Key features involved in using CBT for depression include: identifying and correcting irrational beliefs/ thoughts associated with depressed feelings (cognitive restructuring), helping patients to engage more often in enjoyable activities (behavioural activation), and enhancing problem-solving skills.
Cognitive Behavioural Therapy (CBT) is now a widely recognised and accepted approach to recovery from a whole host of different mental health conditions. There has been much research carried out in to how CBT skills may aid recovery from depression. Below is a list of four key CBT tools used to promoting healthy recovery.
- Challenging negative thoughts
- Challenging core beliefs
- Behavioral activation
- Behavioral experiments
Exterminating NATS: CBT For Depression Recovery
Challenging 'NATS' or Negative Automatic Thoughts is a crucial component of CBT. Firstly, one has to be aware of the forms such thoughts take in order to recognise them. Common thinking errors in depression include: overgeneralising (one person rejected me so the whole world will too), black and white thinking (all or nothing), catastrophizing, mind reading and predicting the future
Once the patient is familiar with being able to recognise depressed thoughts the next step is to challenge them through, known as 'cognitive restructuring.' This can be done by using thought records - use three columns: feelings (key feelings about an event/situation), triggering event (what event has triggered such thoughts/feelings) and thoughts (what thoughts did you have leading up to the event & after). These records can provide valuable insight as well as give the patient a new perspective through stepping back from the situation.
Challenging Core Beliefs: Getting to the Core Problem for Depression Recovery
Core beliefs, usually learned in childhood impact the client’s current behaviour and thinking distortions. These are basic, solid beliefs that can sometimes be misinterpreted as facts and truths. An example of a core belief is when a relationship breaks down this may confirm an ‘I’m unlovable’ core belief developed in childhood through having over-critical parents.
After discovering their core beliefs and rating their strength, the next step is to challenge them through weakening/loosening old beliefs and strengthening new, more helpful beliefs. Techniques used to challenge beliefs include: pros/cons list (advantages/disadvantages of holding on to old beliefs), using a continuum (where you place yourself others relating to belief) and recording evidence to support new beliefs through the use of a ‘positive data log.’
Behavioral Activation for Depression Recovery
As withdrawal and inactivity are recognised to be two of the most fundamental depression maintaining factors, strategies to tackle these issues will now be identified. An activity schedule used to plan a realistic rest/activity balance may help the client to gradually build up activities. Due to depression limiting motivation and promoting lethargy the activity schedule is key to getting the client to begin tackling previously avoided tasks.
The activity schedule provides a basis from which future comparisons can be made and aids the patient in replacing avoidance activity with more productive activity. Through the schedule the new structure helps the patient to regulate their sleeping patterns again.
Behavioral Experiments for Depression Recovery
Another strategy is to use behavioural experiments to test beliefs/predictions, for example if an individual believes they will faint if they go out in public they may negotiate with the therapist an experiment to test the validity of this belief. As predictions guide our behaviour this is an essential technique to challenging false beliefs.
To conclude, CBT clearly has benefits for sufferers of depression as well as many other mental health conditions including the following: behavioural experiments, activity scheduling and thought monitoring. The goal is for the patient to eventually become his or her own therapist and to continue practising CBT skills long after therapy has ended. Ideally, having a qualified CBT therapist to work through core beliefs and thinking distortions underneath the depression is desirable but if this is not possible there are many excellent self-help recovery workbooks now available.
Source:
Wilding, C. & Milne, A. (2008) Teach Yourself CBT London: Hodder Education
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Kate Le Page - Kate Henning-Le Page writes about eating disorders, body image and recovery issues. She specializes in anorexia recovery.
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