Cognitive Therapy for Depression: Simple and Complex

Prof. Steve Hollon

Thursday, 3 March 2022

Introduction

It is important not to lose the capacity to produce rapid symptom change, while simultaneously responding to those patients who may require a more protracted and complex course of therapy. This workshop will help the beginning therapist master the essentials of cognitive therapy and aid the experienced therapist to integrate classic and newly developed strategies within a larger and more complex theoretical model. The presentation will integrate specific behavioral and cognitive strategies that form the core of the approach with more recent theoretical extensions developed to deal with long-standing personality disorders. Two cases (one simple, one complex) will be used to illustrate.


The event will be equivalent to 5.1/4hrs of CPD.

Content

The core of cognitive therapy is to help patients learn to recognize the role that their thoughts play in generating negative affect and maladaptive behaviours. Despite its name the approach is a cognitive behavioural intervention, and it is often the case that the best way to produce change in beliefs is by running behavioural experiments to test those beliefs. Attention also is paid to cognitive restructuring with patients taught to examine the evidence, generate alternative explanations and consider the real implications whenever they have an automatic negative thought. Patients also are trained to recognize the role that core beliefs and underlying assumptions play in generating their automatic negative thoughts in specific situation. Strategies are described for preventing subsequent relapse.

Learning Objectives

At the end of the session, attendees will be able to:
1. provide a conceptual framework relating thoughts, feelings, and behaviours
2. activate patients to engage in adaptive and problem-solving behaviours
3. recognise automatic negative thoughts and underlying beliefs
4. examine the accuracy of specific beliefs and underlying assumptions
5. address compensatory strategies that sabotage efforts to secure life goals

Training Modalities

The workshop will be interactive and include both experiential and didactic teaching and videos. Participants are encouraged to bring examples of clients with whom they are having difficulty and should mention at registration if willing to participate in live role-play with the speaker.

Key References

Beck, A.T., Rush, A.J., Shaw, B.F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.
Beck, A. T., Freeman, A., Davis, D. D., & Associates (2004). Cognitive therapy of personality disorders (2nd ed.). New York: Guilford Press.
DeRubeis, R. J., Hollon, S. D., Amsterdam, J. D., et al. (2005). Cognitive therapy vs. medications in the treatment of moderate to severe depression. Archives of General Psychiatry, 62, 409-416. http://doi:10.1001/archpsyc.62.4.409
Hollon, S. D. (2020). Is cognitive therapy enduring or antidepressant medications iatrogenic? Depression as an evolved adaptation. American Psychologist, 75(9), 1207-1218. http://dx.doi.org/10.1037/amp0000728
Hollon, S. D., DeRubeis, R. J., Shelton, R. C., et al. (2005). Prevention of relapse following cognitive therapy versus medications in moderate to severe depression. Archives of General Psychiatry, 62, 417-422. http://doi:10.1001/jamapsychiatry.2014.1054

About the presenter

Professor Hollon is an internationally recognized expert on the treatment of depression with a particular emphasis on its enduring effects. His primary interest lies in the etiology and treatment of depression in adults and his work extends from basic psychopathology to prevention and treatment. He is particularly interested in the relative contribution of cognitive and biological processes, and comparative efficacy of the cognitive and behavioural therapies versus pharmacological interventions. A current interest is the prevention of depression, both with respect to its initial onset and subsequent recurrence, and the possibility that depression is an evolved adaptation that serves a useful function. To the extent that that is true, then any intervention that facilitates the functions that depression evolved to serve (like the cognitive and behavioural interventions) is likely to be preferred over an intervention that merely anesthetize the distress (like medications).

Who should attend

The workshop is suitable for both the beginning cognitive therapist and experienced cognitive therapists including high intensity IAPT therapists. Integrative strategies are described that span the gamut from relatively straightforward clients who present few problems beyond depression to more complicated clients with multiple comorbidities including depressions superimposed on long-standing personality disorders.