This book introduces an approach to CBT for depression that integrates cognitive-behavioural models, evidence and therapies. Rooted in evidence-based practice and practically focused, it draws on components of first, second and third-wave CBT to help readers tailor therapy to the needs of individual clients. There is a particular focus on challenging presentations: the authors equip students with the skills to work with different depression sub-types, co-morbid disorders and a broad range of bio-psychosocial factors that can complicate depression and its therapy. Linking theory, evidence and case illustrations, the authors provide a wealth of practical tips that support clinical practice. In-depth cases studies and client contributions add further depth to this rich and stimulating book. This book is relevant to those taking postgraduate training courses in mental health such as CBT therapists, counsellors, nurses, clinical psychologists, occupational therapists, social workers and psychiatrists.
Chronic and Persistent Depression
People with chronic and persistent depression form a heterogeneous group who have been in a major depressive episode for at least the past 2 years. As one might expect, when an individual has been in depression for a long period of time, it is much less likely that they will suddenly return to euthymic mood and normal functioning. Most people with chronic depression can recover, or at least make significant improvements, but as illustrated in Figure 9.1, the trajectory of change is usually slow, gradual and stepwise compared with non-chronic depression. This has implications for parameters such as the dose of treatment and frequency of therapy sessions (McCullough, 2003).