Regrettably, psychological treatments are often overlooked in the management of severe late-life depression while ECT is favored, even though it is more likely to be harmful and its evidence base is slim. This is of little surprise given that psychiatrists are often guilty of overlooking potentially beneficial psychosocial interventions preferring more familiar biological treatments. This position is unacceptable: depressed older adults deserve access to a whole range or interventions in order to maximize benefits and choice.