaches which are applicable for treatment of most of the mental disorders. The central idea of the approach is that humans` attitudes, thoughts, beliefs influence behaviors and behavioral problems of people. Therefore, the goal of the cognitive-behavioral approach is changing of those negative, irrational thoughts, beliefs, attitudes which lead to behavioral problems, mental disorders, etc. Also, the goal of CBT is to replace inappropriate patterns of the client`s thinking with new more rational and healthier ways of thinking (Schultz& Schultz, 2016).
Psychotherapists who represent family systems approach believe that members of one family are interdependent psychologically and, therefore, they can influence the development of psychological problems of each other. Also, therapists who adhere to family-systems approach work with the whole family and believe that to solve the problem it is not individual who needs to change but it is a whole family system which must be changed to treat the disorder, etc. Bowen, the founder of family systems approach, indicated that a family is an emotional unit.
Family system therapists indicate that a family as a system seeks to maintain its balance (homeostasis) and to keep its functioning. Therefore, depression, as well as other mental disorders of a member of a family, can be the necessary part of saving family balance and family functioning. Also, depression of a family member can be a sign that a current family system cannot adequately meet needs of family members (Sander & McCarty, 2005).
According to Sander & McCarty (2005), the goal of most of the family system therapies is “to alter patterns of communication and behavior, to assist all family members in meeting their needs and the family’s goals without psychologically distressing symptoms. A common assumption underlying systemic therapy is that depression develops to serve some function within that system.”.
The main goal of the humanistic therapeutic approach is to arouse a client`s need for self-fulfillment, client`s creativeness and to encourage a client`s self-acceptance. Humanists believe that every person is kind and creative inherently and that every person has the inner desire to sell-realize one`s potential, talents. Rogers, one of the founders of humanistic approach pay special attention to the development of a therapeutic relationship between a client and a therapist. The author believed that the relationship full of truth, empathy, congruence and acceptance can encourage personal growth of a client.
Strategies and techniques
Therapists who adhere to psychodynamic approach use techniques such as free associations, hypnosis, analysis of dreams, humor, slips of the tongue, projective tests. The techniques and therapeutic interventions of psychoanalytic are directed to educe and analyze unconscious, repressed impulses, desires of a patient, to find and analyze patients` traumatic childhood experience, etc.
Techniques of humanistic approach associated with evaluating of client`s ideal and actual self, acceptance, respect, empathy, unconditional positive regard, therapist`s genuineness, listening to a client, etc.. Humanistic therapy is more focused on the relationship between a client and a therapist, on the whole process of the therapy, on the emotions, feelings of the client rather than on separate techniques, interventions (Schultz& Schultz, 2016).
For example, unconditional positive regard means that a therapist does not judge or evaluate actions of the client as good or bad actions. The therapist must provide the client with the full acceptance; the efforts of a humanistic therapist are directed to make the client feel that he/she can do what one likes, that he/she can be the way he/she is, etc. (Schultz& Schultz, 2016).
Unlike humanistic approach, the cognitive-behavioral therapeutic approach includes a variety of therapeutic techniques such as behavioral experiments, systematic desensitization, self-monitoring, etc. For example, behavioral experiments may include testing of particular ideas, beliefs, thoughts, and fears of a client. For example, the person who suffers from depression may think that he/she is a bad person, may blame oneself and believe that other people feel bad and unhappy because of one, etc.. In this case, the therapist can ask the client to test this ideas, beliefs, to check if these thoughts coincide with reality, etc. (Schultz& Schultz, 2016).
Family systems therapists, unlike psychodynamic psychotherapists, cognitive-behavioral therapists, humanistic psychologists, focus their attention on the relationship, interaction between members of a family instead of working with psychological problems of each family member.
The effectiveness of different approaches in treatment of depression
Luyten & Blatt (2012)conducted the meta-analysis and made conclusions that many depressed patients accept psychodynamic approach as a viable treatment. Also, evidence demonstrate that psychodynamic therapy can be as effective as other psychotherapeutic approaches for depression treatment, as effective as pharmacotherapy and better than therapy with medications in the long-term run. However, researchers also indicated that there are not enough researches on benefits or disadvantageous and efficiency of psychodynamic therapy for depressive patients.
Leichsenring (2001) compared short-term psychodynamic treatment and cognitive-behavioral treatment for depressive patients and found that both short-term therapies were similarly efficient for depression treatment. The difference of efficiency of both therapies was statistically insignificant. At the same time, the author indicated that neither short-term psychodynamic nor cognitive-behavioral therapy was effective in the long-term run. The review of Leichsenring (2001) demonstrated that depressed patients need therapy which includes at least 16 sessions to succeed in their recovery in the long-term run.
Diamond et al. (2002) conducted the study with depressed adolescents using attachment-based family therapy. The study demonstrated that most of the adolescents who were assigned to family therapy sessions did not demonstrate symptoms of depression after the course of treatment while only half of those adolescents who were assigned to “waitlist” condition and did not go through family therapeutic sessions but were treated by traditional methods (medications) succeed in their recovery.
However, the experiment conducted by Diamond et al. (2002) included the specific family system approach, so it is unclear whether other more popular family systems approaches are effective in the treatment of depression. Also, we did not find evidence about the efficiency of humanistic approach in the treatment of depression.
References
Diamond, G. S., Reis, B. F., Diamond, G. M., Siqueland, L., & Isaacs, L. (2002). Attachment-based family therapy for depressed adolescents: A treatment development study. Journal of the American Academy of Child & Adolescent Psychiatry, 41(10), 1190-1196.
Hjelle, L. A., & Ziegler, D. J. (1992). Personality theories: Basic assumptions, research, and applications. McGraw-Hill Humanities, Social Sciences & World Languages.
Luyten, P., & Blatt, S. J. (2012). Psychodynamic treatment of depression. Psychiatric Clinics of North America, 35(1), 111-129.
Leichsenring, F. (2001). Comparative effects of short-term psychodynamic psychotherapy and cognitive-behavioral therapy in depression: a meta-analytic approach. Clinical psychology review, 21(3), 401-419.
Sander, J. B., & McCarty, C. A. (2005). Youth depression in the family context: Familial risk factors and models of treatment. Clinical Child and Family Psychology Review, 8(3), 203-219.
Schultz, D. P., & Schultz, S. E. (2016). Theories of personality. Cengage Learning.
