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Early Intervention for Adults at High Risk of Recurrent/Chronic Depression: Cognitive Model and Clinical Case Series

Published online by Cambridge University Press:  06 June 2008

Stephen Barton ,
Peter Armstrong ,
Mark Freeston  and
Vivien Twaddle
Stephen Barton*
Affiliation:
Newcastle University and Newcastle Centre for Cognitive and Behavioural Therapies, UK
Peter Armstrong
Affiliation:
Newcastle Centre for Cognitive and Behavioural Therapies, UK
Mark Freeston
Affiliation:
Newcastle University and Newcastle Centre for Cognitive and Behavioural Therapies, UK
Vivien Twaddle
Affiliation:
Newcastle Centre for Cognitive and Behavioural Therapies, UK
*
Reprint requests to Stephen Barton, Consultant Clinical Psychologist, Transitions Service, Chester le Street Health Centre, Newcastle Road, Chester le Street, Co Durham DH3 3UR, UK. E-mail: [email protected]
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Abstract

This paper describes a cognitive model for first/second onset depression that has been precipitated by major life stress, entrenched for several months and is unresponsive to pharmacotherapy. These conditions create high risks for recurrent/chronic depression and early intervention is proposed to identify, treat and protect against relapse/recurrence. Severe life stress interacts with an individual's core self-representations and personal values, identity is disrupted and depression is maintained by dysfunctional goal engagement and disengagement. Treatment aims to restore functional self-regulation by increasing self-diversification and creating balanced goal investments. Outcome and follow-up data are reported in a case series of five consecutive patients. There was good therapist adherence to the prescribed targets and pre-post effect sizes were comparable or larger than published outcome studies. At the 12 month follow-up, three of the four treatment completers (75%) had made reliable and clinically significant changes and were in full remission. This provides encouraging preliminary evidence for the model's validity and the therapy's efficacy.

Keywords

Depressionearly interventionrecurrencepersonal identitygoal investments
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 36 , Issue 3 , May 2008 , pp. 263 - 282
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2008

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