Self-Control Therapy

Description of the Strategy

Self-control therapies are strategies for teaching people skills and techniques for controlling their own behavior when striving to achieve long-term goals. It is usually assumed that people employ self-control strategies implicitly in their efforts to change behavior, such as when starting a diet or exercise program or attempting to quit smoking. Self-control therapies attempt to teach these strategies in an explicit way. A number of self-control models are used as the basis for self-control theories. One example is the selfmanagement therapy (SMT) program for depression developed by the author.

SMT is a structured, manualized, cognitive-behavioral group therapy program for the treatment of depression. The program is currently presented in 14 weekly, 1 1/2-hour sessions. Each session includes a didactic portion, a discussion period, in-session paper-and-pencil exercises, and weekly homework assignments that are reviewed at the beginning of the next session. It is an illustration of self-control therapies in that it is “transparent” to the participants. They are told the targets of the intervention; they are instructed in applying the intervention on their own; and the theoretical rationale for the intervention is explicitly presented. Participants are consciously applying psychological principles to change their own behavior.

SMT can be thought of in three ways. First, it is targeting specific components of depression and teaching the participants self-change techniques for modifying each target behavior. Second, it can be thought of as teaching principles of self-change in the context of depression. Third, it can be seen as teaching behaviors that are the opposite of depression (i.e., positive selfesteem and self-control behaviors). People with positive self-esteem are people who accurately view their world, have a realistic sense of their abilities, set reasonable standards and goals, and are able to control their behavior with feedback to themselves.

The first session of the SMT program serves to introduce the participants to one another and to the program. The nature of depression is described and related to the symptoms presented by the participants. A brief overall description and rationale for the program are presented by the therapist. Homework for this first session involves keeping track of daily mood [Page 513]by rating average mood for each day on a scale of zero to 10, where zero is the worst, most depressed day ever and 10 is the happiest day ever. The purpose of the assignment is to focus on daily variations in mood and to get participants used to the mood scale.

In the second session, homework is reviewed with emphasis on participants' observations on their mood variability during the week and any correlates of their moods that they might have observed (e.g., felt better on days when they were busy). The didactic presentation in this session conveys a central premise of the program. The program asserts that mood is influenced by behavior and cognition (i.e., activities that people engage in daily and the “self-statements” they make to themselves about what they do). While the relationship may go both ways, the program assumes that depressed participants can change their daily moods and thus their depression by changing activities and self-statements. In various ways, the rest of the program involves strategies for increasing positive activities and positive self-statements. The homework assignment is to continue monitoring mood and, in addition, to list positive activities and self-statements each day. This self-monitoring assignment is continued throughout the program, with a variation in focus with each new topic.

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