6. Working with People with Depression Flashcards
Do various therapeutic models come into conflict?
Usually complementary. But one will usually come to the forefront with others offering ad hoc insight. For revolving door clients, can consider different models if previous one not effective.
If child has not been formally assessed and there is no RTI, but have obvious delays in learning, what do you do?
- Recommend for the child to get assessed
- Collect detailed information for parents and psychologist. This is to rule out psychosocial factors and confirm that there is a learning disability.
What are some problems with administration of standardized psychological tests for children?
Can be quite long and tiring (up to 3h). Need to know the purpose of the assessment and meaning of the diagnosis for the child and the family. If assessment is just to soothe the parent’s anxiety, then maybe just need some systemic interventions will do.
How do you introduce psychological tests to children?
Introduce it as “puzzles and games” to assess the child’s strengths and weaknesses.
What does Mick Power argue about emotions?
Argue that all emotions have a function, whether good or bad. If any emotion is sidelined, it can have consequences for the individual.
What are the 3 categories of depression symptoms?
1) Biased thoughts
2) Emotions
3) Physical drives
What are some biased thoughts for people with depression? (3)
- thoughts of worthlessness
- difficulty thinking or concentrating
- suicidal thoughts, attempt or plan
What are some emotions that people with depression have? (3)
- feeling “down or depressed”
- loss of pleasure in activities (anhedonia)
- feelings of guilt
What are some physical drives of people with depression? (4)
- change in weight and appetite
- sleep problems
- visible restlessness or slowing down
- tiredness and loss of energy
What are the 7 theories of depression?
1) Learning view (learnt helplessness)
2) Attributional style theory
3) Cognitive theory (core beliefs and automatic thoughts)
4) Cognitive theory SPAARS (multiple routes)
5) Metacognitive Awareness (seeing thoughts as thoughts)
6) Ruminative response style
7) Memory specificity (overgeneral personal memories)
Describe the learning view of depression. (Martin Seligman)
Learnt helplessness
Dogs in cages who are unable to escape electric shocks. overtime, the dogs just lay there and did not escape even when given the opportunity to. demonstrates learned helplessness and how they feel they can’t do anything about it.
Describe the Attributional Style Theory of depression.
“It’s how you explain events to yourself”
- Refers to how you interpret and make meaning of events
- Attribution style as a vulnerability
- Internal + Stable + Pervasive = low self-esteem
- External + Stable + Pervasive = hopelessness
Describe cognitive theory in explaining depression.
Aaron Beck - “It’s all about the content of your thoughts!”
Core beliefs about the self, the world/others, and the future
Describe the SPAARS approach to cognitive theory with regard to explaining depression.
Mick Power - “There are multiple routes!”
(Event -> NAT -> Appraisal)
(eg. Fail exam -> I am never going to pass -> I am useless)
- Schematic: appraisal of negative automatic thought. Conscious.
- Associative: repeated appraisals become automatic and associative learning occurs. Begin to associate negative event with appraisal (skip NAT). Unconscious.
Keep going through the same schematic route over and over again until it becomes automatic and associative.
What does the metacognitive awareness view say about depression?
“It’s about poor ability to see thoughts as thoughts”
- argues that people lack the metacognitive ability to see thoughts objectively and get too caught up in their thoughts. Cannot remove themselves from their thoughts as their thoughts feel very real to them.
- “I am having a thought that I am useless” vs “I am useless”
What does the ruminative response style say about depression?
argues that depression is caused by repetitious and passive thinking about past action, negative emotions, and negative events.
What does the memory specificity view argue about the cause of depression?
Mark Williams - “It’s all about overgeneral autobiographical memories!”
- when depressed, working memory declines, and ability to think about the past reduces. Tend to think of the past in a biased way, and no working memory available to think about alternatives.
With regard to learnt helplessness and associative learning, what should we do in therapy?
Give clients new positive experiences to help them realise that not all hope is lost and develop a sense of control.
With regard to attentional bias, cognitive errors, and dysfunctional schema, what should we do in therapy?
Help clients develop new meaning about situations and identify logical errors.
With regard to rumination, what should we do in therapy?
- Help clients become aware that rumination is unhelpful and find alternatives.
- Set aside time for rumination and worrying (eg. 10 min) after that you stop worrying and get on with your life. your worries are captured somewhere at least.
With regard to poor metacognitive ability, what should we do?
Help clients distance themselves from negative thoughts. Mindfulness based intervention.
With regard to overgeneralised memories, what should we do?
- Explore positive memories that client has overlooked.
- Help them find other evidence that is inconsistent with current thoughts.
- Narrative therapy: tell a different story about their lives
How do you formulate a case using CBT for a person with depression?
Early experiences -> Core beliefs -> Intermediate beliefs (rules for life) -> Critical incidents/precipitating events -> Vicious cycle (automatic thoughts, feelings, behavior, consequences)
