Types of Therapy for Depression: 8 Evidence-Based Options

If you have tried therapy for depression before and it did not help as much as you hoped, I want to say something clearly at the outset: that does not mean therapy does not work for you. It far more often means the approach was not the right match for what was actually driving your depression.

This is one of the most common conversations I have in my practice. Someone comes in having done six sessions of a standard talking approach years ago, concluded therapy was not for them, and spent the intervening years managing alone. When we look properly at what was happening underneath their depression, it often becomes obvious why that particular approach did not land.

There are many types of therapy for depression, and they work in genuinely different ways. Some target thoughts, some target behaviour, some target unprocessed experiences held in the body, and some target the relationships around you. Understanding the differences puts you in a much stronger position to advocate for what you need. If you would like help working out which direction suits you, you are welcome to get in touch to book an initial consultation, or read more about our depression treatment here.

What you’ll learn about the types of therapy for depression

This guide walks through eight evidence-based types of therapy helpful for depression, what each one actually involves, and how to work out which is most likely to help you. You’ll discover:

Why one type of therapy for depression does not suit everyone: how the same diagnosis can have very different underlying drivers.
The cognitive and behavioural approaches: cognitive behaviour therapy, behavioural activation, and acceptance and commitment therapy.
Depth and pattern-focused approaches: schema therapy and psychodynamic psychotherapy for depression rooted in long-standing patterns.
Trauma-focused and body-based options: EMDR and somatic approaches when depression follows overwhelming experience.
Relationship-focused therapy: interpersonal therapy and couples work when connection is the driver.
Relapse prevention: mindfulness-based cognitive therapy and why it matters if depression keeps returning.
How to choose and how to switch: the questions to ask a psychologist, how long to give an approach, and what to do if it is not working.

Why one type of therapy for depression does not suit everyone

Depression is a description of a set of symptoms, not an explanation of their cause. Two people can meet identical diagnostic criteria and be there for entirely different reasons.

One person may be caught in a cycle of harsh self-critical thinking that feeds low mood. Another may be carrying unprocessed trauma that their nervous system has never been able to settle. A third may be profoundly isolated. A fourth may be exhausted by years of trying to meet impossible standards.

The same treatment will not serve all four equally well. This is not a controversial position clinically. The Australian Psychological Society’s review of evidence-based psychological interventions found that when cognitive behaviour therapy was compared directly with other active psychological therapies such as interpersonal psychotherapy and short-term psychodynamic psychotherapy, no clinically significant differences in effectiveness were found for depression.

In other words, several approaches work. The clinically useful question is not which therapy is best in general, but which therapy is best for what is happening in your particular situation.

Cognitive and behavioural types of therapy for depression

Cognitive behaviour therapy

Cognitive behaviour therapy is the most extensively researched psychological treatment for depression, and for good reason. Healthdirect Australia describes it as a structured approach that helps you identify and change unhelpful thought and behaviour patterns that maintain distress.

In practice, this means learning to notice thoughts such as ‘I always ruin things’ or ‘there is no point trying’, testing them against actual evidence, and building more accurate alternatives. It is practical, structured and usually time-limited.

It works particularly well when depression is driven by identifiable thinking patterns and when you are able to engage analytically with your own mind. It works less well as a starting point when someone is so depleted that homework tasks feel impossible, or when the depression sits on top of unprocessed trauma that thinking differently will not touch.

Behavioural activation

Behavioural activation is often delivered within cognitive behaviour therapy but deserves its own mention, because it is frequently the approach I reach for when someone is too flattened to do cognitive work.

The principle inverts the usual assumption. Rather than waiting to feel motivated before acting, you act first in small, structured, deliberately manageable ways, and motivation follows. Depression withdraws you from the very activities that would lift your mood, and behavioural activation systematically reverses that withdrawal.

I find it especially useful early in treatment. It asks very little cognitive effort, it produces noticeable change relatively quickly, and it gives people evidence that their situation is not fixed.

Acceptance and commitment therapy

Acceptance and commitment therapy takes a different position altogether. Instead of trying to change or dispute difficult thoughts, it teaches you to hold them more lightly and to act according to your values regardless of what your mind is offering.

For people who have spent years fighting their own thoughts and losing, this is often an enormous relief. The goal shifts from feeling better to living well while feeling what you feel.

I tend to suggest this approach when someone has already tried cognitive work and found the disputing exhausting, when depression coexists with chronic illness or circumstances that genuinely cannot be changed, or when a person has become disconnected from what actually matters to them.

Depth and pattern-focused therapy for depression

Schema therapy

Schema therapy addresses the deep, long-standing patterns formed early in life that quietly govern adult behaviour. If you have felt fundamentally defective, unlovable or not good enough for as long as you can remember, you may be dealing with a schema rather than a passing depressive episode.

