Depression Therapy That Works: Evidence-Based Treatment in Missouri
You've been feeling heavy for months now. Maybe years.
Getting out of bed takes effort. Things you used to enjoy don't interest you anymore. Maybe you used to walk the trails at Longview Lake or spend Saturday mornings at the farmers market, but now you can't find the energy or the point. You're exhausted even though you haven't really done anything. People keep saying "it'll get better" or "just think positive," but that doesn't help. If anything, it makes you feel worse - like you're failing at something that should be simple.
You're wondering if therapy could actually help. Or if maybe this is just how life is now.
Here's what we know from tracking outcomes with over 200 clients: depression treatment works. And we can show you exactly how much.
Does Therapy Really Help Depression?
At Aspire Counseling, we track every client's progress using validated questionnaires throughout treatment. For people who came to us with moderate or higher depression, their average scores dropped from 14.78 at the start of treatment to 8.38 by the time they finished.
That's an effect size of 0.68, which researchers consider "medium to large." It means real, measurable change in how you feel and function day to day.
In practical terms? People who started therapy feeling hopeless, exhausted, and disconnected from everything were sleeping better by the end. They had more energy. They could feel moments of genuine hope again. Depression hadn't vanished completely for everyone, but it had loosened its grip enough that they could actually live their lives.
You can read more about how we track outcomes and what makes therapy effective in our comprehensive post on treatment results.
How Does Depression Actually Show Up?
Depression isn't just sadness. It's more complicated than that. Here's what we see in our Columbia and Lee's Summit offices:
Physical exhaustion - You're tired all the time, even after sleeping. Or maybe you can't sleep at all. Your body feels heavy. Simple tasks feel like climbing a mountain.
Loss of interest - Things that used to bring you joy feel flat. You're going through the motions. You used to look forward to browsing the shops at Summit Woods or meeting friends for dinner, but now the thought of doing anything social feels exhausting. Nothing really matters anymore.
Irritability and anger - Sometimes depression looks like snapping at people you love, feeling annoyed by everything, or having a shorter fuse than usual. Our data shows that depression treatment also reduced anger symptoms, with scores dropping from 15.29 to 10.23 (effect size 1.23).
Negative thought spirals - Your brain keeps replaying the same harsh, critical thoughts. You're constantly telling yourself you're not good enough, things won't get better, or there's something fundamentally wrong with you.
Difficulty concentrating - You can't focus. You read the same paragraph three times and still don't know what it says. Making decisions feels overwhelming.
Changes in sleep - Either sleeping too much or lying awake for hours. Our data shows sleep quality improved significantly during depression treatment, with an effect size of 0.91.
Physical symptoms - Headaches, digestive issues, body aches. Depression lives in your body as much as your mind.
What Types of Therapy Actually Help Depression?
We use evidence-based approaches that have been researched and proven effective for depression. Here's what that looks like at Aspire Counseling:
Cognitive Behavioral Therapy (CBT)
CBT helps you identify the connection between your thoughts, feelings, and behaviors. When you're depressed, your brain often gets stuck in patterns of negative thinking. You assume the worst, filter out anything positive, and view yourself harshly.
CBT teaches you to notice these patterns and question them. Not with forced positive thinking - that doesn't work. But by looking at the actual evidence. Is this thought helping you? Is it accurate? What would you tell a friend who thought this about themselves?
CBT also focuses on behavioral activation. When you're depressed, you stop doing things. You withdraw. But that actually makes depression worse. CBT helps you gradually re-engage with activities, starting small and building momentum.
Research consistently shows CBT is one of the most effective treatments for depression. It gives you concrete tools you can use even after therapy ends.
Acceptance and Commitment Therapy (ACT)
ACT takes a different approach. Instead of trying to change or challenge your depressive thoughts, ACT teaches you to change your relationship with them. You learn to notice thoughts as thoughts - mental events passing through - without getting hooked by them or believing they define reality.
ACT also helps you identify what truly matters to you (your values) and take action in line with those values, even when depression is present. You don't have to wait until you "feel better" to start living. You can take small, meaningful steps now.
This approach is particularly helpful if you've been struggling with depression for a long time and feel stuck. Or if you have harsh, critical thoughts about yourself that feel impossible to change.
