Cognitive behavioral therapy focuses on identifying and reframing negative, dysfunctional
thoughts while increasing participation in pleasurable and social activities. A meta-analysis of
23 randomized, controlled trials showed that cognitive behavioral therapy was significantly
more effective in reducing depressive symptoms than treatment as usual or placement on a wait list for treatment but was not more effective than other psychotherapies.However, it may have a weaker effect in physically ill or cognitively impaired persons.More recent trials assessing Internet-based approaches to cognitive behavioral therapy also show efficacy for depression; however, older adults are poorly represented in these studies and may require help navigating the website or using the computer.