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Pluralistic therapy for depression: Acceptability, outcomes and helpful aspects in a multisite open-label trial

Cooper, Mick; Wild, Ciara; van Rijn, Biljana; Ward, Tony; McLeod, John


Mick Cooper

Ciara Wild

Biljana van Rijn

Tony Ward
Associate Professor in Counselling & Psychotherapy

John McLeod


Objectives: The aim of this open-label trial was to assess the outcomes, acceptability and helpful aspects of a pluralistic therapeutic intervention for depression. Design: The study adopted a multisite, non-randomised, pre-/post-intervention design. Methods: Participants experiencing moderate or more severe levels of depression (as assessed by a score of 10 or greater on the Patient Health Questionnaire depression scale, PHQ-9) were offered up to 24 weeks of pluralistic therapy for depression. This is a collaborative integrative practice oriented around shared decision making on the goals and methods of therapy. Of the 42 participants assessed, 39 (92.9%) completed two or more sessions. Participants were predominantly female (n = 28, 71.8%) and white (n = 30, 76.9%), with a mean age of 30.9. The principal outcome indicator was improvement and recovery on the PHQ-9 and Generalized Anxiety Disorder 7-item (GAD-7) scale. Results: Of the completer sample, 71.8% of clients (n = 28) showed reliable improvement and 43.6% (n = 17) showed reliable recovery. Effect sizes (Cohen’s d) from baseline to endpoint were 1.83 for the PHQ-9 and 1.16 for the GAD-7. On average, the clients found the PfD sessions helpful and experienced their therapists as flexible and practising in a collaborative manner. Clients felt that change had been brought about by their own active engagement in therapy and through the therapist’s relational qualities, as well as their use of techniques. Conclusions: Initial indications suggest that pluralistic therapy for depression has adequate outcomes, retention rates, and levels of acceptability. Refinement and further testing of the approach is recommended.


Cooper, M., Wild, C., van Rijn, B., Ward, T., & McLeod, J. (2015). Pluralistic therapy for depression: Acceptability, outcomes and helpful aspects in a multisite open-label trial. Counselling Psychology Review- British Psychological Society, 30(1), 6-20

Journal Article Type Article
Publication Date Mar 1, 2015
Journal Counselling Psychology Review
Print ISSN 0269-6975
Publisher British Psychological Society
Peer Reviewed Peer Reviewed
Volume 30
Issue 1
Pages 6-20
Keywords integrative psychotherapy, depression, pluralism, therapeutic outcomes
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