Depression
Cognitive Distortions – Unhelpful Thinking Styles (Extended)
Unrelenting Standards
Vulnerability To Harm
Scaling - Testing Your Assumptions
Cognitive Distortions – Unhelpful Thinking Styles (Common)
Self-Sacrifice
Assertive Communication
Audio Collection: Psychology Tools For Developing Self-Compassion
Therapy Blueprint (Universal)
Thought Record (Evidence For And Against)
Embracing Uncertainty
Unhelpful Thinking Styles (Archived)
Intolerance Of Uncertainty
Assertive Responses
Activity Menu
Using Behavioral Activation To Overcome Depression
Emotions Motivate Actions
Behavioral Activation Activity Diary
Behavioral Experiment
Abandonment
Valued Domains
Behavioral Experiment (Portrait Format)
What Keeps Depression Going?
Compassionate Thought Challenging Record
Self-Blame
Evaluating Unhelpful Automatic Thoughts
Emotional Deprivation
Values: Connecting To What Matters
Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition): Therapist Guide
Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition): Client Workbook
What Is Rumination?
Choosing Your Values
Insufficient Self-Control
Exploring Valued Domains
Audio Collection: Psychology Tools For Mindfulness
[Free Guide] An Introduction To Values
Understanding Depression
Core Belief Magnet Metaphor
Activity Planning
Changing Avoidance (Behavioral Activation)
Defectiveness
Behavioral Activation Activity Planning Diary
Negative Thoughts - Self-Monitoring Record
Mistrust/Abuse
Overcoming Depression (Second Edition): Workbook
Subjugation
Activity Diary (Hourly Time Intervals)
Thought Record (Considered Response)
Social Comparison
Emotional Inhibition
Boundaries - Self-Monitoring Record
Thought Record – Courtroom Trial
Thought-Action Fusion
Failure To Achieve
Interpersonal Beliefs And Styles
Approval-/Admiration-Seeking
Thoughts And Depression
"Should" Statements
Self-Monitoring Record (Universal)
Emotional Reasoning
CBT Appraisal Model
Self Critical Thought Challenging Record
Pessimism
Cognitive Behavioral Model Of Intolerance Of Uncertainty And Generalized Anxiety Disorder Symptoms (Hebert, Dugas, 2019)
Uncertainty Beliefs – Experiment Record
Dependence / Incompetence
All-Or-Nothing Thinking
Schema Bias
Rumination - Self-Monitoring Record
ABC Model
Enmeshment
Demanding Standards – Living Well With Your Personal Rules
Punitiveness
Catching Your Thoughts (CYP)
Overcoming Depression (Second Edition): Therapist Guide
Depression - Self-Monitoring Record
Developing Psychological Flexibility
Intrusive Memory Record
Body Scan (Audio)
Entitlement
Discounting In Perfectionism – The Ratchet Effect
What Is Imagery Rescripting?
A Guide To Emotions (Psychology Tools For Living Well)
Attention Training Practice Record
Functional Analysis With Intervention Planning
Hindsight Bias
What Is Burnout?
CBT Daily Activity Diary With Enjoyment And Mastery Ratings
Challenging Your Negative Thinking (Archived)
What Do People Think About Themselves (CYP)?
Disqualifying The Positive
Activity Diary (No Time Intervals)
Dysfunctional Thought Record
Mind Reading
Externalizing
Avoidance Hierarchy (Archived)
Mindfulness Of Breath (Short Version) (Audio)
Court Trial Thought Challenging Record (Archived)
Being With Difficulty (Audio)
Activity Selection
Links to external resources
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Assessment
- Valued Living Questionnaire (Version 2) | Wilson, Groom | 2002
-
Ruminative responses scale
| Treynor, Gonzalez, Nolen-Hoeksema | 2003
- Scale
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Edinburgh Post Natal Depression Scale (EPDS)
| Cox, Holden, Sagovsky | 1987
- Scale
- Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. The British Journal of Psychiatry, 150(6), 782-786.
-
Hamilton Rating Scale For Depression (HAM-D)
| Hamilton | 1960
- Scale
- Hamilton M. (1960). A rating scale for depression. J Neurol Neurosurg Psychiatry, 23, 56–62.
