CBT and Depression Denise Hashempour

Altered behaviour in depression Reduced activity The vicious circle of reduced activity Unhelpful Behaviour Reduced helpful behaviour

Physical changes Weight changes Reduced energy/Fatigue Reduced sex drive Constipation Pain Physical agitation

Altered mood Reduced activity The vicious circle of reduced activity Unhelpful Behaviour Reduced helpful behaviour

Altered thinking A bias against yourself Putting a negative slant on things Having a gloomy view of the future Negative view about how others see you Bearing all responsibility Making extreme statements or rules

Unhelpful thoughts Situation observation by supervisor Thoughts I’ll make a mistake, be fired, and wont be able to get another job (catastrophising) Mood Nervous 80% Scared 90%

Questions to identify unhelpful N.A.T.S. What was going through my mind just before I started to feel like this ? What does this say about me if true ? What am I afraid might happen ? What is the worst that could happen ? What images or memories do I have ? Use a thought Record

Patient’s Daily Record of Dysfunctional Automatic Thoughts H:\CBT RESOURCES\FORM27.PDF

Case conceptualisation How is it that the person came to develop this problem? What were the significant life events, experiences, interactions? What are their most basic beliefs about their self, their world, others? What are their assumptions, expectations, rules, attitudes? What strategies have they used to cope with these beliefs? Which automatic thoughts, images, and behaviours help to maintain the problem? What is happening in the persons life right now and how do they perceive it?

Conceptualisation Baseline Assessment is an important part of the process, and may include: Anxiety inventories. Depression inventories. Many other assessment tools

Patient’s Weekly Planning Schedule: Predicting Pleasure and Mastery H:\CBT RESOURCES\FORM26.PDF

Patient’s Weekly Activity Schedule H:\CBT RESOURCES\FORM25.PDF

Summary of techniques Normalising Socratic questioning Assessment Guided Discovery SMART Goals Thought Diaries Identifiying and modifying Core Belief where possible Daily Activity Diary Alternative helpful beliefs Increase helpful behaviour Recognising Negative Automatic Thoughts Reduce unhelpful behaviour Behavioural Activation Psycho Education Altered behaviour in depression Identifiying and challenging unhelpful thoughts