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Depression and Suicidal Behavior: A CBT Approach for Social Workers
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In meta-analysis format the effectiveness of Beck's cognitive therapy for depression was reviewed. Twenty-eight studies were identified that used a common outcome measure of depression, and comparisons of cognitive therapy with other therapeutic modalities were made. The results document a greater degree of change for cognitive therapy compared with a waiting list or no-treatment control, pharmacotherapy, behavior therapy, and other psychotherapies. The degree of change associated with cognitive therapy was not significantly related to the length of therapy or the proportion of women in the studies, and although it was related to the age of the clientele, a lack of adequate representativeness of various age groups renders these results equivocal. Implications for further outcome and process studies in cognitive therapy are discussed.
This book provides an invaluable update on the current status of assessment, treatment, and prevention of suicidal behavior. Consisting of three sections, Part One, "Screening and Assessment," examines empirically based assessment techniques that measure important mood states, personality traits, and attitudes that are associated with suicidal behavior. Part Two, "Intervention and Treatment of Suicidality," compares several different approaches for conducting psychotherapy with suicidal clients. Finally, Part Three presents special issues that have relevance today such as rational suicide, physician-assisted suicide, and adolescent suicidal behavior. Overall, This compilation of information is addressed to nurses, psychiatrists, psychologists, social workers, and other mental health professionals, who will find it useful in providing services to patients and clients who have been or may become suicidal or who indulge in self-harm behavior. In addition to its primary audience of mental health professionals, this book will prove valuable to educators, school counselors, and others who are actively engaged with young people and in a position to help them learn improved coping skills. The authors hope that this book will provide the needed advances in information to help us cross the bridge to a better understanding of how to help suicidal people. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The assessment of risk for suicide in patients with major depression is a difficult task for professional psychologists. Not only is prediction itself a nearly impossible feat, but the literature is full of risk factors to which one should attend. Which of these factors are specific to the patient sitting before you? By combining clinical and empirical literature of major depression-specific risk factors with the reported behaviors of practicing psychologists, the authors present critical factors for assessing suicidal risk. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Suicide is a complex outcome of multiple, inter-related factors. This article presents the epidemiology of completed and attempted suicide and discusses the known risk factors for suicide within a framework designed to encourage a systematic approach to theory testing and prevention. Mental and addictive disorders, frequently in co-occurrence, are the most powerful risk factors for suicide in all age groups, accounting for over 90 percent of all completed suicides. In combination with proximal risk factors such as access to firearms or other lethal means, recent and severe stressful life events, and intoxication, they can form the necessary and sufficient conditions for suicide.
We investigated the effectiveness of two brief psychotherapies, interpersonal psychotherapy and cognitive behavior therapy, for the treatment of outpatients with major depression disorder diagnosed by Research Diagnostic Criteria. Two hundred fifty patients were randomly assigned to one of four 16-week treatment conditions: interpersonal psychotherapy, cognitive behavior therapy, imipramine hydrochloride plus clinical management (as a standard reference treatment), and placebo plus clinical management. Patients in all treatments showed significant reduction in depressive symptoms and improvement in functioning over the course of treatment. There was a consistent ordering of treatments at termination, with imipramine plus clinical management generally doing best, placebo plus clinical management worst, and the two psychotherapies in between but generally closer to imipramine plus clinical management. In analyses carried out on the total samples without regard to initial severity of illness (the primary analyses), there was no evidence of greater effectiveness of one of the psychotherapies as compared with the other and no evidence that either of the psychotherapies was significantly less effective than the standard reference treatment, imipramine plus clinical management. Comparing each of the psychotherapies with the placebo plus clinical management condition, there was limited evidence of the specific effectiveness of interpersonal psychotherapy and none for cognitive behavior therapy. Superior recovery rates were found for both interpersonal psychotherapy and imipramine plus clinical management, as compared with placebo plus clinical management. On mean scores, however, there were few significant differences in effectiveness among the four treatments in the primary analyses. Secondary analyses, in which patients were dichotomized on initial level of severity of depressive symptoms and impairment of functioning, helped to explain the relative lack of significant findings in the primary analyses. Significant differences among treatments were present only for the subgroup of patients who were more severely depressed and functionally impaired; here, there was some evidence of the effectiveness of interpersonal psychotherapy with these patients and strong evidence of the effectiveness of imipramine plus clinical management. In contrast, there were no significant differences among treatments, including placebo plus clinical management, for the less severely depressed and functionally impaired patients.
