The Cognitive Behavioral Analysis System of Psychotherapy (CBASP) is the only psychotherapy model developed specifically for chronic depression. A diagnosis of persistent depressive disorder (PDD) in the DSM-5 means the disorder has persisted for 2 years or more with no more than an 8 weeks hiatus of no depressive symptoms. Depression is the most common cause of disability worldwide, represents one of the greatest — if not the greatest — challenges to global health in the 21st century, and by 2030, it will be the single largest contributor to the global burden of disease(1). Approximately 280 million people in the world have depression, and it is about 50% more common among women than men(2). More than 700,000 people die due to suicide every year. Suicide is the fourth leading cause of death in 15–29-year-olds(3). Sadly, persistent depressive disorder is often under-detected and mistreated. Therefore, patients must receive the appropriate diagnosis and be treated using an evidence-based model for their condition. CBASP was developed with almost half a century of research to help people overcome chronic depression.

One of the common characteristics of people with PDD is their struggle with developing and maintaining relationships. Numerous components make CBASP different from other forms of therapy. One of the significant objectives of CBASP is to assist patients with learning how to interact with greater interpersonal flexibility. The relationship between the therapist and the patient is used as a model for the patient to learn to develop more empathy. The CBASP therapist assists the patient with learning what it means to feel safe, which helps them reduce avoidance behaviors, a common symptom of depression. This leads to learning new methods of having interpersonal relationships, which is a critical component of gaining control and reducing chronic depression. All the therapeutic components of CBASP were developed to teach the patient how to be flexible with their interpersonal behavior.

People with chronic depression commonly have a history of trauma and challenging interpersonal relationships. CBASP helps the patient develop interpersonal safety by focusing on the clinician. This helps them separate from other people who have caused them emotional pain. With CBASP treatment, the therapist teaches the patient what to do in interpersonal situations until they can do it on their own. Over time, the patient becomes aware of how to behave in an interpersonally effective way and is taught how their behavior has consequences on other people, including the therapist and their social environment. If you, or someone you know, believe you are struggling with chronic depression, finding a provider with the experience and training to treat this common condition is essential. Let’s overcome one of the most significant challenges to global health in the 21st century by connecting people who struggle with chronic depression to appropriate treatment.

-Ben Schwartzman, LCSW, A-CBT

1. https://grandchallenges.ucla.edu/depression/problem/

2. Institute of Health Metrics and Evaluation Global Health Data Exchange (GHDx)

3. Woody, C.A., Ferrari, A.J., Siskind, D.J., Whiteford, H.A., & Harris, M.G. (2017). A systematic review and meta-regression of the prevalence and incidence of perinatal depression. J Affect Disord (219), 86–92.