This book uniquely combines CBT with the Department of Health stepped care model to provide the first comprehensive case study-approach textbook. A step-by-step guide to using CBT, the book is structured around case examples of clients who present with the most commonly encountered conditions; from mild depression and GAD to more complex, enduring symptoms and diagnosis like OCD, personality disorder and social phobia.

The distinctive practical format is ideal in showing how to put the principles of CBT and stepped care into effect. As well as echoing postgraduate level training, it provides an insight into the experiences the trainee will encounter in real-world practice. Each chapter addresses a specific client condition and covers initial referral, presentation and assessment, case formulation, treatment interventions, evaluation of CBT strategies and discharge planning.

The book also includes learning exercises and clinical hints, as well as extensive reference to further CBT research, resources and reading. It will be invaluable for trainees on Improving Access to Psychological Therapies (IAPT) programs, and anyone studying graduate CBT courses.

Client Presenting with First-Onset Depression

Client presenting with first-onset depression

Learning Objectives

By the end of this chapter you should be able to:

  • Identify depression using diagnostic criteria
  • Understand the development of depression
  • Discuss the assessment approaches and case formulation
  • Plan and implement the treatment interventions

Diagnostic Criteria

Depression is most commonly identified in clients reporting a change in mood and loss of interest and pleasure in daily activities. Depressive symptoms are varied and often have origins in past events – this chapter and the next discuss first-onset and chronic depression (dysthymia) using the DSM-IV-TR (APA, 2000), code 296.20 to 296.36 and ICD-10 (WHO, 2007), code F32– F33 criteria. Chronic physical disorders or primary psychiatric disorders are excluded as are symptoms that are clearly due to a general medical condition, mood-incongruent delusions or ...

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