Fewer Symptoms and Skills Acquired Goal Prevent Relapse and Generalize Gains over Time and Environments Promote Resilience

When the HRSD has often been below 5 and patients know how to use one or more skills to produce symptomatic relief, the focus of C-CT moves to relapse prevention, stress inoculation, and promotion of sustained remission and a full recovery. "Stress inoculation" comprises constructing an individualized model of depression onsets, offsets, and prevention. Patient and therapist work together to make the model of depression and prevention practical and usable in daily life. They examine common themes associated with prior onsets of depression or with increases in negative affect. They examine the cognitive and behavioral patterns associated with offsets in prior depressions or negative affect. For example, if onsets of prior depressions were associated with the end of romantic relationships and offsets were correlated with starting a new romantic relationship, the therapist would attempt to elicit an underlying belief, such as "I am only worthwhile and happy if I have a partner." Patient and therapist consider the effect of this belief across the life cycle and hypothetical adverse events (e.g., the patient never bonds with a partner, experiences a breakup, loses a partner to death). In session and through homework, they work through the alternative beliefs and behaviors that allow the patient to experience these difficulties without developing another depressive episode.

The patient is encouraged to keep a notebook through therapy and in between sessions. The patient brings thought records to C-CT sessions and identifies the most important entries for review. If the patient does not bring these materials, thought records can be completed retrospectively in session and obstacles to completing these can be identified in session. Recurrent or new symptoms and targets are placed on the agenda and prioritized. The therapist encourages independence by asking the patient to generate solutions and skills that may have helped before (e.g., "What has helped in the past? Are you using these strategies now? What is getting in the way? What is helping you stay on track?").

Natural Depression Cures

Natural Depression Cures

Are You Depressed? Heard the horror stories about anti-depressants and how they can just make things worse? Are you sick of being over medicated, glazed over and too fat from taking too many happy pills? Do you hate the dry mouth, the mania and mood swings and sleep disturbances that can come with taking a prescribed mood elevator?

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