Internal Family Systems (IFS)
IFS views depression not as a single problem but as a signal that different parts of you are in conflict. Maybe one part of you is pushing hard to be productive and keep it together. Another part might be carrying old pain or shame. Another part might be trying to protect you by shutting down emotions entirely.
IFS helps you develop a compassionate relationship with these different parts. When you can approach the parts of you that feel depressed with curiosity instead of judgment, something shifts. The depression isn't the enemy. It's trying to tell you something or protect you in some way - even if it's not working well.
Research shows IFS can significantly reduce depression symptoms while improving overall emotional well-being. It's especially helpful if you struggle with shame, self-criticism, or feeling fragmented.
DBT Skills and Approaches
For clients who experience extreme suicidality or intense emotional swings alongside depression, Dialectical Behavior Therapy (DBT) is the gold standard treatment. While we don't currently have a comprehensive DBT program (though we have in the past and may in the future), several of our therapists are trained in comprehensive DBT and integrate DBT-informed practices into their work.
DBT teaches specific skills for managing emotions, tolerating distress, improving relationships, and staying present. These skills can be incredibly helpful even for people whose depression doesn't include extreme suicidality. Many of our therapists draw on DBT techniques like mindfulness, emotion regulation strategies, and distress tolerance skills when appropriate.
Why Do People Avoid Getting Help for Depression?
We hear these reasons all the time:
"I should be able to handle this on my own." Depression isn't a character flaw or a sign of weakness. It's a real mental health condition that often requires professional support. You wouldn't expect yourself to "just handle" diabetes or a broken bone on your own. Depression is the same.
"I don't have time for weekly therapy." We require weekly sessions at the start because consistency matters for depression treatment. But we offer both telehealth and in-person options, with appointment times throughout the week including some evenings. Most sessions are 45-50 minutes. People find the time when they realize how much weekly therapy helps.
"Therapy is too expensive." We're a private-pay practice, which means we don't take insurance. For some people, this is a barrier. But for many professionals, private pay actually works better - no insurance paperwork, no diagnosis requirements for your permanent record, no session limits, and more scheduling flexibility. We can provide superbills for you to submit to your insurance for possible reimbursement.
"What if it doesn't work?" That's a valid fear, especially if you've tried therapy before without success. This is exactly why we use measurement-based care. We track your progress throughout treatment so both you and your therapist can see what's helping. If something isn't working, we adjust the approach. You're not stuck with a method that doesn't fit you.
"I don't want to burden anyone." Coming to therapy isn't a burden. It's an investment in your wellbeing. And honestly? Your therapist chose this work because they want to help. Supporting you isn't a burden - it's literally what they're trained and passionate about doing.
How Depression Treatment Actually Works
When you contact Aspire Counseling about depression, here's what happens:
Our client care team talks with you about what you're experiencing. They'll match you with a therapist whose approach and expertise fit your specific needs. We have therapists trained in CBT, ACT, IFS, and DBT-informed approaches.
You'll meet weekly with a therapist, at least at the start. Your therapist will want to understand your depression - when it started, what triggers it, how it affects your daily life, what you've tried that's helped or hasn't helped.
You'll complete brief questionnaires through our Blueprint platform to track your symptoms over time. This isn't busywork - it's how your therapist knows if the approach is working or if something needs to shift.
Together, you'll work on specific skills and strategies. You'll process what's contributing to your depression. You'll learn to relate to yourself differently. You'll gradually reconnect with activities and people that matter.
Some weeks you'll feel like you're making huge progress. Other weeks depression might spike and you'll feel discouraged. That's normal. The measurement data helps you see the overall trend, even when individual weeks are hard.
Most people start noticing some relief within the first month. By around 20 weeks, many have made substantial progress. Some continue longer if they're working on related issues or want to reinforce their skills.
When Depression Connects to Other Things
Depression rarely happens in isolation. Often it's intertwined with other concerns:
Anxiety and depression together - This is incredibly common. Your mind races with worry while simultaneously feeling hopeless. We saw strong outcomes for clients dealing with both, with anxiety symptoms improving alongside depression.
Trauma and depression - Unprocessed trauma often leads to depression. We're trauma specialists at Aspire Counseling, trained in EMDR and CPT. We can address both simultaneously.
Grief and depression - Loss can trigger depression that persists long after the initial grief period. We help you process both the grief and the depression without forcing you to "move on."
