THE DEPRESSED CLIENT AND CBT
The Oxford College notes (2006) define depression as a major affective disorder because it affects feelings, mood, and thoughts. Feltham and Dryden (1997) define depression as a short-lived mood or chronic condition characterised by hopelessness, apathy, meaninglessness, withdrawal, low self-esteem, sadness. Depression affects or reveals itself in sadness, dejection; depressed cognitions include negative evaluation of one’s self, the world and one’s future. Depressed behaviour includes lethargy, isolation, and disturbed eating and sleeping patterns.
Dryden and Branch (2008) state that an agenda devised by the client and therapist together helps to keep focus within sessions and maximize the use of time, Westbrook et al., (2007) states that in the early stages of fighting depression, the client is not likely to enjoy anything as much as they did before. It is important to prepare clients for the fact that initially they will probably have to force themselves to do things even though there is not much pleasure.
Milne (2008) states that causes of depression can include genetics, biological predisposition, certain types of upbringing, and events of adult life that can be either chronic or specific and traumatic. The Oxford College notes (2006) state that classification of depression can be made using the symptom list:
On the form below please place a tick against any listed that are the same as, or similar to symptoms you have noticed in relation to yourself:
- An over whelming feeling of sadness.
- Loss of interest or pleasure in things you would normally enjoy. - Feeling of guilt, worthlessness or hopelessness.
- Difficulty in sleeping, waking up early.
- Extreme tiredness, with no energy and possibly little appetite. - Weight loss.
- Difficulty in concentrating, making decisions or remembering things. - Headaches, abdominal pains and palpitations.
- Anxiety, panic attacks, overwhelming sadness, and bouts of crying. - Inability to make decisions, feelings inadequate and unable to cope. - Feelings of isolation and insecurity.
- Lack of interest in self-care/appearance, loss of appetite. - Feelings guilty that you cannot cope, that you are not meeting expectations, both your own and those of other.
From the figure above where you have ticked four or more symptoms from the box, it is likely that you are suffering from a depressive mood.
Milne (2008) states that gradually recognising that a certain situation or a certain time of day, being in the presence of a certain person or, quite often, a marked lack of activity of any sort triggers particular thoughts and moods. This is excellent information for the client as it allows him to adjust the situation or even possibly eliminate it. The client will be aware a head of time, of possible mood changes and can therefore create an action plan to help overcome the depressive mood.
Greenberger and Padesky (1995) state that Activities can be connected to the way a client feels. By tracking feelings of depression, the client discovers when they are depressed and are more passive and less active. Depression tends to stop one from doing pleasurable activities, depression treatment often emphases increasing of weekly number of pleasurable activities.
Days of the Week
Sunday 6-7 a.m.
The figure above: Weekly Activity Schedule Write in each box: (1) Activity. (2) Mood rating for depression (0-100). Beck, et al, (1997) states that the use of activity schedules serves to counteract the...
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