Bespoke Members
Introduction
Depression is among the most burdensome diseases worldwide due to a high prevalence and for many people a long course of illness with a multitude of relapses over the life-course. Since the advent of CBT approaches to treat depression in the 1970s there has been a huge amount of research in this area but treatment outcomes have remained relatively (and stubbornly) stable. However, there is great interest in contemporary approaches to improve outcomes with a number of highly promising studies in recent years building on CBT approaches by targeting reward sensitivity, anhedonia, rumination, and encompassing precision methods to support clinical decision making. In this workshop we will revisit the core elements of CBT for depression, discuss recent research findings that inform us about the risk of poor treatment outcomes and of relapse after treatment, and we will cover a number of techniques for addressing these factors which can support us to improve outcomes in our practice. We will then review recent treatment developments to consider the direction of travel in this field and how this might impact our work in clinic in the near future.
The event will be equivalent to 5.1/2 hrs of CPD.
Content
This workshop will outline strategies for improving outcomes in cognitive behavioural therapy for depression and reducing the risks of relapse after treatment. Workshop participants will revisit the fundamental techniques of CBT for depression, and using examples from clinical practice will consider when they might struggle to use these techniques effectively, with a particular focus on comorbidity, and interpersonal, social, and physical health difficulties. We will consider recent research findings on identifying individual’s risk of poor treatment outcomes and of relapse to expand our formulations and support decision making on what to target and how to intervene with our clients, not just what interventions to use. Participants will also learn how to use routine outcome measurement to improve treatment outcomes. We will discuss how to make use of routine outcome monitoring regardless of the clinical setting and to maximise the use of it at each stage of working with a client, at assessment, during early sessions when setting the tone for therapy, mid-treatment review sessions, towards the end of treatment, and at any follow-up or top-up sessions. With case examples and formulation of complex issues participants will also learn how to improve outcomes by “going deeper” in treatment, targeting interpersonal issues, and working with dysfunctional assumptions and core beliefs. The remainder of the workshop will focus on recent developments in the treatment of depression with CBT and augmented CBT approaches, precision methods in the treatment of depression and consider what this might mean for our practice at present and in the near future.
Learning Objectives
1. To ensure a solid foundation of the core techniques of CBT for depression.
2. Understanding the research literature on prognostic and prescriptive factors in depression, and on the use of routine outcome monitoring to improve treatment outcomes.
3. To be able to use individual formulations encompassing issues that are typically considered as related to “complexity” and identify strategies that might help address these issues in the therapy
4. To be able to use routine outcome monitoring to inform what we do at all stages of treatment and facilitate discussions to support joint clinician-client treatment decision making.
5. To consider ways of addressing deeper held beliefs and contextual issues that increase the risk for poor outcomes and of relapses post-treatment.
Training Modalities
Didactic content, presentation of case examples, polls, Q&A, and live role plays.
Key References
Buckman JEJ, Saunders R, Cohen ZD, et al. The contribution of depressive ‘disorder characteristics’ to determinations of prognosis for adults with depression: an individual patient data meta-analysis. Psychol Med 2021; 51: 1068–81.
Delgadillo J, de Jong K, Lucock M, et al. Feedback-informed treatment versus usual psychological treatment for depression and anxiety: a multisite, open-label, cluster randomised controlled trial. The Lancet Psychiatry 2018; 5: 564–72.
Dunn BD, Widnall E, Warbrick L, et al. Preliminary clinical and cost effectiveness of augmented depression therapy versus cognitive behavioural therapy for the treatment of anhedonic depression ( ADepT ): a single- centre, open-label, parallel-group, pilot, randomised, controlled trial. Lancet eClinicalMedicine 2023; 61: 1–15.
Craske MG, Meuret AE, Ritz T, Treanor M, Dour H, Rosenfield D. Positive affect treatment for depression and anxiety: A randomized clinical trial for a core feature of anhedonia. J Consult Clin Psychol 2019; 87: 457–71.
Buckman JEJ, Underwood A, Clarke K, et al. Risk factors for relapse and recurrence of depression in adults and how they operate: A four-phase systematic review and meta-synthesis. Clin Psychol Rev 2018; 64: 13–38.
Deisenhofer A, Barkham M, Beierl ET, et al. Implementing precision methods in personalizing psychological therapies: Barriers and possible ways forward. Behav Res Ther 2024; 172: 104443.
About the presenter
Dr Joshua Buckman is an Associate Professor of Clinical Psychology at University College London, the Clinical Director of the UCL University Clinic and the Co-Director of the CORE Data Lab at UCL within the Research Department of Clinical, Educational, and Health Psychology. He is an NHS Clinical Psychologist who has worked in NHS Talking Therapies for anxiety and depression (formerly Improving Access to Psychological Therapies) for the last 15 years. He specialises in the study and treatment of depression, with a particular focus on understanding prognosis, mitigating the risks of relapse and the use of big-data analytics to leverage precision medicine methods to improve treatment outcomes for people with depression. Dr Buckman has trained over 2000 clinicians in the use of CBT techniques to treat depression over the last 10 years and continues to work with colleagues across Europe in training programmes for psychological practitioners in a variety of settings.
Who should attend
This workshop is intended for a wide range of mental health professionals who work with adults with depression, including clinical and counselling psychologists, high intensity CBT practitioners, psychiatrists, and trainees enrolled in CBT or doctoral clinical or counselling psychology programs.