Could a Custom-Tailored therapy beat standard talk therapy for tough depression?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Current diagnosis of major depressive disorder, defined as: * Positive diagnosis on the MINI diagnostic interview, and * PHQ-9 score greater than 10 * Evidence of personality dysfunction, defined as a score above the cutoff on the Level of Personality Functioning Scale-Brief Form (LPFS-BF 2.0). * History of moderate to severe early life adversity, defined as elevated scores on at least one scale of the Childhood Trauma Questionnaire (CTQ), and/or clinically significant alterations in self-organization. * Presence of at least one elevated domain of alteration of self-organization, including emotion regulation difficulties, interpersonal sensitivity, and/or interpersonal functioning problems, as assessed by standardized self-report measures (DERS, A-RSQ, OQ-45-IR). * Receiving care at a participating public community mental health center in Chile. * Ownership of a smartphone (Android or iOS) with internet access and an active data plan. * Ability to provide written informed consent. Exclusion Criteria: * Acute suicide risk requiring immediate intensive intervention, as assessed by the MINI. * Any severe psychiatric disorder other than major depressive disorder that is the primary clinical diagnosis, including: * Schizophrenia or other psychotic disorders * Bipolar I disorder * Severe substance use disorder, active within the past 6 months. * Diagnosis of post-traumatic stress disorder (PTSD) meeting full diagnostic criteria, as assessed by standardized instruments (ITEM and ITQ). * Meeting diagnostic criteria for: * Antisocial personality disorder (two or more criteria), or * Borderline personality disorder with more than three diagnostic criteria * Severe medical, cognitive, or psychosocial condition that would interfere with participation in weekly psychotherapy. * Concurrent participation in another active psychotherapy or initiation/change of psychotropic medication during the study period, except for: * Stable antidepressant treatment * Medications prescribed for sleep * Benzodiazepines used only on an as-needed (PRN) basis. * Inability to comply with study procedures or assessments.