Essential components of cognitive-behavior therapy for depression.

Abstract

Essential Components of Cognitive-Behavior Therapy for Depression Jacqueline B. Persons, Joan Davidson, and Michael A. Tompkins. American Psychological Association Press. 2001, 256 pp., $34.95 (hardcover). What, another book on Cognitive Behavior Therapy? Yes, and it's a good one, casting a somewhat different light on the topic than previous publications. In addition, it's associated with a series of demonstration video tapes by the first author, although I did not receive these for review. The book is explicitly based on Beck's Cognitive Theory and Therapy of Depression and is at once more comprehensive and less comprehensive than previous books. (The authors explicitly state that they use and behavior interchangeably and so will I). There are seven chapters; Empirical and theoretical underpinnings, Individualized case formulation and treatment planning, Structure of the therapy session, Activity scheduling, Using the thought record, Schema change methods, and an extended case example (the case of Nancy). It is an intervention-based book rather than a theoretical one and is designed to teach four basic interventions. These are; activity scheduling, using the thought record, schema change methods, and the use of a structured therapy session; the material of Chapters 3 through 6. However, theory and research are not neglected. Most of the chapters have a theoretical section and an empirical section, the latter presents the research that supports the topic under discussion. As an academician more than a clinician, I found the empirical sections to be useful in summarizing the research and they even alerted me to some literature of which I was not aware. For example, I was not aware of all the research indicating the importance to a positive outcome of a structured therapy session. The theoretical sections will likely be a review for those professionals who are already familiar with Beck's theory. There is a companion booklet which contains seven reproducible forms for use in therapy, such as an activity schedule, thought record, and positive data log. Chapter one introduces the theory and research behind Beck's model. I found the discussion of the differences between efficacy and effectiveness to be especially interesting. There is also a section on evidence-based clinical practice. Although it's basically a review for those familiar with Beck's work, it's a good one with the authors' own clinical insights. Chapter two discusses and illustrates how to construct individualized case formulations and plan treatments, the subject of an earlier book by the first author. This chapter contains an excellent example of such a formulation, the case of Jenna. The other chapters (except for the last) are devoted to a discussion of ways of implementing the topic under consideration. For example, the chapter on structure describes how to set the agenda, how to work the agenda, how to assign homework, and overcoming obstacles to using a structured session. The chapter on using the thought record discusses how to identify themes, how to identify cognitive distortions, gathering information for a case formulation, and what to do if problems or obstacles develop. Each chapter has several exhibits in which major concepts are set off and summarized. There are examples of evidence records, schema change sheets, completed activity sheets, as well as summarized guidelines for conducting certain methods. I found the list of cognitive distortions to be particularly useful as a client information device, although it differs somewhat from previous lists I've seen. These exhibits both illustrate and summarize. Most chapters also contain several practice exercises which include questions on how to handle issues described in the case vignettes. The authors then provide tentative answers to these questions with the caveat that the reader may come up with other answers. There are also case vignette examples, often including short sample dialogues, sprinkled throughout the chapters which are helpful in fleshing out the concepts. …