Cognitive Behavioral Therapy for Depression (CBT-D)

Description:

This intensive 2-day workshop provides training in the fundamentals of Cognitive Behavioral Therapy for Depression for behavioral health providers working with Service members.  Depression in the military will be discussed, as will the theory underlying cognitive behavioral therapy. Participants will learn how to conceptualize depressed patients, plan treatment, and utilize both cognitive and behavioral strategies.  Participants will have the opportunity to both watch role-play videos and practice intervention strategies through their own role plays. Participants must attend both days.​

Learning Objectives:

  1. Examine prevalence rates of depression in military populations.
  2. Identify military specific implications regarding diagnosing and treating depression in Service members.
  3. Review the theory relevant to Cognitive Behavioral Therapy (CBT).
  4. State the key principles of CBT.
  5. Understand the CBT formulation of depression.
  6. Learn how to develop an individualized case conceptualization for patients based on the cognitive behavioral model.
  7. Understand the role of assessment in developing a CBT case formulation.
  8. Examine the components of Cognitive Behavioral Therapy for Depression (CBT-D) sessions.
  9. Determine cognitive strategies utilized in CBT-D in order to modify unhelpful cognitions in Service members.
  10. Summarize behavioral strategies utilized in CBT-D in order to modify unhelpful behavioral patterns in Service members.
  11. Apply the use of Socratic Method in CBT.
  12. Identify common cognitive distortions of military personnel.
  13. Illustrate CBT techniques to treat depressed Service members via video and experiential approaches.
  14. Demonstrate increased skills and confidence to use CBT skills when working with depressed Service members.

Detailed CBT-D Outline:

Day #1

  1. Depression in the Military

    1. What do Depressed Service Members Look Like?
    2. Warriors See the World Differently
    3. Mental Health vs. Military Culture
    4. Perceived Stigma in the Military
    5. Minimizing Stigma
    6. Myths About Depression
    7. Treatment Considerations
    8. Level of Depression in the Military
    9. Depression and Deployment
  2. Evidenced-Based Psychotherapy (EBP)
    1. Why EBPs?
    2. VA/DoD Clinical Practice Guideline
    3. Recommended MDD Therapies
    4. Why CBT?
    5. CBT for Depression
  3. History of Cognitive Behavioral Therapy for Depression (CBT-D)
    1. Psychodynamic Therapy
    2. Rational Emotive Therapy
    3. Cognitive Therapy
    4. Principles of Cognitive Therapy
    5. Behavioral Components
    6. What is CBT?
    7. Orientation to CBT-D: Session Structure
  4. Cognitive Theory
    1. Basic Cognitive Model
    2. Expanded Cognitive Model
    3. Automatic Thoughts
    4. Intermediate Beliefs
    5. Core Beliefs
    6. Schemas
    7. Cognitive Theory & the Military Mindset
    8. Cognitive Model of Psychopathology
    9. Maladaptive Schemas
    10. Psychopathology: Diathesis-Stress Model
    11. Cognitive Theory of Depression
    12. Negative Cognitive Triad
    13. Core Beliefs Associated with Depression
         i.Helpless Core Beliefs  
        ii.Unlovable Core Beliefs
       iii.Worthless Core Beliefs
  5. Behavioral Theory
    1. Behavioral Theory of Depression
    2. Influence of Social Learning Theory
    3. Cycle of Depression
    4. Behavioral Theory of Depression in a Military Setting
    5. CBT “In a Nutshell”
    6. Cognitive Behavioral Model
  6. Behavioral Strategies
    1. Core Principles of Behavioral Activation
    2. Behavioral Strategies
        i.Activity Monitoring  
       ii.Activity Scheduling
      iii.Pleasant Events Schedule
      iv.Behavioral Activation with Service Members
      v.Graded Task Assignment
      vi.Relaxation Strategies
  7. Cognitive Strategies
    1. Identifying Automatic Thoughts
                i.Identifying Emotions  
                ii.Thoughts vs. Emotions
               iii.Thoughts vs. Situations
               iv.Introducing Thought Records
                v.Three-Column Thought Record
               vi.Unhelpful Thinking Styles
              vii.Errors in Thinking
             viii.Common Cognitive Distortions of Military Personnel
              ix.Military Culture and Cognitive Distortions
    2. Evaluating Automatic Thoughts
               i.Guided Discovery  
              ii.Socratic Method
             iii.Socratic Questioning: Changing Minds vs. Guided Discovery
             iv.Socratic Questioning that Incorporates Guided Discovery
              v.Four Stages of Guided Discovery
             vi.Types of Socratic Questions
            vii.Five-Column Thought Record
           viii.Unsuccessful Cognitive Restructuring
            ix.Coping Cards
             x.The 3Cs Approach
  8. Working with Core Beliefs
                     ​i.Downward Arrow Technique  
                    ii.Core Belief Modification
  9. Problem Solving
                     i.ITCH Strategy  
                    ii.Brainstorming
                   iii.Pros/Cons

Day #2

  1. Elements of Cognitive Behavioral Therapy (CBT)

    1. Therapeutic Alliance
    2. Planning Treatment
    3. Cognitive Restructuring
    4. Behavioral Experiments
    5. Emphasizing the Positive
    6. Homework
  2. CBT Treatment
    1. Phases of CBT Treatment
    2. Timeline of CBT
    3. Initial Phase of Treatment

i.Clinical Assessment

  1. Overlap of Post-Deployment Disorders
  2. Symptom/Complaint Overlap
  3. Self-Report Screens and Measures
  4. PHQ-9 Symptom Checklist
  5. Structured Interviews to Assess for Depressive Disorders
  6. Suicide Specific Assessment
  7. Safety Planning

ii.Motivational Enhancement Strategies
iii.Socialization into CBT

  1. CBT Case Conceptualization
              i.Case Formulation Approach 
             ii.Elements of Case Formulation
            iii.Problem List
            iv.Cognitive Conceptualization Diagram
            v.Goal Setting
           vi.SMART Treatment Goals
          vii.Collaborative Case Conceptualization
  2. General CBT-D Session Structure

i.Brief Mood Check
ii.Bridge from Previous Session
iii.Agenda Setting
iv.Review of Homework
v.Discussion of Agenda Items
vi.Periodic Summaries
vii.Assigning Homework
viii.Final Summary and Feedback
ix.Brief CBT Checklist

  1. Middle Phase of Treatment
               i.Implementation of Cognitive and Behavioral Strategies 
  2. Later Phase of Treatment
              i.Progress Toward Treatment Goals   
             ii.Review/Consolidation of Skills
            iii.Relapse Prevention
            iv.Additional Treatment Planning
    10. Review of CBT Skills