Depression is an increasing problem affecting New Zealand society with enormous social costs. Determining the best form of treatment for depressive symptoms is a complex issue located in an ongoing professional debate. This article asks what is best treatment for a hypothetical patient, Nancy residing in Aotearoa. It considers how we might know what is best for the patient. The medical model, with its disease perspective , sees cure in specific ingredients. Within this model Randomised Clinical Trials (RCTs) are viewed as the best research method to determine the mos t effective therapy modality. RCTs however do not establish effectiveness in the practice setting. Within the bicultural New Zealand context this suggests that our patient may not be helped by a practitioner following an intervention recommended by the findings of RCTs. The contextual model views the effectiveness of psychotherapy as related to the context of the psychotherapy process regardless of the modality used. A related research methodology is single participant case studies. It is suggested that recording and aggregating the findings of single participant-case studies might produce more realistic data , generalisable to both New Zealand's Pakeha and Maori populations