These patterns are largely invisible to the person holding them because they do not feel like beliefs. They feel like facts. Schema therapy works to identify them, trace where they came from, and gradually build alternatives through both understanding and experiential work.

It suits people whose depression is chronic or recurrent rather than episodic, and those with entrenched low self-esteem or perfectionism. It generally takes longer than cognitive behaviour therapy, and I am always upfront with clients about that.

Psychodynamic psychotherapy

Psychotherapy with a psychodynamic focus explores how earlier relationships and experiences continue to shape present-day emotional life, often outside conscious awareness. It is less structured than cognitive approaches and more exploratory.

This is a good fit when someone repeatedly finds themselves in the same painful situations without understanding why, or when depression seems connected to something they cannot articulate. It is often less suitable when someone needs rapid symptom relief and practical tools.

Trauma-focused types of therapy for depression

A significant proportion of the depression I see has trauma underneath it. When that is the case, working only on present-day thoughts is a bit like repeatedly mopping the floor without turning off the tap. Phoenix Australia, Australia’s national centre of excellence in post-traumatic mental health, provides guidance on trauma-informed treatment for exactly this reason.

EMDR

Eye movement desensitisation and reprocessing, usually shortened to EMDR, uses bilateral stimulation such as guided eye movements while you briefly hold a distressing memory in mind. The aim is to help the brain reprocess experiences that have remained stuck in an unresolved state.

Clients often report that the memory does not disappear, but it stops carrying the same emotional charge. It becomes something that happened rather than something still happening.

Although EMDR is best known as a treatment for trauma and PTSD, it is increasingly used where depression is trauma-linked. The EMDR Association of Australia maintains standards for practitioner training here, and it is reasonable to ask any therapist what EMDR training they have completed.

Somatic and body-based approaches

Somatic approaches work with the body rather than only the narrative. Depression is not merely a mental state. It shows up as physical heaviness, collapsed posture, shallow breathing and a nervous system stuck in shutdown.

These approaches build awareness of bodily sensation and gently expand your capacity to tolerate it, helping a nervous system that has been braced for a long time to settle. They suit people who intellectually understand their depression perfectly well but find that understanding changes nothing, and people who feel disconnected or numb in their bodies.

Relationship-focused therapy for depression

Interpersonal therapy

Interpersonal therapy treats depression as something that occurs within a relational context rather than purely inside an individual. It focuses on a small number of areas: grief and loss, role transitions such as becoming a parent or retiring, disputes with significant people, and difficulties forming relationships. The Australian Psychological Society review found a medium effect size in favour of interpersonal therapy for depressive symptoms.

It is a strong option when depression clearly began around a relational event, and when grief or loss or a major life adjustment is central to the picture.

Relationship and couples counselling

Depression does not occur in isolation, and it places real strain on partners and families. Sometimes the most effective intervention involves the people around you. Relationship counselling can help a partner understand what depression actually is rather than reading withdrawal as rejection, and can rebuild connection that depression has eroded.

Where relationship difficulties are contributing to depression rather than only resulting from it, this becomes even more important. I explore the protective role of connection in more depth in can human connection help you fight depression?.

Mindfulness-based cognitive therapy for recurring depression

Mindfulness-based cognitive therapy combines cognitive therapy with mindfulness training, and it was developed specifically to prevent depressive relapse rather than to treat an acute episode.

It teaches you to notice the early rumination patterns that precede a depressive episode and to step out of them before they gather momentum. Healthdirect outlines mindfulness as a practice of paying deliberate attention to the present moment without judgement, which is the underlying skill being trained.

If you have had two or more depressive episodes, this approach deserves serious consideration. It is generally used once acute symptoms have settled rather than at the lowest point, and it pairs well with the relapse prevention strategies I cover in how to stop depression from recurring.

How to choose the right type of therapy for depression

Rather than trying to self-diagnose which approach you need, the more useful move is to find a psychologist trained across several and let the assessment guide the decision.

Questions worth asking a psychologist

Which approaches are you trained in, and which do you use most often for depression?
Based on what I have described, which approach would you suggest starting with and why?
Roughly how many sessions before we would expect to see some shift?
How will we know if this is working, and what happens if it is not?
Do you have specific training in trauma-focused approaches if that turns out to be relevant?

A good psychologist will welcome these questions. You can check any practitioner’s registration and any conditions on it through AHPRA, and the Psychology Board of Australia sets the standards all registered psychologists work under.

How long to give an approach

Most people should notice something shifting within six to eight sessions. That does not mean feeling better necessarily. It might mean understanding yourself differently, or noticing a pattern you had not seen before, or having one slightly easier week.

If nothing at all has moved after eight sessions, that is worth raising directly with your psychologist rather than quietly giving up. Sometimes it means adjusting the approach. Sometimes it means the working relationship is not the right one, which is genuinely common and not a failure on anyone’s part.