Cognitive therapy (CT) has been studied in 78 controlled clinical trials from 1977 to 1996.
The meta-analysis used Hedges and Olkin d+ and included 48 high-quality controlled trials. The 2765 patients presented non-psychotic and non-bipolar major depression, or dysthymia of mild to moderate severity.
At post-test CT appeared significantly better than waiting-list, antidepressants (P < 0.0001) and a group of miscellaneous therapies (P < 0.01). But, CT was equal to behaviour therapy. As between-trial homogeneity was not met, the comparisons of CT with waiting-list or placebo, and other therapies should be taken cautiously. In contrast, between-trial homogeneity was high for the comparisons of CT with behaviour therapy and antidepressants. A review of eight follow-up studies comparing CT with antidepressants suggested that CT may prevent relapses in the long-term, while relapse rate is high with antidepressants in naturalistic studies.
CT is effective in patients with mild or moderate depression.
Patients with depression, particularly those seen by primary care physicians, may report somatic symptoms, such as headache, constipation, weakness, or back pain. Some previous studies have suggested that patients in non-Western countries are more likely to report somatic symptoms than are patients in Western countries. We used data from the World Health Organization's study of psychological problems in general health care to examine the relation between somatic symptoms and depression. The study, conducted in 1991 and 1992, screened 25,916 patients at 15 primary care centers in 14 countries on 5 continents. Of the patients in the original sample, 5447 underwent a structured assessment of depressive and somatoform disorders.
A total of 1146 patients (weighted prevalence, 10.1 percent) met the criteria for major depression. The range of patients with depression who reported only somatic symptoms was 45 to 95 percent (overall prevalence, 69 percent; P=0.002 for the comparison among centers). A somatic presentation was more common at centers where patients lacked an ongoing relationship with a primary care physician than at centers where most patients had a personal physician (odds ratio, 1.8; 95 percent confidence interval, 1.2 to 2.7). Half the depressed patients reported multiple unexplained somatic symptoms, and 11 percent denied psychological symptoms of depression on direct questioning. Neither of these proportions varied significantly among the centers. Although the overall prevalence of depressive symptoms varied markedly among the centers, the frequencies of psychological and physical symptoms were similar.
Somatic symptoms of depression are common in many countries, but their frequency varies depending on how somatization is defined. There is substantial variation in how frequently patients with depression present with strictly somatic symptoms. In part, this variation may reflect characteristics of physicians and health care systems, as well as cultural differences among patients.
Psychiatric hospital in-patients are known to be at high risk of suicide, yet there is little reliable knowledge of risk factors or their predictive power.
To identify risk factors for suicide in psychiatric hospital in-patients and to evaluate their predictive power in detecting people at risk of suicide.
Using a case-control design, 112 people who committed suicide while in-patients in psychiatric hospitals were compared with 112 randomly selected controls. Univariate analysis and multivariate analyses were used to estimate odds ratios and adjusted likelihood ratios.
The rate of suicide in psychiatric in-patients was 13.7 (95% CI 11.7-16.1) per 10,000 admissions. There were five predictive factors with likelihood ratios > 2, following adjustment: planned suicide attempt, 4.1; actual suicide attempt, 4.9; recent bereavement, 4.0; presence of delusions, 2.3; chronic mental illness, 2.2; and family history of suicide, 4.6. On this basis, only two of the patients who committed suicide had a predicted risk of suicide above 5%.
