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cognitive behaviour therapy for depression in young people manual for therapists date february 2010 version 1 0 author s impact study cbt sub group change summary initial draft version impact ...

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             COGNITIVE BEHAVIOUR THERAPY FOR 
                DEPRESSION IN YOUNG PEOPLE 
                  MANUAL FOR THERAPISTS 
        
        
                  Date:  February 2010 
                Version:  1.0 
              Author(s):  IMPACT Study CBT Sub-Group 
                        
         Change summary:  Initial (DRAFT) version  
                      
        
        
        
        
        
        
        
        
        
        
                                             IMPACT Trial Office 
                                           Developmental Psychiatry 
                                               Douglas House 
                                            18b Trumpington Road 
                                                 Cambridge 
                                                  CB2 8AH 
                                                      	
                                                      	
                                                      	
        
        
            COPYRIGHT ©: Not to be copied or distributed without the Lead Author’s 
                    permission, on behalf of the IMPACT Group 
                                                                                                                 DRAFT  Feb 2010 Version 1 
                                                                         CONTENTS 
                    
                   INTRODUCTION .................................................................................................................. 4        Ian M Goodyer 31/5/2016 19:48
                                                                                                                                                            Deleted: 13
                   COGNITIVE BEHAVIOURAL THERAPY AND DEPRESSION IN ADOLESCENCE ............................. 4                                              Ian M Goodyer 31/5/2016 19:48
                             What is depression? .................................................................................................. 5       Deleted: 14
                             What is Cognitive Behaviour Therapy? ........................................................................ 5                Ian M Goodyer 31/5/2016 19:48
                             Is CBT an effective treatment for young people with depression? ................................. 6                            Deleted: 14
                             The IMPACT Trial ...................................................................................................... 7      Ian M Goodyer 31/5/2016 19:48
                                                                                                                                                            Deleted: 18
                                                                                                                                                            Ian M Goodyer 31/5/2016 19:48
                   PART 1 A Cognitive Behavioural Understanding of Depression ................................................. 9                           Deleted: 21
                             The basis of Cognitive Behavioural Therapy ................................................................ 9                  Ian M Goodyer 31/5/2016 19:48
                                       1:  The collaborative relationship ................................................................... 10            Deleted: 25
                                       Collaborative empiricism ............................................................................... 11          Ian M Goodyer 31/5/2016 19:48
                             2:  Behavioural theories of depression ...................................................................... 12               Deleted: 25
                                       TOM   ........................................................................................................ 15    Ian M Goodyer 31/5/2016 19:48
                                       How does a behavioural model of depression apply to Tom? ........................... 16                              Deleted: 25
                                       Including parents and carers in behavioural work ........................................... 19                      Ian M Goodyer 31/5/2016 19:48
                             3:  Cognitive behavioural theories of depression ........................................................ 20                   Deleted: 27
                                       SOPHIE ....................................................................................................... 21    Ian M Goodyer 31/5/2016 19:48
                                       How does CBT apply to Sophie? .................................................................... 22                Deleted: 27
                                       Formation of dysfunctional assumptions ........................................................ 26                   Ian M Goodyer 31/5/2016 19:48
                                                                                                                                                            Deleted: 27
                                       Critical incidents ........................................................................................... 26    Ian M Goodyer 31/5/2016 19:48
                                       Activation of assumptions ............................................................................. 26           Deleted: 27
                             4.  Using CBT to help Sophie feel less depressed ....................................................... 26                    Ian M Goodyer 31/5/2016 19:48
                                       The formulation in CBT ................................................................................. 26          Deleted: 28
                                       Formation of (dysfunctional)assumptions ....................................................... 28                   Ian M Goodyer 31/5/2016 19:48
                                       Critical incidents ........................................................................................... 28    Deleted: 28
                                       Activation of assumptions ............................................................................. 28           Ian M Goodyer 31/5/2016 19:48
                                       Formulation diagrams ................................................................................... 28          Deleted: 29
                                       Using the formulation to guide clinical work ................................................... 29                  Ian M Goodyer 31/5/2016 19:48
                                       Psycho-education with young people ............................................................. 29                  Deleted: 29
                                       Identifying vicious cycles .............................................................................. 30         Ian M Goodyer 31/5/2016 19:48
                                       Behavioural experiments ............................................................................... 30           Deleted: 29
                                       Monitoring moods and feelings ...................................................................... 30              Ian M Goodyer 31/5/2016 19:48
                                       Identifying negative automatic thoughts (NATs) ............................................. 31                      Deleted: 30
                                       Challenging negative automatic thoughts ....................................................... 32                   Ian M Goodyer 31/5/2016 19:48
                                       Learning new skills ....................................................................................... 33       Deleted: 31
                                       Identifying assumptions ................................................................................ 34          Ian M Goodyer 31/5/2016 19:48
                                       Cognitive restructuring ................................................................................. 35         Deleted: 32
                             5.  Including parents and carers in CBT .................................................................... 36                Ian M Goodyer 31/5/2016 19:48
                                       Involving parents in the assessment .............................................................. 36                Deleted: 33
                                       Including parents in the formulation .............................................................. 36               Ian M Goodyer 31/5/2016 19:48
                                       Working with parents to support individual CBT .............................................. 37                     Deleted: 34
                                       The parental role during therapy ................................................................... 39              Ian M Goodyer 31/5/2016 19:48
                                       Opportunities to involve parents in therapy .................................................... 39                  Deleted: 38
                             6.   Adapting CBT for young people .......................................................................... 40               Ian M Goodyer 31/5/2016 19:48
                                       Key developmental processes ....................................................................... 41               Deleted: 41
                             7.  How to adapt CBT for young people .................................................................... 44                  Ian M Goodyer 31/5/2016 19:48
                                                                                                                                                            Deleted: 45
                                                                                  2 
                    