Combining approaches

In my practice I rarely use a single approach in isolation. A typical course of treatment might begin with behavioural activation to build some baseline capacity, move into trauma processing once there is enough stability, and finish with mindfulness-based skills for relapse prevention.

This is part of what I mean by a holistic psychology approach. Alongside the therapy itself, I look at sleep, nutrition, movement, stress load and relationships, because these materially affect how well any psychological treatment works. Read more about our depression treatment approach at Integrated Health Specialists.

What about medication?

I am a psychologist, not a prescriber, so decisions about medication sit with your GP or psychiatrist. What I can say is that antidepressant medicines and psychological therapy are not competing options, and for many people a combination works better than either alone.

Medication can reduce symptoms enough that therapy becomes possible, particularly when depression is severe. Therapy addresses the patterns and experiences underneath. My consistent position is that medication alone rarely resolves the underlying drivers, which is why evidence-based psychological therapy remains central to good depression treatment, alongside medication if needed.

Accessing therapy for depression in Australia

Cost is a genuine barrier for many people, so it is worth knowing what support exists. A Mental Health Treatment Plan from your GP gives eligible people access to Medicare rebates under the Australian Government’s Better Access initiative, covering up to 10 individual sessions with a registered psychologist each calendar year.

The Australian Bureau of Statistics reports that of the 4.3 million Australians with a 12-month mental disorder (which just means a mental health concern that lasted at least a year), only 21.3% saw a psychologist about it. That gap is not because therapy does not help. It is largely about cost, availability and not knowing where to start.

If you are ready to explore which type of therapy might suit you, you are welcome to contact my practice on the Gold Coast to book an initial consultation. If you are still weighing it up, not sure about therapy? may help, and you can read more about my experience and my training here.

FAQs about types of therapy for depression

What is the most effective type of therapy for depression?

Cognitive behaviour therapy has the largest evidence base, but the Australian Psychological Society review found no clinically significant difference in effectiveness when it was compared directly with other active therapies such as interpersonal psychotherapy and short-term psychodynamic psychotherapy. The most effective approach is the one matched to what is actually driving your depression, which is why proper assessment matters more than picking a modality in advance.

How do I know which type of therapy for depression is right for me?

You do not need to work this out alone. A psychologist trained across several approaches will assess your history, symptoms and circumstances and recommend a starting point. Broadly, thought-driven depression often responds to cognitive approaches, trauma-linked depression to trauma-focused work, chronic lifelong patterns to schema or psychodynamic therapy, and relationally triggered depression to interpersonal approaches.

Can I try more than one type of therapy for depression?

Yes, and many people do. Treatment is often sequenced deliberately, for example beginning with behavioural activation to build capacity, then moving into deeper work once there is enough stability. Trying a different approach after one has not worked is a normal part of treatment rather than starting over.

How long before therapy for depression starts working?

Most people notice some shift within six to eight sessions, though that shift is often insight or a small behavioural change rather than feeling substantially better. More entrenched patterns generally take longer. If nothing has moved after around eight sessions, raise it directly with your psychologist so the approach can be reviewed.

Is online therapy as effective as in-person therapy for depression?

For many people, yes. Research into internet-delivered and telehealth psychological treatment has shown meaningful reductions in depressive symptoms, and Medicare telehealth services for mental health are now permanent in Australia. In-person work may suit better where trauma processing, somatic approaches, or significant risks are involved.

What if therapy has not worked for me before?

This is extremely common and rarely means therapy cannot help you. The most frequent explanations are that the approach did not match the underlying driver, treatment ended too early, the therapeutic relationship was not the right fit, or trauma underneath the depression was never addressed. It is worth naming the previous experience clearly with a new psychologist.

Do I need a referral to see a psychologist for depression?

No. You can book directly with a psychologist without any referral. A referral and a Mental Health Treatment Plan from your GP are only needed if you want to claim a Medicare rebate under the Better Access initiative.

Can therapy help if my depression is caused by real-life circumstances?

Yes. Therapy cannot change a difficult diagnosis, a financial situation or a bereavement, but it can substantially change how those circumstances affect you. Acceptance and commitment therapy in particular was developed for situations that cannot simply be problem-solved away, and it focuses on living meaningfully alongside genuine hardship.

Medical disclaimer

This article is intended for general education and information only. It does not constitute psychological, medical or diagnostic advice, and it is not a substitute for personalised assessment and treatment by a qualified health professional. If you are concerned about your mental health, please speak with your GP, a registered psychologist, or another appropriately qualified practitioner.

If you are in crisis or concerned about your immediate safety, call 000. For 24-hour support, contact Lifeline on 13 11 14 or the Suicide Call Back Service on 1300 659 467.