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Depression

Depression is characterized by an extended period of low mood, anhedonia, and reduction in activity. Dysthymia (persistent depressive disorder) is characterized by a depressed mood that occurs for most of the day, more days than not, and has been present for at least two years. Depression is a heterogeneous condition with many different triggers, presentations, and maintaining factors. Cognitive behavioral therapies (including acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), compassion focused therapy (CFT), and dialectical behavior therapy (DBT)) are effective evidence-based treatment for depression, and mindfulness-based cognitive therapy (MBCT) is an effective intervention for preventing the recurrence of depression. Read more
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Activity Menu for behavioral activation

Activity Menu

Helping clients to choose which activities to target during behavioral activation can be accomplished in a variety of ways: activity monitoring can b ... https://www.psychologytools.com/resource/activity-menu/

Information Handout

Mindful Attention Audio Exercise

Mindful Attention (Audio)

Mindful Attention is a technique for becoming aware of one’s thoughts and experiences, and being able to observe these as transient mental events. ... https://www.psychologytools.com/resource/mindful-attention-audio/

Audio

A Guide To Emotions (Psychology Tools For Living Well)

Cognitive behavioral therapy can help your clients to live happier and more fulfilling lives. Psychology Tools for Living Well is a self-help course ... https://www.psychologytools.com/resource/a-guide-to-emotions-psychology-tools-for-living-well/

Chapter

Activity Diary

Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ... https://www.psychologytools.com/resource/activity-diary/

Worksheet

Activity Diary (No Time Slots)

Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ... https://www.psychologytools.com/resource/activity-diary-no-times/

Worksheet

Activity Planning

Research suggests that an activity is more likely to be completed if it is planned and scheduled in advance. The Activity Planning worksheet can be us ... https://www.psychologytools.com/resource/activity-planning/

Worksheet

Activity Selection

Activity selection is a tool for rating the difficulty of different activities. It is a helpful tool when clients have difficulty choosing between act ... https://www.psychologytools.com/resource/activity-selection/

Exercise

Assertive Communication

Communicating assertively is an essential skill for maintaining healthy self-esteem and strong relationships. This information handout describes the k ... https://www.psychologytools.com/resource/assertive-communication/

Information Handout

Assertive Responses

Communicating assertively is an essential skill for maintaining healthy self-esteem and strong relationships. The Assertive Responses exercise helps c ... https://www.psychologytools.com/resource/assertive-responses/

Exercise

Avoidance Hierarchy

Avoidance and safety-seeking behavior serves to maintain anxiety, and exposure to the fear stimuli/situation is an effective treatment for anxiety. Th ... https://www.psychologytools.com/resource/avoidance-hierarchy/

Exercise

Behavioral Experiment (Portrait Format)

Behavioral experiments allow individuals to test the validity of their beliefs and assumptions. They are a core experiential technique for therapeutic ... https://www.psychologytools.com/resource/behavioral-experiment-portrait-format/

Worksheet

CBT Appraisal Model

The CBT Appraisal Model worksheet is a transdiagnostic formulation tool. The centrality of appraisals underpins all of the disorder-specific cognitive ... https://www.psychologytools.com/resource/cbt-appraisal-model/

Worksheet

CBT Daily Activity Diary

Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ... https://www.psychologytools.com/resource/cbt-daily-activity-diary/

Worksheet

CBT Daily Activity Diary With Enjoyment And Mastery Ratings

Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ... https://www.psychologytools.com/resource/cbt-daily-activity-diary-e-m/

Worksheet

CBT Daily Activity Diary With No Time Slots

Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ... https://www.psychologytools.com/resource/cbt-daily-activity-diary-no-times/

Worksheet

CBT Thought Record

The CBT Thought Record is an essential tool in cognitive behavioral therapy. Thought challenging records help people to evaluate their negative automa ... https://www.psychologytools.com/resource/cbt-thought-record/

Worksheet

Challenging Your Negative Thinking

Challenging Your Negative Thinking

A cornerstone of cognitive behavioral therapy is that an individual’s interpretation of an event determines how they feel and behave. We all experie ... https://www.psychologytools.com/resource/challenging-your-negative-thinking/

Guide

Cognitive Case Formulation

A CBT case conceptualization tool to help therapists derive core beliefs from an analysis of current events. ... https://www.psychologytools.com/resource/cognitive-case-formulation/

