Behavioural Techniques for Cognitive Therapy in Depression
1. Understanding Depression and Behaviour Change
• Depression is characterised by low levels of positive reinforcement.
• Behaviour change is crucial in cognitive therapy to help patients cope with negative feelings.
• Patients often seek short-term relief through behaviours that may be detrimental in the long run.
2. The Role of Negative Reinforcement
• Negative reinforcement involves removing an aversive stimulus, which can lead to increased likelihood of certain behaviours.
• Example: Social withdrawal can provide short-term relief from social anxiety, reinforcing the behaviour.
3. Identifying Vicious Cycles
• Patients may feel incapable of engaging in activities they once enjoyed.
• It's essential to help patients recognise the link between their thoughts, feelings, and behaviours.
4. Activity Scheduling as a Tool
• Activity scheduling aims to identify and challenge negative automatic thoughts.
• Helps patients realize they are engaging in more activities than they believe.
5. Grading Tasks and Setting Goals
• Collaboratively plan hourly tasks that are meaningful to the patient.
• Each task should be viewed as an experiment to test beliefs about their capabilities.
6. Mastery and Pleasure Ratings
• Patients should rate their sense of mastery and pleasure from activities on a scale of 1 to 5.
• Focus on understanding negative appraisals and selective attention to pleasure.
7. Task Assignment and Acknowledgement
• Define problems clearly and break tasks down into manageable steps.
• Acknowledge and praise each completed step to reinforce progress.
8. Addressing Negative Appraisals
• Identify and challenge negative thoughts during the activity scheduling process.
• Emphasise the patient's skills and efforts.
9. Cognitive Rehearsal Techniques
• Encourage patients to visualise each step of their tasks to overcome roadblocks.
• Break down tasks into smaller, manageable actions.
10. Assertiveness Training and Role-Playing
• Role-play scenarios to develop assertiveness skills, such as ordering food or addressing issues with roommates.
• Consider the potential reactions of others to assertive behaviours.
11. Conclusion and Summary
• Behavioural change techniques are essential in cognitive therapy for depression.
• The goal is to foster cognitive change and improve overall functioning.