Residual Symptoms andor Low Skills Acquisition Goal Complete Remission and Promotion of Basic Skills Mastery

At times C-CT can look a lot like A-CT continued! This occurs when patients' symptoms no longer meet criteria for MDD, yet they have not achieved full and sustained remission and/or have not completely mastered the use of efficacious compensatory strategies, in which case C-CT and ACT are very similar. Therapists then help patients identify cognitive, emotional, and environmental obstacles that support and impede their use of critical skills. For example, consider a patient who no longer meets criteria for MDD, yet whose HRSD score is above 5. The patient does not consis tently note a reduction in negative affect when he/she attempts a thought record and continues to blame him/herself solely for chronic relationship discord. Then the C-CT focus may be finding the skills deficit in the application of the thought record or determining whether a different compensatory skill (see Table 6.1; problem solving regarding conflictual issues) might be useful in lowering and maintaining an HRSD score consistently below 5.

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