The primary goal of this chapter is to provide an overview of the clinical adaptations to CT for depression that may make it more effective for individuals with persistent depressive symptoms. The evidence from research studies is that a combination of CT and antidepressants can help to resolve or ameliorate the symptoms and social problems associated with this debilitating condition. In day-to-day practice, CT alone or in combination with medication appears to be a highly acceptable intervention for individuals with chronic depression and may produce durable benefits for 50-70% patients. However, it would be wrong to assume that we have gone as far as we can in conceptualizing and treating chronic depression with CT. A number of exciting cognitive theory and therapy developments are being explored. For example, research on rumination (which may play a crucial role in the maintenance of depressive symptoms) suggests that it may be useful to conceptualize rumination in terms of processing styles rather than simply as recurrent negative thought content. To date, psychological treatments for chronic depression have not explicitly focused on shifting processing modes during focus on negative self-experience. The work on mindfulness-based CT (MBCT) has only been used for patients with fully remitted, rather than partially remitted, depression (Teasdale et al., 2000), so we do not yet know if this approach is suitable for chronic depression. However, the success of MBCT in preventing relapse is consistent with the argument that a shift processing style when faced with negative self-experience may be of therapeutic benefit. It is therefore timely to consider exploring how CT might be varied to explicitly shift the mode of processing negative self-experience in residual depression, without requiring a background in mindfulness meditation (Watkins, 2004). Such work is now underway and will perhaps offer another useful advance on our current CT models that may then allow us to understand further the causes of chronic depression, as well as to offer a range of CT approaches to tackle this problem.


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Belief Change 101

Belief Change 101

Do you suffer from a habit or a behavior or a repetitive thought pattern that keeps you from being who you want to be? Do you try to change this or that aspect of your life, but wind up right back where you started? You're not alone! Millions of Americans try to make changes, but the whopping majority fail exceptionally.

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