Depression

Cognitive Distortions – Unhelpful Thinking Styles (Extended)
Cognitive Distortions – Unhelpful Thinking Styles (Common)
Assertive Communication
Audio Collection: Psychology Tools For Developing Self-Compassion
Embracing Uncertainty
Therapy Blueprint (Universal)
Thought Record (Evidence For And Against)
Audio Collection: Psychology Tools For Mindfulness
Intolerance Of Uncertainty
Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition): Client Workbook
Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition): Therapist Guide
Assertive Responses
Activity Menu
Unhelpful Thinking Styles (Archived)
Behavioral Activation Activity Diary
Emotions Motivate Actions
Self-Blame
Using Behavioral Activation To Overcome Depression
Behavioral Experiment
Compassionate Thought Challenging Record
Behavioral Experiment (Portrait Format)
Overcoming Depression (Second Edition): Workbook
What Keeps Depression Going?
Evaluating Unhelpful Automatic Thoughts
Abandonment
What Is Rumination?
Behavioral Activation Activity Planning Diary
Unrelenting Standards
Insufficient Self-Control
Activity Planning
Thought Record (Considered Response)
Self-Sacrifice
Managing Bipolar Disorder: Workbook
Changing Avoidance (Behavioral Activation)
Social Comparison
Brief Behavioral Therapy For Anxiety And Depression In Youth: Therapist Guide
Thoughts And Depression
Self Critical Thought Challenging Record
Thought-Action Fusion
Brief Behavioral Therapy For Anxiety And Depression In Youth: Workbook
Emotional Deprivation
"Should" Statements
Understanding Depression
Values: Connecting To What Matters
Core Belief Magnet Metaphor
Valued Domains
Self-Monitoring Record (Universal)
Activity Diary (Hourly Time Intervals)
Choosing Your Values
Negative Thoughts - Self-Monitoring Record
Interpersonal Beliefs And Styles
Thought Record – Courtroom Trial
Managing Bipolar Disorder: Therapist Guide
Emotional Inhibition
CBT Appraisal Model
Cognitive Behavioral Model Of Intolerance Of Uncertainty And Generalized Anxiety Disorder Symptoms (Hebert, Dugas, 2019)
Vulnerability To Harm
Body Scan (Audio)
Mistrust/Abuse
Uncertainty Beliefs – Experiment Record
[Free Guide] An Introduction To Values
Attention Training Practice Record
Boundaries - Self-Monitoring Record
Failure To Achieve
Defectiveness
Exploring Valued Domains
Discounting In Perfectionism – The Ratchet Effect
Intrusive Memory Record
Enmeshment
Emotional Reasoning
Approval-/Admiration-Seeking
Scaling - Testing Your Assumptions
Catching Your Thoughts (CYP)
ABC Model
Subjugation
What Is Imagery Rescripting?
Depression - Self-Monitoring Record
Schema Bias
Disqualifying The Positive
Hindsight Bias
Developing Psychological Flexibility
All-Or-Nothing Thinking
Dependence / Incompetence
Mindfulness Of Breath (Short Version) (Audio)
A Guide To Emotions (Psychology Tools For Living Well)
What Is Burnout?
Demanding Standards – Living Well With Your Personal Rules
Rumination - Self-Monitoring Record
Punitiveness
Pessimism
CBT Daily Activity Diary With Enjoyment And Mastery Ratings
Entitlement
Externalizing
Functional Analysis With Intervention Planning
Overcoming Depression (Second Edition): Therapist Guide
Being With Difficulty (Audio)
Dysfunctional Thought Record
Avoidance Hierarchy (Archived)
Mind Reading
Personalizing
Links to external resources
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Assessment
- Valued Living Questionnaire (Version 2) | Wilson, Groom | 2002
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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.
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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.
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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.
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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.
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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
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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
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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
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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
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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
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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.