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Abstract <p>Depression is a prevalent and complex condition that often requires approaches beyond single-model interventions. This study describes patterns of therapeutic change across five cases of Major Depressive Disorder treated with an integrative psychotherapy approach combining cognitive-behavioral, analytical, and existential principles. A retrospective clinical case series design was used, with data derived from psychotherapy records and analyzed through reflexive thematic analysis. Across cases, change followed a progressive and recursive pattern. Early stages involved improved cognitive regulation and behavioral engagement, followed by greater emotional responsiveness and reorganization of relational patterns. Symbolic processes, particularly through dreams and imagery, supported the integration of previously unarticulated experiences. In later stages, participants engaged in meaning reconstruction, reflecting increased autonomy and alignment with personal values. These findings suggest that psychotherapy may operate as a multi-level process and highlight the potential of integrative approaches in addressing the complexity of depression.</p> Key Practitioner Message <p> This study shows that psychotherapy for depression may be more effective when organized progressively, beginning with cognitive and behavioral stabilization and moving toward deeper emotional and meaning-focused work. It highlights how integrating techniques across different levels of experience can support more sustained and meaningful change in clinical practice.</p>

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A Clinical Case Series of Integrated Psychotherapy in Major Depressive Disorder

  • 期刊论文

  • 发表日期：

    2026年5月11日

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  • Luiz Guilherme Mafle Ferreira Duarte,
  • Anadir Gabriel Teixeira,
  • Ana Carolina Ribeiro de Oliveira,
  • Daniel Araujo de Castro,
  • Josicleide Maciel da Silva,
  • Rafaela Vasconcelos Carvalho

摘要

Abstract

Depression is a prevalent and complex condition that often requires approaches beyond single-model interventions. This study describes patterns of therapeutic change across five cases of Major Depressive Disorder treated with an integrative psychotherapy approach combining cognitive-behavioral, analytical, and existential principles. A retrospective clinical case series design was used, with data derived from psychotherapy records and analyzed through reflexive thematic analysis. Across cases, change followed a progressive and recursive pattern. Early stages involved improved cognitive regulation and behavioral engagement, followed by greater emotional responsiveness and reorganization of relational patterns. Symbolic processes, particularly through dreams and imagery, supported the integration of previously unarticulated experiences. In later stages, participants engaged in meaning reconstruction, reflecting increased autonomy and alignment with personal values. These findings suggest that psychotherapy may operate as a multi-level process and highlight the potential of integrative approaches in addressing the complexity of depression.

Key Practitioner Message

This study shows that psychotherapy for depression may be more effective when organized progressively, beginning with cognitive and behavioral stabilization and moving toward deeper emotional and meaning-focused work. It highlights how integrating techniques across different levels of experience can support more sustained and meaningful change in clinical practice.