Although several factors were identified that were strongly associated with suicide, their clinical utility is limited by low sensitivity and specificity, combined with the rarity of suicide, even in this high-risk group.
This therapist guide is designed to give mental health professionals the necessary tools to assess and treat a broad range of mood disorders, particularly depression. Based on the principles of cognitive-behavioral therapy, the ‘Taming the BEAST (TTB)’ program helps patients develop a set of coping strategies and skills to proactively manage their depressed mood. Using the acronym BEAST, treatment modules address biology, emotions, activity, situations, and thoughts. Each module comes complete with step-by-step instructions for delivering treatment including outlines and lists of materials needed. In-session exercises as well as home assignments help motivate the patient and allow for the monitoring of progress. Written by experts in the field, this guide comes complete with chapters on assessment, socialization, and termination. The TTB program offers both therapist and patient a roadmap for overcoming depression.
The cognitive approach to phobias (Beck and Emery 1985) emphasizes the mediating role of thought patterns and mental images that allow individual adaptation to internal and external stimuli. Cognitions themselves are not considered a cause of anxiety and avoidance behavior but represent an intervening information-processing system whose dysfunction may result from the interaction of an innate biological vulnerability with a faulty cognitive learning history. Therapeutic reduction of fear and avoidance is thought to result from the modification of maladaptive conscious or unconscious thought patterns.
Cognitive therapy has been influenced by a variety of theories of psychopathology and the process of therapy. At the theoretical level, it has been primarily influenced by three sources: (1) the phenomenological approach to psychology, (2) structural theory and depth psychology, and (3) cognitive psychology. The “phenomenological” approach to psychology is rooted in Greek Stoic philosophy. It maintains that one’s view of self and one’s personal world largely determine behavior. This concept appears in Kant’s (1798) emphasis on conscious subjective experience and in the more contemporary writings of Adler (1936), Alexander (1950), Homey (1950), and Sullivan (1953).
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In this paper, a number of theoretical issues concerning rational beliefs in REBT will be discussed. In particular, a distinction will be made between rational beliefs which appear rational but are only partially rational (called here, partially formed rational beliefs) and rational beliefs that are fully rational (called here, fully formed rational beliefs). Making this distinction has a number of benefits. For example, it helps explain how people transform their partially formed rational beliefs into irrational beliefs and it provides authors of counseling and psychotherapy textbooks with clear, accurate information to pass on to their readership (Dryden 2012). A number of other issues concerning rational beliefs will also be discussed.
The resurgence of the cognitive perspective in the early 1970s was so strong that it became widely described as the “cognitive revolution” (Dember, 1974). More than a decade later, there still has been little in the way of critical response or sober reevaluation of the enthusiastic claims and polemics that accompanied this shift in perspective. As measured by the continued outpouring of articles, chapters, books, and even new journals, the cognitive perspective is clearly in ascendance in clinical psychology, as well as much of the rest of the discipline. Dissent is muted, and, with the exception of the perennial question of the causal priority of cognition over emotion (Lazarus, 1984; Zajonc, 1984), there is little in the way of spirited theoretical debate. On the rare occasions when theoretical disagreements do occur, they are largely confined to minor issues arising within the cognitive perspective, rather than representing any challenge to the basic assumptions of the perspective.
In this handbook, the author teaches how the techniques of CBT can be used to overcome depression, conquer anxiety, and enjoy greater intimacy. These skills can also be adapted to hurdle roadblocks to success, from test anxiety and fear of public speaking to procrastination and self-doubt.