-
Montgomery & Asberg Depression Rating Scale (MADRS)
| Montgomery, Asberg | 1979
- Scale
- MADRS Score Card
- Montgomery, S.A., Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134 (4): 382–89.
-
Patient Health Questionnaire 9 (PHQ-9)
| Kroenke, Spitzer | 2002
- Scale phqscreeners.com
- Kroenke, K., & Spitzer, R. L. (2002). The PHQ-9: a new depression diagnostic and severity measure. Psychiatric annals, 32(9), 509-515.
-
Severity Measure For Depression – Adult (Adapted from the Patient Health Questionnaire–9 (PHQ-9))
| APA (Spitzer, Williams, Kroenke and colleagues)
- Scale – Adult
- Scale – Child Age 11-17
-
Zung Self-Rating Depression Scale
| Zung | 1965
- Scale
- Reference Zung, W. W. (1965). A self-rating depression scale. Archives of General Psychiatry, 12(1), 63-70.
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Clinically Useful Depression Outcome Scale (CUDOS)
| Zimmerman, Chelminski, McGlinchey, Posternak | 2008
- Scale
- Zimmerman, M., Chelminski, I., McGlinchey, J. B., & Posternak, M. A. (2008). A clinically useful depression outcome scale. Comprehensive psychiatry, 49(2), 131-140.
Case Conceptualization / Case Formulation
- Cognitive conceptualisation (excerpt from Basics and Beyond) | J. Beck
- Developing and using a case formulation to guide cognitive behaviour therapy | Persons | 2015
Guides and workbooks
- Mood And Substance Use | NDARC: Mills, Marel, Baker, Teesson, Dore, Kay-Lambkin, Manns, Trimingham | 2011
- The Path to Positivity: Six Practical Sections for Becoming a More Positive Person | Caroline Lavelock, Everett Worthington | 2013
Information Handouts
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Depression (Information Handouts)
| Centre For Clinical Interventions
- What Is Depression?
- What Causes Depression?
- Psychotherapy for Depression
- Vicious Cycle of Depression
- Behavioural Activation: Fun and Achievement
- Fun Activities Catalogue
- Improving How You Feel
- Thinking and Feeling
- Analysing Your Thinking
- Changing Your Negative Thinking
- Unhelpful Thinking Styles
- What Are Core Beliefs?
- Problem Solving
- Staying Healthy
- Grief and Bereavement
Information (Professional)
- Get out of the TRAP and back on TRAC (for rumination and worry) | GoodMedicine
Self-Help Programmes
-
Behavioral Activation For Depression
| Southwark Psychological Therapies Service | 2012
- Introduction to BA for depression
- Monitoring Activity And Mood
- Roadmap: The Activation Plan
- Finding Direction: Values, Flow, And Strengths
- Avoidance And Depression TRAPs
- Thinking Habits
- Next Steps
-
Back from the Bluez (Workbook)
| Centre For Clinical Interventions | 2003
- Module 1: Overview of Depression
- Module 2: Behavioural Strategies for Managing Depression
- Module 3: The Thinking-Feeling Connection
- Module 4: The ABC Analysis
- Module 5: Unhelpful Thinking Styles
- Module 6: Detective Work and Disputation
- Module 7: The End Result
- Module 8: Core Beliefs
- Module 9: Self-Management
-
Back From The Bluez (Workbook)
| Centre For Clinical Interventions | 2003
- Module 1: Overview Of Depression
- Module 2: Behavioral Strategies For Managing Depression
- Module 3: The Thinking-Feeling Connection
- Module 4: The ABC Analysis
- Module 5: Unhelpful Thinking Styles
- Module 6: Detective Work And Disputation
- Module 7: The End Result
- Module 8: Core Beliefs
- Module 9: Self Management
Treatment Guide
- Metacognitive Training For Depression (D-MCT) Manual | Jelinek, Schneider, Hauschild, Moritz | 2023
- Suicide and self injury: a practitioners guide | Forensic Psychology Practice Ltd | 1999
- Depression In Adults: Treatment And Management (NICE Guideline) | NICE | 2022
- Behavioural activation treatment for depression (BATD) manual | Lejuez, Hopko & Hopko | 2001
-
Metacognitive Training For Depression
| Jelinek, Hauschildt, Moritz & Schneider | 2022
- Module 1: Thinking and reasoning 1
- Module 2: Memory
- Module 3: Thinking and reasoning 2
- Module 4: Self-worth
- Module 5: Thinking and reasoning 3
- Module 6: Behaviors and strategies
- Module 7: Thinking and reasoning 4
- Module 8: Perception of feelings
- Cognitive-behavioral therapy for depression in young people: a modular treatment manual | Orygen | 2015