Life transitions and depression - Sometimes depression hits during major changes - career shifts, divorce, becoming a parent, kids leaving home. These transitions deserve support.
Our therapists are trained to treat you as a whole person, not just address isolated symptoms.
Depression Looks Different at Different Life Stages
One of the strengths of our team at Aspire Counseling is that we treat depression across the entire lifespan. Depression in a 10-year-old looks different than in a college student, which looks different than in a new parent, which looks different than in someone approaching retirement.
Children (as young as elementary age) - Depression in kids often shows up as irritability, frequent stomachaches or headaches, not wanting to go to school, or regressing in behaviors. Madi Sveum works with children and adapts treatment to be developmentally appropriate, using play, creative interventions, and concrete strategies they can understand.
Teens and college students - This age group often experiences depression alongside identity questions, social pressures, academic stress, and major transitions. Our therapists who work with teens (like Casey Jackson and Adam White) understand the unique challenges of this developmental stage and create a space where young people feel heard without being talked down to.
Young adults and parents - Depression during these years often connects to career pressure, relationship challenges, becoming a parent, or that feeling of "I should have it together by now but I don't." Many of our therapists specialize in this age range and understand the specific stressors of building a life and career.
Midlife and beyond - Depression can hit during career transitions, empty nest, divorce, caring for aging parents, health changes, or retirement. Sometimes it's the first time someone has experienced depression. Other times it's a return of something they struggled with earlier in life. Either way, it deserves attention and support.
The evidence-based approaches we use - CBT, ACT, IFS, and DBT-informed skills - work across all ages. We adapt the language, examples, and specific techniques to fit where you (or your child, teen, or parent) are in life.
Who's a Good Fit for Depression Treatment at Aspire?
Depression treatment at Aspire Counseling works best for people who:
Are willing to come weekly, at least initially
Want evidence-based approaches, not just venting or advice
Are open to doing some work between sessions (not hours of homework, but practicing skills)
Value having data to track their progress
Are ready to try things that might feel uncomfortable at first
We work with clients of all ages - children, teens, college students, adults, parents, and retirees. We're LGBTQ+ affirming and anti-racist. We welcome people from all backgrounds and belief systems.
We're not a good fit if you're looking for someone to just tell you what to do, if you want to come once a month without practicing anything between sessions, or if you're seeking a specific diagnosis for disability purposes (we're a private-pay practice, not an evaluation center).
You Don't Have to Keep Feeling This Way
Depression lies. It tells you nothing will help, you'll always feel this heavy, there's no point in trying.
But the outcome data tells a different story. People who come to therapy with moderate depression see their scores drop by nearly half on average. They sleep better. They have more energy. They can feel hope again.
Depression treatment isn't about becoming happy all the time or never having hard days. It's about lifting that weight enough that you can actually live. It's about reconnecting with yourself and the things that matter. It's about learning to work with your brain instead of constantly fighting it.
Get Started with Depression Counseling in Missouri
If you're ready to actually feel better, we're here.
Call us at 573-328-2288 or fill out our contact form. Our client care team will learn about what's bringing you to therapy and help match you with the right therapist for your needs.
We have offices in Columbia and Lee's Summit, Missouri. We also offer telehealth throughout the state if coming to an office doesn't work for you.
Your first step is usually a free 15-20 minute consultation with your therapist to make sure it's a good fit. Then you'll schedule your first full session and start the work.
Depression has taken enough from you. Let's do something about it.
About the Author
Jessica Oliver, LCSW is the founder and clinical director of Aspire Counseling. She's been treating depression for over a decade, working with clients from teens through older adults. Jessica specializes in trauma and anxiety but has extensive experience helping people who struggle with persistent depression that hasn't responded well to other treatments. She's trained in EMDR, CPT, CBT, & ACT - and believes in matching the approach to the person, not forcing everyone into the same method.
Beyond her clinical work, Jessica is proud of the diverse team at Aspire Counseling. Each therapist brings unique training and perspective, and the collaborative atmosphere means they consult with each other about client care regularly. When she's not seeing clients or supporting her team, Jessica is busy homeschooling her kids and building My Clinical Content, which helps other therapists create effective marketing. She's grateful for the opportunity to serve the Missouri community and help people reclaim their lives from depression.
