Depression

NICE NG222 first-line recommendation for depression across severities.

Cognitive Behavioural Therapy (CBT) is a structured, time-limited psychological therapy that helps people understand how their thoughts, behaviours, and physical responses interact to maintain emotional distress. It focuses on present-day difficulties and aims to develop practical skills that can be used beyond therapy.

NICE NG222 recommendation; non-inferior to CBT in COBRA trial.

Behavioural Activation is a structured psychological therapy that focuses on increasing engagement in meaningful activities to improve mood. It is grounded in behavioural models of depression and emphasises action before motivation — the principle that waiting to feel better before doing things keeps people stuck.

NICE NG222 recommendation, particularly for interpersonally-driven depression.

Interpersonal Therapy is a time-limited, structured therapy focusing on the link between mood and current interpersonal relationships. It helps people improve communication, resolve relational difficulties, and process losses or life transitions.

Growing evidence; comparable to CBT in several trials.

Acceptance and Commitment Therapy (ACT, pronounced as a single word) is a behavioural therapy that helps people develop psychological flexibility — the ability to be present with difficult thoughts and feelings without being controlled by them, while moving toward what matters most. Rather than trying to eliminate distressing internal experiences, ACT changes the relationship people have with them.

Particularly for recurrent depression with relational patterns.

Cognitive Analytic Therapy (CAT) is a time-limited, relationally focused integrative psychological therapy that draws on cognitive psychology, psychoanalytic object relations theory, and activity theory (Vygotskian developmental psychology). Developed by Anthony Ryle in the 1980s, CAT helps people understand and change longstanding patterns of thinking, feeling, and relating that cause ongoing distress. It places particular emphasis on understanding how early relational experiences shape current patterns, and uses unique collaborative tools — including reformulation letters and diagrams — to make these patterns visible and open to change.

Particularly for shame-based depression.

Compassion-Focused Therapy is a psychological therapy designed to help people who experience high levels of shame and self-criticism. Developed by Paul Gilbert, CFT focuses on developing compassion toward self and others using evolutionary and neurobiological models of emotion regulation.