Filled with quizzes, charts, weekly self-assessment, and a daily mood log,
The Feeling Good Handbook actively engages its readers in their own recovery. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Traces the development of the cognitive approach to psychopathology and psy hotherapy from common-sense observations and folk wisdom, to a more sophisticated understanding of the emotional disorders, and finally to the application of rational techniques to correct the misconceptions and conceptual distortions that form the matrix of the neuroses. The importance of engaging the patient in exploration of his inner world and of obtaining a sharp delineation of specific thoughts and underlying assumptions is emphasized. (91/4 p ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
We have previously written articles and chapters covering important aspects of the practice of RET (Dryden, 1985b; Ellis, 1969, 1974a, 1982a, c, 1986a), but some of these are outdated and/or out of print. Therefore, in this book we have revised and updated this previous material, added several chapters of new RET formulations, and attempted to produce a volume that will present a comprehensive picture of the practice of RET that can be used effectively by any therapist who wants to employ its important clinical modalities. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
review the conceptual underpinnings and empirical status of the cognitive and cognitive-behavioral interventions / despite their common core, these approaches differ with respect to the processes presumed to mediate and the procedures used to produce change / try to highlight this variability and to examine its relation to clinical efficacy
depression and the prevention of relapse / panic and the anxiety disorders / eating disorders and obesity / child and adolescent disorders / substance abuse and the prevention of relapse / treatment of personality disorders / behavioral medicine / marital distress (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Robert Leahy describes Aaron Beck's seminal model of depression, anxiety, anger, and relationship conflict and shows how each of these problems is handled by the cognitive therapist in the context of an interactive therapeutic relationship. Leahy demonstrates how uncovering resistance to change and using the therapeutic relationship enhances recovery and promotes rapid change. With concrete examples he shows how to implement all of the basic cognitive techniques, including: activity scheduling; graded task assignments; exposure hierarchies; response prevention; challenging underlying schemas and thought monitoring.
Drawing from cognitive and dynamic orientations and taking into account the complexity of countertransference and resistance, this book is for today's clinicians who, rather than being wedded to a specific approach, are committed to a quick and successful therapeutic outcome. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Choosing to Live is the first self-help guide addressed to those who are considering suicide. In an empathetic nonjudgmental tone, the authors provide tools to help readers assess the risk and understand the factors that reinforce suicidal talk and behaviors. A step-by-step program for change shows how to replace negative beliefs and develop alternative skills for solving problems. For professionals who are helping seriously depressed clients, Choosing to Live offers the clear guidance of a treatment manual plus readings and exercises for clients to do at home.
Forty-one unipolar depressed outpatients were randomly assigned to individual treatment with either cognitive therapy (N =19)or imipramine (N =22).As a group, the patients had been intermittently or chronically depressed with a mean period of 8.8 years since the onset of their first episode of depression, and 75%were suicidal. For the cognitive therapy patients, the treatment protocol specified a maximum of 20 interviews over a period of 12 weeks. The pharmacotherapy patients received up to 250 mg/day of imipramine for a maximum of 12 weeks. Patients who completed cognitive therapy averaged 10.90 weeks in treatment; those in pharmacotherapy averaged 10.86 weeks. Both treatment groups showed statistically significant decreases in depressive symptomatology. Cognitive therapy resulted in significantly greater improvement than did pharmacotherapy on both a self-administered measure of depression (Beck Depression Inventory)and clinical ratings (Hamilton Rating Scale for Depression and Raskin Scale).Moreover, 78.9%of the patients in cognitive therapy showed marked improvement or complete remission of symptoms as compared to 22.7%of the pharmacotherapy patients. In addition, both treatment groups showed substantial decrease in anxiety ratings. The dropout rate was significantly higher with pharmacotherapy (8 Ss)than with cognitive therapy (1 S).Even when these dropouts were excluded from data analysis, the cognitive therapy patients showed a significantly greater improvement than the pharmacotherapy patients. Follow-up contacts at three and six months indicate that treatment gains evident at termination were maintained over time. Moreover, while 68%of the pharmacotherapy group re-entered treatment for depression, only 16%of the psychotherapy patients did so.
