Coping with the Seasons: A Cognitive Behavioral Approach to Seasonal Affective Disorder, Therapist Guide

152 Pages·2008·0.63 MB·English

by  Kelly J Rohan

Coping With the Seasons
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
Coping With the
Seasons
A COGNITIVE-BEHAVIORAL APPROACH TO SEASONAL
AFFECTIVE DISORDER
T h e r a p i s t G u i d e
Kelly J. Rohan
1
2009
1
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Rohan,KellyJ.
Copingwiththeseasons:acognitive-behavioralapproachtoseasonalaffectivedisorder:
therapistguide/KellyJ.Rohan.
p. ; cm.—(TreatmentsThatWork)
Includesbibliographicalreferences.
ISBN978-0-19-534108-9
1.Seasonalaffectivedisorder—Treatment. 2.Cognitivetherapy.
I.Title. II.Series:Treatmentsthatwork.
[DNLM: 1.SeasonalAffectiveDisorder—therapy. 2.Cognitive
Therapy—methods. 3.Psychotherapy,Group—methods.WM171R737c2008]
RC545.R642008
616.85(cid:2)27—dc22
2008017766
9 8 7 6 5 4 3 2 1
PrintedintheUnitedStatesofAmerica
onacid-freepaper
Tomyparents,BettyandJohnF.Rohan,Jr.
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About TreatmentsThatWorkTM
Stunning developments in healthcare have taken place over the last
severalyears,butmanyofourwidelyacceptedinterventionsandstrate-
gies in mental health and behavioral medicine have been brought into
questionbyresearchevidenceasnotonlylackingbenefit,butperhaps,
inducing harm. Other strategies have been proven effective using the
bestcurrentstandardsofevidence,resultinginbroad-basedrecommen-
dations to make these practices more available to the public. Several
recent developments are behind this revolution. First, we have arrived
at a much deeper understanding of pathology, both psychological and
physical, which has led to the development of new, more precisely tar-
getedinterventions.Second,ourresearchmethodologieshaveimproved
substantially,suchthatwehavereducedthreatstointernalandexternal
validity, making the outcomes more directly applicable to clinical sit-
uations. Third, governments around the world and healthcare systems
andpolicymakershavedecidedthatthequalityofcareshouldimprove,
thatitshouldbeevidencebased,andthatitisinthepublic’sinterestto
ensurethatthishappens(Barlow,2004;InstituteofMedicine,2001).
Of course, the major stumbling block for clinicians everywhere is the
accessibility of newly developed evidence-based psychological inter-
ventions. Workshops and books can go only so far in acquainting
responsible and conscientious practitioners with the latest behavioral
healthcare practices and their applicability to individual patients. This
newseries,TreatmentsThatWorkTM,isdevotedtocommunicatingthese
excitingnewinterventionstocliniciansonthefrontlinesofpractice.
Themanualsandworkbooksinthisseriescontainstep-by-stepdetailed
procedures for assessing and treating specific problems and diagnoses.
vii
But this series also goes beyond the books and manuals by provid-
ing ancillarymaterialsthat will approximatethe supervisory process in
assistingpractitionersintheimplementationoftheseproceduresintheir
practice.
In our emerging healthcare system, the growing consensus is that
evidence-based practice offers the most responsible course of action
for the mental health professional. All behavioral healthcare clinicians
deeplydesiretoprovidethebestpossiblecarefortheirpatients.Inthis
series, our aim is to close the dissemination and information gap and
makethatpossible.
This therapist guide applies cognitive-behavioral therapy (CBT) for
depression to the treatment of seasonal affective disorder (SAD). The
prevalence of winter-type SAD is significant, especially at higher lati-
tudes; even more common is subsyndromal SAD (S-SAD) or milder
“winterblues.”Dr.Rohanprovidesamuch-neededtreatmentforSAD
in a complete and accessible package. The therapist guide outlines a
12-sessiongroupprogramtobeconductedover6weeksduringthefall
orwinter.Itmayalsobeusedwithindividualclientsorinconjunction
withlighttherapy(LT).ParticipantslearneffectiveCBTtechniquesthat
will serve them this winter and beyond. The protocol consists of psy-
choeducation,behavioralactivation,cognitiverestructuring,andrelapse
prevention.Thecorrespondingworkbookfollowstheprogramsession-
by-session and provides forms for homework. Specifically tailored for
use with the SAD population, clinicians will find this a unique and
beneficialprogramfortheirclients.
DavidH.Barlow,Editor-in-Chief,
TreatmentsThatWorkTM
Boston,MA
References
Barlow, D. H. (2004). Psychological treatments. American Psychologist, 59,
869–878.
InstituteofMedicine.(2001).Crossingthequalitychasm:Anewhealthsystem
forthe21stcentury.Washington,DC:NationalAcademyPress.
viii
Acknowledgments
First, I would like to acknowledge the contribution of all of the
participantsintheSeasonalityTreatmentProgram,formerlyattheUni-
formed Services University of the Health Sciences (USUHS) and now
at the University of Vermont, who have made this work possible and
rewarding. The development of a cognitive-behavioral therapy (CBT)
treatment for seasonal affective disorder (SAD) would not have been
possiblewithoutdecadesofpriorworkbyothersonthecognitivetheory
and therapy of depression and on the behavioral conceptualization of
depressionandbehaviortherapy.Forthis,IammostgratefultoAaron
T. Beck and his colleagues, particularly Judith S. Beck, in developing
the theory and treatment principles that inspired me to modify cogni-
tive therapy for SAD and to Peter M. Lewisohn and his colleagues for
developingpleasanteventsschedulingasapotentbehavioraltreatment
strategy that has proven very useful for SAD. These treatment compo-
nentsrepresentmuchofthematerialcontainedwithinthismanual,and
theiroriginatorsdeservefullcreditforthem.Iwouldalsoliketothank
Alan Peterson for sharing his ideas on basic psychoeducation regard-
ing depression symptoms and relapse prevention. I am grateful to my
colleagues,DavidA.F.HaagaandTeodorT.Postolache,andtomyfor-
merclinicalgraduatestudentsandco-therapists,mostnotablyKathryn
A. Roecklein, Kathryn Tierney Lindsey, and Brenda Elliot, who pro-
videdhelpfulfeedbackonthecontentofthisprogramatthetimeitwas
initially being conceptualized and tested. Thanks also to the National
Institute of Mental Health (NIMH) and to the USUHS for funding
theclinicaltrialsthathavetestedthisprotocoltodate.
ix