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Cognitive Therapy Skills and Risk of Relapse
While we assume that the skills we teach to clients are an important part of the effectiveness of CT, relatively few studies have tested to see if this is indeed the case. In a recent study Strunk, et al. (2007) examined whether clients' competence in using CT skills and their independent use of the skills is related to the risk of relapse. They studies 35 moderately- to severely-depressed individuals who responded to CT. Both competence in CT skills and in-session evidence of independent use of CT skills predicted lower relapse rate. This effect was not accounted for by symptom severity, degree of symptom change over the course of treatment, or post-treatment self-esteem.
Strunk, D. R., DeRubeis, R. J., Chiu, A. W., & Alvarez, J. (2007). Patients' competence in and performance of cognitive therapy skills: Relation to the reduction of relapse risk following treatment for depression. Journal of Consulting and Clinical Psychology, 75, 523-530. |
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Re: Relapse and recurrent major depression
Quote:
Which is not to say that people who exercise and eat well don't get depression. But if you combine mood enhancing behaviors with CT, the results may a source of natural antidepressants and possibly eliminate the need for medication. Also, if exercise can be something fun rather than a chore, this is time spent doing something construcitive instead of time left open to ruminate about depressing things. I know this is all outside the CT box, but I truly believe that if clients want to get off meds they need to give diet and exercise a try. |
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Re: Relapse and recurrent major depression
Whether or not clients want to get off of medication, diet and exercise can be important. Certainly, if an individual is not eating a reasonably balanced diet, getting regular exercise, getting enough sleep, participating in rewarding relationships, and engaging in enjoyable activities, they are at increased risk for a variety of problems. Books on CT often don't emphasize this because authors assume it should be obvious and because it applies to all approaches to therapy, not just CT or CBT. This doesn't mean that CT doesn't address these issues, we address them routinely. For example, see judy Beck's recent books on diet.
Yesterday I had a session with a client complaining of tension, anxiety, and insomnia. He also mentioned drinking 40 oz/day of caffeinated soda. This obviously is something we need to address. |
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