Although suicidal behavior is a serious public health problem, few effective treatments exist to treat this population. This article describes a new cognitive therapy intervention that has been developed for treating recent suicide attempters. The intervention is based on general principles of cognitive therapy and targets the automatic thoughts and core beliefs that were activated just prior to the individual's suicide attempt. Specific cognitive and behavioral techniques are taught to the patient with the goal of decreasing suicidal thoughts and preventing future suicide attempts. The treatment is unique in targeting suicidal behavior as the primary problem, apart from psychiatric diagnosis. Three detailed case examples are provided that illustrate the use of the treatment with different types of patients.
This paper reports on an ethological study of 11 depressed hospitalized subjects. Major depression and recovery are described in terms of general behavioral traits, i.e., behavior parameters. The hypothesis, that the primary behavioral feature of major depression is a reduction of social interaction and that secondary features are reduced self occupation and body mobility (posture flexibility) is tested. The behavioral patterns of depression and recovery are described and elucidated by 12 defined behavioral parameters, eight of which show significant changes between the first and the last hospital week. Findings from six of the parameters are consistent with the hypothesis and demonstrate social inhibition during depression; interactions between depression and nonverbal behavior are particularly striking. Findings also confirm that, during depression, self occupation and body mobility are reduced to a less significant degree than social inhibition. Possible relationships between findings and agitated forms of major depression are discussed. A final section examines findings in an evolutionary context and emphasizes their clinical implications.
2nd Ed Bibliogr. s. 360-367
Guía sobre la terapia conductual-cognoscitiva en que se describen, explican y demuestran más de cien técnicas de la terapia; para cada una de ellas se ofrecen las bases teóricas que las sustentan. Especial atención se pone al caso de pacientes adictos o con enfermedades mentales serias.
This study investigated information processing and cognitive organization in clinical depression. The specificity of various cognitive mechanisms to depression was also examined. Twenty-six depressed/anxious individuals, 24 pure depressives, 25 never-depressed anxious controls, and 25 nonpsychiatric controls completed a modified Stroop task, the Self-Referent Encoding Task, and two tasks designed to assess cognitive structure. Comorbid depressed/anxious, depressed, and anxious groups performed similarly to one another but differed significantly from nonpsychiatric controls, on the processing and organization of negative content. Specificity to depression was also obtained, as both depressed groups endorsed and recalled less positive information and organized positive self-relevant information with less interconnectedness than anxious individuals and nonpsychiatric controls. These results suggest that depressed individuals have an interconnected negative self-representational system and lack a well-organized positive template of self. These findings are discussed in terms of cognitive models of depression and the tripartite model of depression and anxiety.
Cognitive therapy (CT) for depression has been found to be efficacious for the treatment of depression. In comparison to other psychotherapies, CT has been shown to be approximately equal to behavior therapies, but sometimes superior to 'other therapies.' The latter comparison is problematic given that 'other therapies' contain bona fide treatments as well as treatments without therapeutic rationale for depression.
A meta-analysis was conducted for studies that compared CT to 'other therapies' in an earlier meta-analysis, except that in this meta-analysis 'other therapies' were classified as bona fide and non-bona fide.
The benefits of CT were found to be approximately equal to the benefits of bona fide non-CT and behavioral treatments, but superior to non-bona fide treatments.
The results of this study fail to support the superiority of CT for depression. On the contrary, these results support the conclusion that all bona fide psychological treatments for depression are equally efficacious.
The phenomenon of somatization was explored in relation to the experiences of acculturation, stress, support, and distress.
A representative community sample of 1,747 Chinese Americans (aged 18-65 years), selected by a multi-stage household sampling design, in the Los Angeles County was interviewed to tap their psychiatric diagnoses, symptomatology, level of acculturation, stress, and support.