Worksheet

Compassionate Thought Challenging Record

Thought challenging records are commonly used in CBT to help people to evaluate their negative automatic thoughts for accuracy and bias. This Compassi ... https://www.psychologytools.com/resource/compassionate-thought-challenging-record/

Worksheet

Core Belief Magnet Metaphor

Core beliefs (schemas) are self-sustaining. They act to ‘attract’ confirmatory evidence and ‘repel’ (or distort) disconfirmato ... https://www.psychologytools.com/resource/core-belief-magnet-metaphor/

Information Handout

Daily Monitoring Form

Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ... https://www.psychologytools.com/resource/daily-monitoring-form/

Worksheet

Daily Record of Dysfunctional Thoughts

Thought challenging records are commonly used in CBT to help people to evaluate their negative automatic thoughts for accuracy and bias. The Daily Rec ... https://www.psychologytools.com/resource/daily-record-of-dysfunctional-thoughts/

Worksheet

Developing Psychological Flexibility

Developing Psychological Flexibility is a client information handout which can be used to familiarize clients with the ACT model. ... https://www.psychologytools.com/resource/developing-psychological-flexibility/

Information Handout

Dysfunctional Thought Record

The Dysfunctional Thought Record is a Rational Emotive Behavior Therapy (REBT) tool to record and challenge dysfunctional thoughts. ... https://www.psychologytools.com/resource/dysfunctional-thought-record/

Worksheet

Emotions Motivate Actions

Many clients find it helpful to recognize the range of actions that are motivated by different emotional states. This worksheet encourages clients to ... https://www.psychologytools.com/resource/emotions-motivate-actions/

Information Handout

Information handout on exercise for mental health

Exercise For Mental Health

Exercise is an evidence-based treatment for depression and anxiety and research suggests that, in the treatment of depression, exercise interventions ... https://www.psychologytools.com/resource/exercise-for-mental-health/

Information Handout

Functional Analysis

Functional analysis examines the causes and consequences of behavior. This classic A-B-C Functional Analysis worksheet can be used to collect informat ... https://www.psychologytools.com/resource/functional-analysis/

Worksheet

Functional Analysis With Intervention Planning

This classic A-B-C functional analysis worksheet can be used to collect information about what came before a behavior (antecedents), the behavior itse ... https://www.psychologytools.com/resource/functional-analysis-with-intervention-planning/

Worksheet

Gratitude Journal

Cultivating gratitude is an evidence-based positive psychology technique. This information handout describes reasons to cultivate a grateful attitude ... https://www.psychologytools.com/resource/gratitude-journal/

Exercise

Intrusive Memory Record

Intrusive (unwanted, involuntary) memories are a common feature of PTSD, but also depression and other conditions. This Intrusive Memory Record is des ... https://www.psychologytools.com/resource/intrusive-memory-record/

Worksheet

Mastery And Pleasure Activity Diary

Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ... https://www.psychologytools.com/resource/mastery-and-pleasure-activity-diary/

Worksheet

Motivational Systems (Emotional Regulation Systems)

At the heart of Compassion Focused Therapy (CFT) is an evolutionary model of human motivational systems. Developed by Paul Gilbert it is a helpful len ... https://www.psychologytools.com/resource/motivational-systems-emotional-regulation-systems/

Information Handout

Problem Solving

Problem Solving is a structured worksheet which encourages solution-focused thinking. Clients are encouraged to identify a problem, identify multiple ... https://www.psychologytools.com/resource/problem-solving/

Exercise

Problem Solving CBT Worksheet

Problem Solving (CYP)

Effective problem solving is an essential life skill and this Problem Solving worksheet is designed to guide children and adolescents through steps wh ... https://www.psychologytools.com/resource/problem-solving-cyp/

Worksheet

Psychology Tools For Living Well

Psychology Tools For Living Well

Cognitive behavioral therapy can help your clients to live happier and more fulfilling lives. Psychology Tools for Living Well is a self-help course ... https://www.psychologytools.com/resource/psychology-tools-for-living-well/

eBook

Recognizing Depression

Depression is characterized by an extended period of low mood, anhedonia, and reduction in activity. Recognizing Depression compares the DSM-5 and IC ... https://www.psychologytools.com/resource/recognizing-depression/

Information Handout

Recognizing Persistent Depressive Disorder (Dysthymia)

Dysthymia is characterized by a depressed mood that occurs for most of the day, more days than not, and has been present for at least two years. It is ... https://www.psychologytools.com/resource/recognizing-persistent-depressive-disorder-dysthymia/