                                                                                                                DRAFT  Feb 2010 Version 1 
                                                                                                                                                          Ian M Goodyer 31/5/2016 19:48
                   PART 2: THE INTERVENTION ............................................................................................. 48              Deleted: 49
                             1.  Basic skills that all CBT therapists need ................................................................ 48 
                             2.  Core features of CBT .......................................................................................... 49       Ian M Goodyer 31/5/2016 19:48
                             3.  Characteristics of CBT therapy ............................................................................ 50           Deleted: 49
                             4.  A typical CBT programme for a depressed young person ....................................... 52                          Ian M Goodyer 31/5/2016 19:48
                                                                                                                                                          Deleted: 50
                                                                                                                                                          Ian M Goodyer 31/5/2016 19:48
                   PART 3: APPENDICES FOR USE IN CBT FOR DEPRESSION ................................................... 58                                Deleted: 51
                             APPENDIX A Psycho-Education ................................................................................ 59              Ian M Goodyer 31/5/2016 19:48
                             APPENDIX B Engagement and goal setting ............................................................... 63                    Deleted: 53
                             APPENDIX C Emotional recognition .......................................................................... 67               Ian M Goodyer 31/5/2016 19:48
                             APPENDIX D Activity Schedule ................................................................................. 73            Deleted: 59
                             APPENDIX E Self-monitoring and detection of NATS .................................................. 79                       Ian M Goodyer 31/5/2016 19:48
                             APPENDIX F Challenging negtive thinking ................................................................. 86                 Deleted: 60
                             APPENDIX G Communication and interpersonal skills ................................................. 95                       Ian M Goodyer 31/5/2016 19:48
                             APPENDIX H Social problems ................................................................................. 100             Deleted: 64
                             _Toc255804043                                                                                                                Ian M Goodyer 31/5/2016 19:48
                             APPENDIX I Symptomatic interventions .................................................................. 106                  Deleted: 68
                             APPENDIX J Ending: Closure and therapy ............................................................... 115                   Ian M Goodyer 31/5/2016 19:48
                             REFERENCES ........................................................................................................ 120      Deleted: 74
                                                                                                                                                          Ian M Goodyer 31/5/2016 19:48
                                                                                                                                                          Deleted: 80
                   Acknowledgements:                                                                                                                      Ian M Goodyer 31/5/2016 19:48
                                                                                                                                                          Deleted: 87
                   This manual is developed from those used in the Manchester CBT trials. Thanks are due to                                               Ian M Goodyer 31/5/2016 19:48
                   workers involved with the original manuals including Alison Wood, the late Richard Harrington                                          Deleted: 96
                   and Julia Rogers.                                                                                                                      Ian M Goodyer 31/5/2016 19:48
                                                                                                                                                          Deleted: 101
                                                                                                                                                          Ian M Goodyer 31/5/2016 19:48
                                                                                                                                                          Deleted: 108
                                                                                                                                                          Ian M Goodyer 31/5/2016 19:48
                                                                                                                                                          Deleted: 117
                                                                                                                                                          Ian M Goodyer 31/5/2016 19:48
                                                                                                                                                          Deleted: 123
                                                                                 3 
                    
                                                                                                              DRAFT  Feb 2010 Version 1 
                                                                   INTRODUCTION 
                                                                                 
                    COGNITIVE BEHAVIOURAL THERAPY AND DEPRESSION IN ADOLESCENCE 
                   
                   
                  This manual aims to outline the main principles of Cognitive Behaviour Therapy (CBT) for 
                  depression,  to  describe  the  key  therapeutic  techniques  of  CBT,  and  to  provide  specific 
                  information about how these may be adapted or developed for use with young people.  The 
                  manual has been specifically developed for use by therapists who are taking part in the 
                  IMPACT Trial; Improving Mood with Psychodynamic and Cognitive Therapy.  However, the 
                  contents of the manual are intended to be of value to therapists working with young people 
                  within a range of contexts.   
                   
                  The manual assumes that CBT therapists have experience of working with young people and 
                  their families, have basic knowledge about developmental psychology and mental health, can 
                  build  and  maintain  a  therapeutic  relationship  with  young  people,  are  sensitive  to  power 
                  issues, boundaries and managing risk, and have a sound grounding of the  principles of CBT.  
                  We also assume that they receive regular CBT supervision and are working within the context 
                  of a multi-disciplinary team.   
                   
                  In  this  manual  we  provide  background  information  about  the  theory  behind  Cognitive 
                  Behavioural Therapy and background information about Depression and how it is experienced 
                  by young people.  However, most of this manual is about the nuts and bolts of doing CBT 
                  with young people.  It is this that we expect most therapists to use most often.  We would be 
                  grateful for your feedback and comments, as this manual is also a work in progress.  We 
                  hope it will be a useful resource for therapists, a useful source of reassurance when therapy 
                  is difficult, and a handy reminder of basic principles.   
                   
                                                                               4 
                   
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...Cognitive behaviour therapy for depression in young people manual therapists date february version author s impact study cbt sub group change summary initial draft trial office developmental psychiatry douglas house b trumpington road cambridge cb ah copyright not to be copied or distributed without the lead permission on behalf of feb contents introduction ian m goodyer deleted behavioural and adolescence what is an effective treatment with part a understanding basis collaborative relationship empiricism theories tom how does model apply including parents carers work sophie formation dysfunctional assumptions critical incidents activation using help feel less depressed formulation diagrams guide clinical psycho education identifying vicious cycles experiments monitoring moods feelings negative automatic thoughts nats challenging learning new skills restructuring involving assessment working support individual parental role during opportunities involve adapting...

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