Cognitive-behavioral treatment of depression, part V: Enhancing self-esteem and self-control

Abstract

Cognitive-behavioral treatments for depression have included attempts to improve social functioning, reduce cognitive biases, and improve interpersonal problem-solving skills. However, many depressed clients report problems caused by low self-esteem. The present manuscript describes a cognitive-behavioral approach to improving self-esteem in depressed clients. Psychosocial exploration can be used to gather detailed information about the client's view of self, and help both therapist and client understand the various components of self-esteem. Then, adaptive change can be structured around four general issues: (1) expanding the client's perspective to include a more balanced view of both positive and negative events, (2) increasing the frequency of self-reinforcement by praising areas of success, (3) modifying the client's coping strategies so as to maximize the likelihood of successful performance, and (4) revising the client's goals and standards that underlie the self-evaluation process. Using a combination of these approaches, the therapist may be able to help clients improve their self-esteem and reduce the likelihood of depression.