Beck Ch 7 Flashcards
Why is activity scheduling important in the treatment of depression?
Because depression leads to decreased activities and avoidance, which maintains low mood.
Clients often think they can’t change how they feel.
Helping clients become more active and giving themselves credit for their effort improves mood and increases self-efficacy
When do you typically start activity scheduling?
Early on - in the first or second therapy session.
Describe the cognitive model of inactivity?
What are two common conceptualizations in treating depression?
Conceptualization of inactivity
Conceptualization of lack of mastery or pleasure
What are some options for monitoring activities? Which does the author prefer?
- Can use an activity chart where you ask the client to indicate the activities they do each hour and rate their levels of mastery or pleasure
- But not all clients are willing to do this, author prefers asking clients to describe their activities on a typical day
What are the steps in activity scheduling with clients (7)
- Determine what the client’s typical day looks like with a focus on activities they are avoiding/might help
- Explain rationale for activity scheduling
- Set an action plan, make sure it is specific and achievable
- Explain that it might help right away but it might not
- Elicit the rationale for activity scheduling from client (why it would be good to do this)
- Identify what might get in the way of the action plan (including automatic thoughts)
- Have client write down the action plan, why it is important to them, possible obstacles, how likely they are to complete it
Explain the rationale for activity scheduling
- First, research show that an essential part of getting over depression is becoming more active. Second, it doesn’t sound as if there’s much you’re currently able to do that brings you much pleasure or helps you feel competent and effective and in control. Is that right?
- You know, most people who are depressed think they’ll feel better if they stay in bed. Can I ask you this? Haven’t you already done the experiment of staying in bed, actually for months and months? Has it helped you recover from your depression? [refer- ring to Maria’s aspirations] Has it helped you get to where you want to be in life—having more friends, working and earning money, having a better apartment, finding a romantic relation- ship . . . ?
When clients are resistant to activity scheduling what is an approach that you can take?
- Re-explain rationale
- Ask if they want to start with something meaningful or easy
- Help by proposing categories
- Make a chart of things that make them feel better and things that make them feel worse
- Ask if they would do it as an “experiment”
What are some good categories of activities to propose (4)?
- Self-care (showering, getting dressed, eating well, exercise)
- Connecting with people
- Managing better at home.
- Recreation or entertainment
How can you explain to a client who is skeptical of activity scheduling because their life has big problems and they don’t see how these small things will help?
- I probably should have explained some more. You’re absolutely right. You have big problems that you need help in solving. But here’s what I’ve found. When people are as depressed as you are, trying to solve really big problems becomes overwhelming. That’s why it’s better to start with small things and build up your confidence by showing you that you can take control of parts of your life and that you can be effective. That’s why the small steps are important.
Why is asking clients to do ratings immediately after an activity (or at regular intervals throughout the day) important?
When people are depressed, their memories are often more negative than their actual experience. They may believe that an entire day or week was bad. Doing ratings immediately after an activity (or at lunch, dinner, and bedtime) helps them recognize the parts that were better
f you don’t know which activities to suggest to clients, what should you do?
Review their typical day and then ask the following questions
Given my client’s aspirations
Which activities is my client doing too much of?
Which are they doing too little of or avoiding
Do they have a good balance of mastery, pleasure, self-care, and social experiences?
What can they do that will be meaningful and lead to positive emotion, connection and empowerment?
What can they do that will help them draw positive conclusions about themselves?
And: Which new activities is the client most likely to engage in?
Why can it be helpful to get clients to predict their levels of mastery and pleasure and connection OR overall mood on an activity chart and then record the actual ratings?
If the client finds that their predictions are inaccurate, they usually become more motivated
If their predictions are accurate, you can ask questions to conceptualize the problem and then do problem solving and respond to unhelpful thinking
