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Cognitive Behavioral Therapy for Adolescent Depression: Skills and Techniques

Learn the characteristics of CBT approach for treating adolescent depression, social cognitive factors, core skills like mood monitoring, social skills, and relaxation techniques. Enhance your understanding of cognitive distortions and develop problem-solving skills for adolescents struggling with depression.

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Cognitive Behavioral Therapy for Adolescent Depression: Skills and Techniques

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  1. Objectives • Understand the basic characteristics of CBT approach to treating adolescents with depression, • Become familiar with the interrelationship of interventions involved in CBT • Identify skills that you can teach to a depressed adolescent in a behavioral health or primary care setting

  2. Characteristics of Cognitive Behavioral Therapy (CBT) Approach • Based in social learning theory • Addresses thoughts, feelings and behaviors • Changing thoughts and behaviors can improve affect. • Adolescents can turn a “downward spiral” into an “upward spiral” by changing behavior and thinking.

  3. Social cognitive factors that characterize depressed adolescents • Beliefs about Self • Behaviors that support depression • CBT focuses on changing thoughts and behaviors, to change feelings.

  4. Core Adolescent Skills • Mood monitoring • Increasing Pleasurable Activities • Improve Problem-solving • Address Automatic Thoughts and Cognitive Distortions • Counterthoughts • Social Skills • Affect Regulation • Relaxation

  5. Social Skills • Social Interaction • Making and keeping friends • Assertion • Communication and Compromise

  6. Affect Regulation • Enhance a teen’s ability to control sudden changes in mood • “Keeping things under control”

  7. Mood monitoring • Teaches how to track feelings • Gives a more realistic impression of actual time spent “feeling bad” • Enables teen to see that moods vary in strength (not only what they are feeling, but how strong the feeling is) • Track what situations, events and thoughts are connected with feeling good or bad

  8. Increasing Pleasurable Activities • Depressed teens stop engaging in activities that were once enjoyable • Repertoire of fun activities gets circumscribed to solitary, relatively passive activities (video games, TV, depressing music etc)

  9. Improve Problem-solving • Depressed teens often have impaired problem-solving skills • Teaching a structured method to solve problems can help teens to adaptively cope with problems that would otherwise further their depression

  10. Address Automatic Thoughts and Cognitive Distortions • Patterns of maladaptive thinking negatively influence emotions and behavior (Beck) • Fundamental CBT skill is to identify and challenge errors in thinking

  11. Realistic Counterthoughts • “Talk back” to cognitive distortions by formulating and using realistic Counterthoughts (Contrasting coaches) • Use methods to question negative thinking

  12. Relaxation Training • Deep Breathing • Progressive Muscle Relaxation • General Stress Busters

  13. Deep Breathing • Breathe from the stomach rather than from the lungs • Can be used in class without anyone noticing • Can be used during stressful moments such as taking an exam or while trying to relax at home

  14. Progressive Muscle Relaxation • Alternating between states of muscle tension and relaxation helps differentiate between the two states and helps habituate a process of relaxing muscles that are tensed • Many good tapes/c.d.’s available on relaxation • Especially suited for middle and high school students

  15. Mental Imagery/Visualization • Can enhance other relaxation techniques or be used on its own • Provides relief from troubling thoughts, emotions, or feelings • Evokes a pleasing, calming mental image (e.g., the beach, park, forest, playing with a favorite pet)

  16. General Stress Busters • Go for a walk • Take a nap • Play with a pet • Take a bath • Listen to music • Talk to a friend • Exercise • Write in a journal • Write a letter that you never send • Do something creative – an art project, poem, write a rap • Watch television • Talk on the phone • Read

  17. Don’t forget to take a packet of handouts!

  18. References • Characteristics and Components of the TADS CBT Approach, Paul Rohde, Oregon Research Institute, Eugene; Norah C. Feeny, Case Western Reserve University; Michele Robins, University of Pennsylvania Medical School • CAMHD Biennial Report: Effective Psychosocial Interventions for Youth With Behavioral and Emotional Needs, Hawaii Department of Health, Child and Adolescent Mental Health Division, 2009 • Enhancing Quality in School Mental Health, Center for School Mental Health, University of Maryland School of Medicine http://csmh.umaryland.edu

  19. References con’t… • Enhancing Quality in School Mental Health, Center for School Mental Health, University of Maryland School of Medicine http://csmh.umaryland.edu/

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