Assessment Skills in Cognitive Therapy for Depression
1. Initial Assessment
• Conduct assessment over two sessions.
• First session focuses on diagnostic assessment:
o Determine if the patient has depression.
o Identify any comorbidities.
o Discuss which disorder to focus on if multiple are present.
2. Deciding on Treatment Approach
• Decide between behavioural activation or cognitive therapy for depression.
• Refer to NICE guidance for decision-making.
3. Detailed Assessment for Cognitive Therapy
• If choosing cognitive therapy, conduct a more detailed assessment.
• Refer to Aaron Beck's book for assessment content tips.
4. Building Trust with the Client
• Establish trust as a foundational element of cognitive therapy.
• Encourage clients to express thoughts they may not have verbalised before.
5. Engaging with the Patient
• Cognitive therapy is about genuine exploration, not persuasion.
• Develop skills through practice and supervision.
6. Importance of Collaboration
• Collaboration is key in cognitive therapy.
• Encourage active participation from the patient.
7. Effective Communication Techniques
• Use questioning techniques and shared problem-solving.
• Avoid allowing patients to ramble; steer conversations towards set agendas.
8. Balancing Verbal and Nonverbal Skills
• Use verbal skills to encourage teamwork and alternative thinking.
• Incorporate nonverbal skills like joint activities and summarising information.
9. Openness in the Therapeutic Process
• Be transparent about therapy processes and interventions.
• Share summaries and admit confusion when necessary.
10. Learning from Mood Fluctuations
• Treat difficult weeks as learning opportunities.
• Explore triggers and processes of thoughts and feelings.
11. Self-Exploration and Formulation
• Encourage self-exploration while formulating treatment plans.
• Validate patient input and adjust hypotheses as needed.
12. State Dependent Learning
• Teach cognitive skills during depressive states for better recall.
• Gradually move practice closer to triggering events.
13. Setting Treatment Goals
• Discuss specific goals for treatment with the patient.
• Key aims include:
o Relieving symptoms.
o Preventing recurrence of depression.
o Modifying faulty thinking and dysfunctional behaviour.
14. Targeting Key Symptoms
• Focus on emotions, motivations, cognitions, behaviours, and physical feelings.
• Prepare for practical application in upcoming sessions.