CBT v Psychodynamic Therapy for Treating Major Depression - Which is Most Effective?
The mental health world is split between two powerhouse approaches to treating depression - but does the research suggest one is actually better than the other?
Depression is the second highest burden and disability-causing disease among all diseases by 2020, and it is expected to become the world's largest disease burden by 20301.
What is Short Term Psychodynamic Therapy (STPP)?
Short Term Psychodynamic Therapy is another option for patients who may not respond to CBT or other approaches. Psychodynamic Therapy focuses on the unconscious and its involvement in developing and maintaining mental health disorders. There are several approaches under this umbrella with most sharing pillars based upon objects relations theory, attachment theory and drive theory.2
How does it compare to CBT?
Cognitive Behavioural Therapy (CBT) and STPP are fundamentally different therapies with different principles, CBT is fundamentally rooted in our own perception of events and subsequent behaviour3.
Alternately, Short Term Psychotherapy focuses heavily on unresolved conflicts and past experiences. Kaluzeviciute‐Moreton and Lloyd (2024)4 identify what they refer to as a ‘turf war’ between CBT therapists and those specialised in Psychodynamic therapy but are the two approaches all that different in outcomes?
The effectiveness of each has been compared by a multitude of research papers. Malkomsen et al. (2025) explored and examined modern improvements to both methods5.
For one group, a traditional method of CBT for depression was administered. In the STPP group connections behind past experiences to current ones were examined, aiming to reduce depressive symptoms.
Patient's depressive symptoms improved in both groups, however limited statistical significance was recorded between the two approaches.
Research supporting both STPP and CBTT is numerous; with reductions in depression and an increased quality of life reported in both6.
This is in line with other comparative studies that conclude both options as effective whilst suggesting the benefits of offering patients a range of therapeutic options7.
What about therapy and medication?
Di Salvo et al. (2024)8 found the addition of STPP alongside medication can improve hospitalisation rates and cost effectiveness, sustaining long term results at 12 months. Similarly, combining antidepressant and CBT has been observed to have improved results9.
Who wins the turf war?
Both Cognitive Behavioural Therapy and Psychodynamic therapy are similarly effective in treating depression.
As Yan (2024)10 highlight, understanding variables that moderate how effective each option is needs to be a priority for future research, allowing professions to make educated decisions regarding what treatment option to take when treating a patient.
Importantly, Leichsenring et al. (2024)11 argue the World Health Organisation needs to take additional steps to equally endorse evidence-based psychodynamic therapy compared to their endorsement of CBT.
Each approach seemingly has similar effectiveness and in some situations, each approach shares many similarities. Indeed even analysis of patients post-therapy interviews who received either Psychodynamic Therapy or Cognitive Behavioural Therapy concluded the important elements to the improvement of patients' symptoms had ‘striking’ similarities12.
Regardless of the theoretical differences, it could be inferred that CBT and STPP, in practice, may be more similar than different when it comes to outcomes.
Author: Max Roberts