Information Handout

Rumination Diary

Self-monitoring of thoughts, feelings, and symptoms is an essential skill in cognitive behavioral therapy (CBT). The Rumination Diary helps clients to ... https://www.psychologytools.com/resource/rumination-diary/

Worksheet

Rumination Self-Monitoring Record

Rumination-Focused CBT (RF-CBT) takes a functional-analytic approach to rumination and aims to help depressed clients to identify the contexts in whic ... https://www.psychologytools.com/resource/rumination-self-monitoring-record/

Worksheet

Self Critical Thought Challenging Record

Disputing thoughts is a critical skill in cognitive therapy. The Self-Critical Thought Challenging Record helps clients to identify and challenge thei ... https://www.psychologytools.com/resource/self-critical-thought-challenging-record/

Worksheet

Self Critical Thought Monitoring Record

Self-monitoring of thoughts, feelings, and symptoms is an essential skill in cognitive behavioural therapy (CBT). This Self-Critical Thought Monitorin ... https://www.psychologytools.com/resource/self-critical-thought-monitoring-record/

Worksheet

Self Criticism Self Monitoring Record

Self-monitoring of thoughts, feelings, and symptoms is an essential skill in cognitive behavioural therapy (CBT). This Self-Criticism Self-Monitoring ... https://www.psychologytools.com/resource/self-criticism-self-monitoring-record/

Worksheet

Task Planning And Achievement Record

The Task Planning and Achievement Record can be used to plan daily tasks and record goal attainment. It is most suited for encouraging frequent or rep ... https://www.psychologytools.com/resource/task-planning-and-achievement-record/

Worksheet

Therapy Blueprint

Since the publication of this version of the therapy blueprint we have also developed a more sophisticated version: Therapy Blueprint (Universal) A th ... https://www.psychologytools.com/resource/therapy-blueprint/

Exercise

Things To Do List

The Things To Do List is a form of activity record. It encourages the client to think about the priority of each item and to record (and celebrate!) c ... https://www.psychologytools.com/resource/things-to-do-list/

Worksheet

Thought Challenging Record 7 Column

The thought record is an essential tool in cognitive behavioral therapy (CBT). Thought challenging records help people to evaluate their negative auto ... https://www.psychologytools.com/resource/thought-challenging-record-7-column/

Worksheet

Thoughts And Depression

Depression is associated with cognitive biases, one of which is a failure to notice positive information. This information handout presents this conce ... https://www.psychologytools.com/resource/thoughts-and-depression/

Information Handout

Transdiagnostic Processes CBT Worksheet

Transdiagnostic Processes

A ‘transdiagnostic process’ is the label given to a mechanism which is present across disorders and which is either a risk or maintaining factor f ... https://www.psychologytools.com/resource/transdiagnostic-processes/

Information Handout

TRAP TRAC

TRAP & TRAC worksheets can be usefully used as part of a behavioral activation programme as a way of overcoming responses which result in avoidanc ... https://www.psychologytools.com/resource/trap-trac/

Exercise

Unhelpful Thinking Styles

Human thinking is subject to a number of characteristic biases. Cognitive restructuring is the process of helping individuals to overcome their biases ... https://www.psychologytools.com/resource/unhelpful-thinking-styles/

Information Handout

Information handout concerning what exercise does for the mind and body

What Does Exercise Do For the Mind And Body?

Exercise is an evidence-based treatment for depression and anxiety and research suggests that in the treatment of depression exercise interventions le ... https://www.psychologytools.com/resource/what-does-exercise-do-for-the-mind-and-body/

Information Handout

What Is Imagery Rescripting?

Unwanted images are a feature common to a variety of problems including PTSD and depression. Imagery rescripting is an evidence-based treatment techni ... https://www.psychologytools.com/resource/what-is-imagery-rescripting/

Information Handout

What Is Rumination?

Rumination and repetitive thought is a transdiagnostic maintenance process underpinning a range of difficulties. This information sheet explores the c ... https://www.psychologytools.com/resource/what-is-rumination/

Information Handout

Assessment

Case Conceptualization

Intervention

Treatment guidelines

CBT treatment manuals

Behavioural activation (BA & BATD)

Suicide & self-harm

Information Handouts

Worksheets

Self-Help Programmes

Behavioral activation for depression

Overcoming your depression

Antidepressant skills workbook

Antidepressant skills workbook (2nd edition) | Blisker & Paterson download archived copy

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:

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.

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