Antidepressant medication and the assimilation of problematic experiences in psychotherapy

The authors assessed whether the psychotherapeutic process is enhanced by the addition of antidepressant medication. Mildly to moderately depressed patients received client-centered therapy with or without medication. Patients were assessed for symptoms of depression and the ability to assimilate problematic experiences successfully. Ratings of improvement on Stiles's Scale for the Assimilation of Problematic Experiences rose significantly in both treatment conditions. There was no significant effect of the addition of antidepressant medication on the psychotherapeutic process. However, patients without medication tended to reach higher stages of assimilation (e.g., problem clarification and insight). Psychotherapy alone seems as effective in reducing depression as that with the addition of pharmacotherapy and may be superior in supporting the psychotherapeutic process in the longer term. The question remains as to the nature of the conditions in which one may achieve additive effects of psychotherapy and medication.