Cognitive behavioural case formulation for complex and recurrent depression

Abstract

This chapter presents a cognitive maintenance model for chronic and recurrent depression. It aims to integrate the cognitive science of depression into the clinical cognitive therapy for depression. This is illustrated using a clinical example. As Moore and Garland observe, depression is a heterogeneous disorder and as such, a range of theoretical models framed within the broad umbrella of CBT treatments can be found in the literature. For the clinician this can prove challenging. Often, in the face of complexity and non-response to standard cognitive and behavioral interventions clinicians are prone to 'mix and match' interventions without consideration of a coherent theoretical rationale for so doing. Hence a popular approach to chronic and recurrent depression currently is an eclectic mix of 'behavioral activation', 'mindfulness' and 'compassion'-based interventions, with an apparent abandonment of potentially efficacious cognitive interventions. This eclecticism goes against the spirit of the scientist-practitioner model that lies at the heart of the behavioral and cognitive therapies. The scientist-practitioner model exhorts the clinician to develop competencies in generating, analyzing and applying research data and using this in the treatment of patients. Thus, scientific methods and research underpin clinical practice with the aim of using scientific methodology to inform clinical decision-making. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(chapter)