Cognitive Behavioral Therapy for Depression

Dr.Rabaa k. Al-Momen, FKSFM, FRCGP

Depression and psychotherapy

Types for psychotherapy : Non bipolar Non psychotic Background: Medical treatment alone is limited. Depression is a result of multiple factors: biological , historical , environmental , psychological. Psychotherapy in adjunct to medical treatment or independently should be considered for effective outcome management of depression.

Psychotherapeutic approaches
Supportive psychotherapy Analytical and explorative approach Cognitive behavioral therapy CBT Interpersonal Therapy IPT Problem solving

Efficacy of CBTStrong Evidence based on controlled experimental trials

  

Mild Moderate Severe Immediate effect Post-treatment Long term effects

  

Aron T Beck model



Negative thinking is not simply a symptom of depression, but one of the primary maintaining factors. The aim of therapy is to eliminate negative thoughts . Challenging patients own belief and own assumptions. Guided discovery process.

Complex interweaving of cognitive and behavioral techniques for depression:



Pleasant event scheduling:

Structure time to distract patient from negative thoughts and engage in pleasurable activities.

Graded task assignment:

Divide large tasks to small achievable ones .

Re-evaluation of depressive attribute:

Generating rational for negative thoughts rather than self blame.

Negative Thoughts
    

Over- generalization Selective abstraction Dichotomous reasoning Personalization Arbitrary inference

Characteristics of CBT


     

Therapeutic collaboration between patient and therapist- partnership Brief- time limited Structured Directive focus on main training factors Reliant on a process of questioning Guided discovery Educational skills

Understanding my depression
Early depression Dysfunctional assumptions Critical incident life event Negative automatic thoughts Symptoms: Behavioral: Motivational: Affective: Cognitive: Somatic:

Balance sheet
Negative thoughts Positive answers

Thought Diary
Date time Situation Emotions Thoughts Rational response