In spite of almost 50 years of experience with antidepressants, the long term outcome of depression still remains a problem. Many patients do well, but at least one recurrence at some point is common, and some patients have many recurrences. For bipolar disorder recurrences and disability are more frequent. Modern drug treatments have a large evidence base for efficacy in continuation and maintenance, but it has become clear that for some patients benefit is nevertheless limited, and recently the pace of further advance has become slow. There is now good evidence that cognitive therapy can reduce relapse and recurrence rates in unipolar depression, and it is indicated as an adjunct to medication in patients at risk. Evidence is growing for a range of psychological treatments in bipolar disorder, with the best evidence for psychoeducational approaches incorporating family involvement. This presentation will review recent evidence, particularly for psychological treatments, where research has been active in the last ten years.