More threads by David Baxter PhD

David Baxter PhD

Late Founder
Treating Depression with Cognitive Therapy
by Jerry Kennard, Health CentralWednesday, June 01, 2011

Change the way we think about a situation and the result usually influences the way we feel about it. Cognitive therapy makes the best use of this simple association by showing how thoughts, beliefs, emotions, physical feelings and actions interact and affect one another. Once a patient grasps these essentials, and applies them to their own situation, the process of recovery is underway.

Cognitive therapy is a very pragmatic approach to getting better. As the patient you need to be prepared to be actively involved in the process. If you are depressed, this will require a level of motivation and concentration you may find difficult, but the effort is worth it. Although cognitive therapy isn't to everyone's taste, the fact remains that it is one of the most effective forms of treatment for mild-to-moderate depression.

Cognitive therapy is often described as a problem-solving method of treatment involving the achievement of goals agreed between patient and therapist. The aim of therapy is to target the core beliefs and negative ways of thinking that serve to reinforce depression, and replace them with more helpful alternatives. Because therapy focuses on your own goals it seems to be suited to people who are naturally inclined towards a rational way of thinking.

The very first step in therapy involves setting up a therapeutic alliance. This is a scene-setting and information giving stage in which the therapist informs the patient about the approach and clears up any misgivings or questions the patient has. The therapist acts as educator during this early stage but his or her role will change soon afterwards.

As therapy progresses the therapist will try to elicit the patterns of thinking that underpin your situation. Then, during the third stage of therapy, some direct illustrations and challenges of your personal thoughts and beliefs are made. All the time this is happening you are in a secure setting with your therapist. Your therapist is trying to demonstrate how well-known thought patterns can influence mood. You may be confronted with examples of some of the negative automatic thoughts you use and alternative, and more realistic alternatives, will be suggested. Thought challenging often reveals those embedded and very stubborn core beliefs we all carry about certain issues.

Learning how to reinterpret situations will have a big influence on your mood and behavior. Distorted interpretations are known to lead to emotional problems. Negative automatic thoughts, for example, are particularly obvious in depression and involve a single inflexible interpretation of the truth, such as ‘nobody cares'.

The number of therapy sessions for depression can range from 6-8 for mild depression and up to 20 sessions for moderate-to-severe depression. Although the basic format for cognitive therapy is always similar, goal-setting may vary according to the severity of depression. As therapy moves towards a conclusion, one or more sessions will be directed towards self-help strategies geared towards preventing relapse.
 
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