- Depression In Adults: Recognition And Management | National Institute for Health and Care Excellence (NICE) guidelines | 2009
- Individual therapy manual for cognitive-behavioural treatment of depression | Ricardo Muñoz, Jeanne Miranda | 1996
- Manual for group cognitive-behavioral therapy of major depression: a reality management approach (Instructor’s manual) | Muñoz, Ippen, Rao, Le, Dwyer | 2000
- Cognitive-Behavioural Therapy (CBT) Group Program For Depression | Milner, Tischler, DeSena, Rimer
- Cognitive behaviour therapy for depression in young people: manual for therapists | Improving Mood with Psychoanalytic and Cognitive Therapies (IMPACT) Study CBT Sub-Group | 2010
- CBT For Depression In Veterans And Military Service Members – Therapist Manual | Wenzel, Brown, Carlin | 2011
- Group therapy manual for cognitive behavioral treatment of depression | Muñoz, Miranda | 1993
- Behavioural activation treatment for depression – revised (BATD-R) manual | Lejuez, Hopko, Acierno, Daughters, Pagoto | 2011
Worksheets
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Depression (Worksheets)
| Centre For Clinical Interventions
- Symptoms of Depression
- Behavioural Activation
- My Behavioural Antidepressants
- Weekly Activity Schedule
- Weekly Goals Record
- Making the Connection (Between Thoughts and Feelings)
- Thought Diary 1
- Thought Diary 2
- Thought Diary 3
- Thought Diary (Tri-fold)
- Core Beliefs Worksheet
- Healthy Me
- Goal Setting (End of Therapy)
Recommended Reading
- Behavioural activation treatment for depression: returning to contextual roots | Jacobson, Martell, Dimidjian | 2001
What Is Depression?
Signs and Symptoms of Depression
To meet DSM-5 diagnostic criteria for major depressive disorder an individual must have experienced five of the following symptoms for at least two weeks:
- a depressed mood that is present most of the day, nearly every day
- diminished interest in activities which were previously experienced as pleasurable
- fatigue or a loss of energy
- sleep disturbance (insomnia or hypersomnia)
- feelings of worthlessness, self-reproach, or excessive guilt
- a diminished ability to think or concentrate, or indecisiveness
- recurrent thoughts of death or suicide, or suicidal behavior
- changes in appetite marked by a corresponding weight change
- psychomotor agitation or retardation to a degree which is observable by others
Psychological Models and Theory of Depression
Beck’s cognitive theory of depression (Beck, Rush, Shaw, & Emery, 1979) forms the basis for cognitive behavioral approaches for the treatment of depression. Beck’s theory proposes that there are different levels of cognition that can be dysfunctional in depression: core beliefs, rules and assumptions, and negative automatic thoughts. CBT aims to balance negatively biased cognition with more rational and accurate thoughts, beliefs, and assumptions. CBT also systematically aims to increase levels of rewarding activity.
Acceptance and commitment therapy (ACT) proposes that distress, including symptoms of depression, are the result of psychological inflexibility (Hayes, Luoma, Bond, Masuda, & Lillis, 2006). Indicators of psychological inflexibility include:
- ‘buying in’ to negative thoughts and narratives;
- engaging in worry or rumination that takes us away from the present moment;
- losing contact with our values—what is important to us.
Evidence-Based Psychological Approaches for Working with Depression
Many psychological therapies have an evidence base for working with depression:
- Cognitive behavioral therapy (CBT)
- Behavioral activation (BA)
- Acceptance and commitment therapy (ACT)
- Mindfulness-based cognitive therapy (MBCT) for preventing relapse
- Interpersonal therapy (IPT)
Resources for Working with Depression
Psychology Tools resources available for working therapeutically with depression may include:
- psychological models of depression
- information handouts for depression
- exercises for depression
- CBT worksheets for depression
- self-help programs for depression
References
- Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.
- Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. BehaviourResearch and Therapy, 44(1), 1–25.