Across all indices, Chinese Americans' level of somatic symptoms, impairment related to somatization, and percentage of meeting the Somatic Symptom Index 5/5 (SSI 5/5) criterion were comparable to those found in other populations. Length of residence in the U. S. and acculturation were not related to somatization. Regression analyses showed that anxiety, depression, gender, age, education, stressors, and support were significantly related to somatization, ps < 0.05. Somatizers tended to perceive themselves with poor health and utilized both Western and indigenous Chinese medicine.
The importance of demographics, psychological distress, and stress was emphasized in the explanation of somatization tendencies among immigrant Chinese Americans. Somatization might be a stress response with regard to increased distress severity and psychosocial stressors rather than a cultural response to express psychological problems in somatic terms.
Are our emotions and behaviors helping you or hurting you
- M E Bernard
Bernard, M.E. (1993). Are our emotions and behaviors helping you or hurting you? In:
M.E. Bernard & J.L. Wolfe (eds.), The RET Resource Book for Practitioners.
New York: The Albert Ellis Institute for Rational Emotive Behavior Therapy.
Differentiating preferential from exaggerated and musturbatory beliefs in Rational Emotive Behavior Therapy
- A Ellis
Ellis, A. (2003) Differentiating preferential from exaggerated and musturbatory beliefs
in Rational Emotive Behavior Therapy. In Dryden, W. (Ed.), Rational emotive
behavior therapy: Theoretical developments (pp. 22-34). New York, N.Y.:
Brunner-Routledge.
Rational emotive behavior therapy for depression: Achieving unconditional self acceptance
- R Digiuseppe
- K Doyle
- R D Rose
DiGiuseppe, R., Doyle, K. & Rose, R.D. (2002). Rational emotive behavior therapy for
depression: Achieving unconditional self acceptance. In Reinecke, M.A.; &
Davison, M. R. (Eds.). Comparative treatments of depression, ((pp220-246). New
York:Springer Publishing Company.
A comparison of cognitive therapy, pharmacotherapy, and their combination in depressed outpatients
- I Blackburn
- S Bishop
Blackburn, I., & Bishop, S. (1979). A comparison of cognitive therapy,
pharmacotherapy, and their combination in depressed outpatients. Paper
presented at the annual meeting of the Society for Psychotherapy Research,
Oxford, England.
Cognitive and cognitive-behavioral therapies Handbook of psychotherapy and behavior change
- S Hollon
- A T Beck
Hollon, S., Beck, A.T., (1985) Cognitive and cognitive-behavioral therapies. In
A.E.Bergin and S.A.Garfield (eds) Handbook of psychotherapy and behavior
change (3 rd ed. pp 443-482) New York: John Wiley & Son.
Cognitive behavioral therapy with suicidal patients in Yufit Assessment, treatment, and prevention of suicidal behavior
- Mark A Reinecke
- Elizabeth R Didie
Reinecke, Mark A; Didie, Elizabeth R. Cognitive behavioral therapy with suicidal
patients in Yufit, Robert I (Eds); Lester, David (Ed). (2005). Assessment,
treatment, and prevention of suicidal behavior. (pp. 205-234). New York, NY,
US: John Wiley & Sons, Inc. xvi, 482 pp.
Schema Focused Workshop presented at Cornell Hospital
- J Young
Young, J. (2003) Schema Focused Workshop presented at Cornell Hospital, New York.
Schema-focused therapy for depression In Reinecke
- J Young
- Matilla
Young, J & Matilla (2002). Schema-focused therapy for depression In Reinecke, M.A.;
REBT resourse book for practitioners
- M E Bernard
- J Wolfe
Bernard, M.E. & Wolfe, J. REBT resourse book for practitioners. http://www.rebt.org.
The original therapist's toolkit http
- D Burns
Burns, D. (2003) The original therapist's toolkit http://www.feelinggood.com
Comprehensive handbook for cognitive therapy
- L E Simon
- Butler
Simon, L.E. Butler, & H. Arkowitz (Eds.) Comprehensive handbook for cognitive
therapy (pp.227-244). New York: Plenum Press.