Cognitive Therapy For Depression In Patients With Comorbid Pds

Once some of the symptoms of depression have been relieved, the therapeutic focus switches to core schemas about self and life, which tend to trigger problems and depressive symptoms (Young, Weinberger, & Beck, 2001). Educating the patient about schemas is pertinent in this phase, for instance, explaining that schemas are rules by which people live and how they make sense of the world. Next, it is important for the patient reflectively to explore and identify personal schemas. Through the identification process, "CT [cognitive therapy] aims at counteracting the effects of schemas and replacing dysfunctional techniques and methods with new approaches, making the patient less vulnerable to future depressions" (Young, Weinberger, & Beck, 2001, p. 278).

Once the core and active schemas have been identified, the corollary schema can be investigated and tested. For example, the schema might be, "The world is a dangerous place," and the corollary schema might be, "The most dangerous thing in the world are relationships. Relationships can injure you," or "Avoid relationships." The decision can then be made as to the therapeutic interventions. Schemas can be constructed, reconstructed, modified, reinterpreted, or camouflaged. If the individual has no schema for dealing with a particular experience, the schema may have to be built or constructed within the therapy (e.g., a patient is aggressive but has no schema for assertive behavior). Rules for being assertive may have to be constructed within the therapeutic collaboration.

Reconstructing schemas is akin to urban renewal. The individual's present schematic structure is not working well. The structure can be deconstructed and a more flexible and useful structure may be put in its place. For example, if the schema is "Men are always dangerous," the recon structed schema might be "Men are not always dangerous." Schematic modification involves keeping much of the schema yet changing small parts of it to better accommodate new experience (e.g., " Men are often dangerous"). In schematic reinterpretation, the individual maintains the schema but finds new and more adaptive uses and applications of it. For example, if the schema is, "I am special and should be noticed," then the reinterpretation might be, "I will become a teacher (actor, politician) and always be on stage." Finally, in schematic camouflage, individuals learn to mask or hide certain schemas that they recognize as being asocial, undesirable, or destructive to self or others. For example, someone with the schema, "If no one is there to see me break the law, then it is OK," might never break the law if he/she were always being watched. Prisoners who merit time off from the imposed sentence for good behavior in prison might not fare well outside of a highly controlled environment.

Relapse prevention is key to the second phase of treatment. The patient continues in an active role identifying problem areas, hypothesizing solutions, and following through with homework assignments. In this phase, the therapist's role changes more to that of a consultant discussing problems and potential solutions, practicing solutions, and discussing the effects of homework assignments. As the patient becomes more comfortable with self and homework assignments, the number of sessions decreases until therapy is eventually completed (Young et al., 2001).

Exploring EFT

Exploring EFT

EFT stands for Emotional Freedom Technique. It works to free the user of both physical and emotional pain and relieve chronic conditions by healing the physical responses our bodies make after we've been hurt or experienced pain. While some people do not carry the effects of these experiences, others have bodies that hold onto these memories, which affect the way the body works. Because it is a free and fast technique, even if you are not one hundred percent committed to whether it works or not, it is still worth giving it a shot and seeing if there is any improvement.

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