Kate Dobson, the first President of the world Confederation of cognitive-behavioral therapy (The World Confederation of Cognitive and Behavioural Therapies), which brings together all associations.
his Entire professional career he has focused on the study of the treatment of depression, and it is almost 40 years old. His seminar is a brief overview of how was the treatment then and how it looks now, effectively, what you should pay attention in the first place.
last week at the Congress in Berlin (wcbct2019) I was able to visit his workshop and here is what we talked about:
(1) Based on the diagnosis of DSM-5 can be obtained 945 different combinations of factors of depression, and hence approaches to build therapy
(2) Cognitive triad: futility (I'm bad), helplessness (I can't), meaninglessness (I'll never be better). Question: how many thoughts in this comes from belief, and how much from real life events?
(3) the three-strikes Rule = if the client 3 times violates the agreement and is not ready to work independently, passing all (!) responsibility for their lives to the therapist, it is a reason to terminate the therapeutic relationship
(4) In working with depression it is very important work between sessions. Plan behavioural experiments/researches/answers to questions even after the session (=“homework” should be always). It is also good to discuss the result, which is supposed to be, so you can compare what worked and what went wrong and why
(5) the First benefit, the first to reach the goal of therapy should be 2-3 session, the task of the therapist the right to determine and together with the client to agree on what you are working on it in the first place. The purpose is defined based on the criteria of depression and components that are easiest to change in the current event - this enables the client to feel better and make the work more efficient.
(6) Questions about the past are always with “bloom” depressive components, questions about the future - easier to adjust perception, to experiment, to practice, to understand the difference between “assume” and “turned”
(7) When you work with depression CBT therapist needs to be prepared for what will be a lot that goes beyond the standard approach of CBT, but is a mandatory component in the treatment (retreat - discussion of biological and social factors, the search for resources and points of reference there)
(8) the average life of a client with depression is about 6 episodes of depression: as was treated in previous episodes? what has been effective? what didn't work? we helped to emerge from the episode? From this match its behavior.
(9) it is Important in the treatment always have a sheet of problems with the priorities (joint work)
(10) the Structure of the session: in the main part of the discussion don't plan on more than 2-4 key ideas, better fewer, but higher quality.
(11) Discussion of negative thoughts/beliefs - only in the first half for the clients with depression
(12) Diet sleep is an important components
it was Also sooooo nice when the seminar came to thank him, and he remembered his exact date of arrival in Russia.
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