Overcoming Depression: A Cognitive Therapy Approach Workbook

209 Pages·2009·0.69 MB·English

by  Mark Gilson

Overcoming Depression
EDITOR-IN-CHIEF
DavidH.Barlow,PhD
SCIENTIFIC
ADVISORY BOARD
AnneMarieAlbano,PhD
GillianButler,PhD
DavidM.Clark,PhD
EdnaB.Foa,PhD
PaulJ.Frick,PhD
JackM.Gorman,MD
KirkHeilbrun,PhD
RobertJ.McMahon,PhD
PeterE.Nathan,PhD
ChristineMaguthNezu,PhD
MatthewK.Nock,PhD
PaulSalkovskis,PhD
BonnieSpring,PhD
GailSteketee,PhD
JohnR.Weisz,PhD
G.TerenceWilson,PhD
Overcoming
Depression
A COGNITIVE THERAPY APPROACH
SECOND EDITION
W o r k b o o k
Mark Gilson • Arthur Freeman • M. Jane Yates • Sharon
Morgillo Freeman
1
2009
1
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About TreatmentsThatWorkTM
One of the most difficult problems confronting patients with various disorders
and diseases is finding the best help available. Everyone is aware of friends or
family who have sought treatment from a seemingly reputable practitioner, only
to find out later from another doctor that the original diagnosis was wrong or
the treatments recommended were inappropriate or perhaps even harmful. Most
patients,orfamilymembers,addressthisproblembyreadingeverythingtheycan
about their symptoms, seeking out information on the Internet, or aggressively
“askingaround”totapknowledgefromfriendsandacquaintances.Governments
and healthcare policymakers are also aware that people in need don’t always
get the best treatments—something they refer to as “variability in healthcare
practices.”
Now healthcare systems around the world are attempting to correct this vari-
ability by introducing “evidence-based practice.” This simply means that it is in
everyone’s interest that patients get the most up-to-date and effective care for a
particular problem. Healthcare policymakers have also recognized that it is very
useful to give consumers of healthcare as much information as possible, so that
theycanmakeintelligentdecisionsinacollaborativeefforttoimprovehealthand
mentalhealth.Thisseries,TreatmentsThatWorkTM isdesignedtoaccomplishjust
that. Only the latest and most effective interventions for particular problems are
described in user-friendly language. To be included in this series, each treatment
program must pass the highest standards of evidence available, as determined by
ascientificadvisoryboard.Thus,whenindividualssufferingfromtheseproblems
or their family members seek out an expert clinician who is familiar with these
interventions and decides that they are appropriate, they will have confidence
that they are receiving the best care available. Of course, only your health care
professional candecide ontheright mix oftreatmentsforyou.
This workbook is designed to help you as you work together with a qualified
mental health professional to overcome your depression. The program described
will help you develop a set of coping strategies and skills so that you can proac-
tively deal with depression and prevent it from compromising your quality of
life. Based on the idea that depression is a “beast” to be tamed, the treatment
v
utilizesanacronymtohelpyouunderstandthegoalsoftreatment.Youwillwork
with your therapist to understand the biology of depression, as well as how your
emotions,youractivitylevel,thesituationsyoufindyourselfin,andthethoughts
youhaveallcontribute toyourdepression(theBEAST).
Filledwithworksheetsandformsforcompletingin-sessionexercises,aswellasat-
home assignments, this workbook provides all the tools you need to successfully
overcomeyourdepressionand preventfuturerelapse.
DavidH.Barlow,Editor-in-Chief,
TreatmentsThatWork™
Boston,MA
vi
Acknowledgments
WhenAaronT.Beckbegantodevelophisworkondepressionintheearly1960s,
he also began a revolution in understanding and treating depression. Over the
past decades, his work in cognitive therapy has evolved in clinical sophistica-
tion, empirical support, and popularity. The Academy of Cognitive Therapy,
TheAssociationofBehaviorandCognitiveTherapy,andtheInternationalAsso-
ciation for Cognitive Psychotherapy, along with many professional journals are
nowdedicatedtotheadvancementanddisseminationofthecognitive-behavioral
model. The authors have had the good fortune of being either faculty (Art Free-
man and Mark Gilson) at the Center for Cognitive Therapy at University of
Pennsylvania under Dr. Beck’s wise guidance and/or having extensive contact
with the organizations he represents. We are grateful for what Aaron T. Beck
hasofferedtousand,byextension, totheclinical community.
David Barlow,PhD, is apioneer inthedevelopment ofpsychology asanapplied
empiricalscience,andhetirelesslyattemptedtogarnerrespectforpsychotherapy
as a credible means to help people change for the better. His invitation to Mark
Gilsontobeginthisproject willalwaysbe considered anhonorand aprivilege.
Aspecialnoteofappreciationgoestoanotherpersonwhohasdeliveredanthems
ofhopeintimesofhardship.PeteSeeger,calledthefatherofAmericanfolkmusic
andsingerofsongssuchasWeShallOvercomeandTurn,Turn,Turn,offeredsug-
gestions for this book when it was first published. As a mentor to Mark Gilson,
hismessages(andhislife)ofperseveranceduringtimesofunfairnessandstruggle
have helped so many and remain an inspiration. Simple ideas, humility, and sin-
cerityofpurposecanmovemountains,andPetehastaughtmanypeopletohold
onandfind hope inthemidstofunhappiness andsuffering.
Coauthor M. Jane Yates deserves special recognition for doing more editing and
rewriting than anyone else on this project. When any of the other authors were
delayed,she stepped inand savedtheday.
Sharon Morgillo Freeman gives a heartfelt thanks to the many patients whose
individual stories and successes contributed to the development of the materials
contained in this book. Without their wisdom, assistance, and input this book
vii
wouldnothavebeenpossible.Tofamilyandfriendsforyourpatiencewhiletime
was taken away during the development and completion of yet another project;
thank you for your love and support, it means a great deal more than you will
everknow.
Much gratitude is owed to Mariclaire Cloutier and Cristina Wojdylo at Oxford
UniversityPressfortheirincrediblepatience,tirelesshoursofediting,andsupport
aswellasfriendshipthroughoutthisproject.Theeditorialstaffhavecontributed
immensely to making the materials we put together readable without sacrificing
the voice of the authors or the impact of clinical concepts and ideas. Thanks are
nowherenearenough.
viii
Contents
Chapter1 Overview 1
Chapter2 Beginning QuestionsandAnswers 15
Chapter3 TheTheoryandPractice ofCognitive Therapy 25
Chapter4 Understanding YourBody:TheBoftheBEAST 33
Chapter5 Understanding theImpact ofEmotion:TheEoftheBEAST 59
Chapter6 TakingAction:TheAoftheBEAST 79
Chapter7 LifeSituationsandVulnerability: TheSoftheBEAST 101
Chapter8 ThoughtsandDepression: TheToftheBEAST 115
Chapter9 RelapsePrevention 155
Chapter10 FinalWords ofHope 169
Appendix ofForms 175
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