Pluralistic therapy for depression: Acceptability, outcomes and helpful aspects in a multisite study

Objectives: The aim of this study 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 per cent) completed
two or more sessions. Participants were predominantly female (N=28, 71.8 per cent) and white (N=30, 76.9
per cent), with a mean age of 30.9. The principal outcome indicator was improvement and recovery on the
PHQ-9 and Generalised Anxiety Disorder 7-item (GAD-7) scale.
Results: Of the completer sample, 71.8 per cent of clients (N=28) showed reliable improvement and 43.6 per
cent (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 valued the
flexibility and collaborative approach of their therapists. Clients felt that change had been brought about by
their own active engagement in therapy and through the therapists relational qualities, as well as their use
of techniques.
Conclusions: Initial indications suggest that pluralistic therapy for depression has acceptable outcomes,
retention rates, and user satisfaction. Refinement and further testing of the approach is recommended.