CBT can reduce risk of Perinatal Depression

If you have a history or family history of depression and are pregnant please let your healthcare team know.  Evidence based treatments prior to delivering your child can significantly reduce your risk of perinatal depression. The Task Force reviewed 50 studies which examined a variety of different treatments including counselling, physical activity, education, and medication such as antidepressants and omega-3 fatty acids. They determined there was convincing evidence that counseling interventions such as cognitive behavioral therapy and interpersonal therapy were effective in preventing perinatal depression.In fact, both types of therapy reduced the risk of depression by 39 percent. Link

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Work and Depression

A recent study in the UK came out with some predictable results…. Relative to a standard 35–40 hours/week, working 55 hours/week or more related to more depressive symptoms among women (ß=0.75, 95% CI 0.12 to 1.39), but not for men (ß=0.24, 95% CI −0.10 to 0.58). Compared with not working weekends, working most or all weekends related to more depressive symptoms for both men (ß=0.34, 95% CI 0.08 to 0.61) and women (ß=0.50, 95% CI 0.20 to 0.79); however, working some weekends only related to more depressive symptoms for men (ß=0.33, 95% CI 0.11 to 0.55), not women (ß=0.17, 95% CI −0.09 to 0.42). The differences between genders …

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Make Decisions Like a Ninja

Decision making can be difficult when we’re struggling with a strong emotion and can be problematic when we’re coping with depression and anxiety. Pros and Cons is a flexible, easy to use and effective CBT skill that can improve our decision-making skills and increase confidence when making decisions. Pros and Cons can be helpful in the following areas: 1. Distress Tolerance: Comparing the Maladaptive coping mechanism to the Adaptive Coping Mechanism 2. Life Skills (exercise, medication compliance, eating well): Comparing, for example, Working Out v. Netflix. 3. Social Anxiety: Comparing Avoiding a Social Event v. Attending 4. Depression: Getting out of …

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Challenging Irrational Beliefs with the Continuum Technique

The Continuum Technique is a tool used in CBT to help people challenge irrational beliefs about themselves or the world around them. It’s a pretty simple tool that acts as a contrast to harmful beliefs that we simply accept as true or allow to remain unchallenged. We’re going to apply the technique to a hypothetical situation that some folks with OCD may be able to relate to. This example involves someone who believes that contamination is going to create a threat to their baby which can then lead to reduced affection, touch, and play. The belief we are going to challenge is: …

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Does Shame Work?

Before we get into whether shame is effective, we should probably talk about the purpose of shame. Shame has less to do with the morality of a behavior and more to do with the social impact of others knowing about it. The arbitrator of morality is guilt. Not a very effective or accurate arbitrator, but that’s its job. Shame is more about conformity. It is less likely to cause a person to change their behavior and more likely to increase a person’s efficacy in hiding it. Not because the behavior is wrong, just socially or economically harmful and its disclosure …

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Suicidality and Safety Plans

One area of critical importance in working with clients who struggle with depression, anxiety, and OCD is ensuring that a thorough assessment of suicide risk and a plan in coping with suicidal ideation is completed during the assessment and throughout treatment.  Even if a client does not have a history of suicidality, a safety plan is a good thing to discuss and have in place. Safety Plans should include the following: Activites that clients have engaged in that have helped them avoid suicide and parasuicidal behaviors in the past or if there is no history, activities they imagine would help them cope. …

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Drive the Feeling

Most of us tend to think about emotions as either good or bad, positive or negative but every emotion can be helpful and destructive.  One goal of DBT and CBT is to help folks use emotions more effectively; to understand the purpose of each emotion and to decide how to use emotions (if at all) in achieving our objectives.  One important step is to determine whether the context or situation reasonably connect to the feeling. If they do, then we work towards figuring out how to abide by the emotion effectively. If they don’t then we act opposite the emotion. …

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Get your Greek on…

Did you know that much of CBT (Cognitive Behavioral Therapy) is based on the work of the Athenian philosophers (Socrates, Plato, and Aristotle)?  One common skill taught in CBT is Socratic questions which can be used as a means of stepping away from our initial (and provocative) interpretation of an event and coming to a more reasonable conclusion. Socratic reasoning takes a conclusion (or anything really) and begins with a  process of asking open-ended questions.  This can be helpful when we are struggling with depression or anxiety because we are more likely to come to the worst possible meaning of …

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Self-Validation

DBT and CBT are both pretty big on changing how you think as a way of changing how you feel.  Both recognize cognitive distortions which are faulty patterns of thinking that develop during periods of distress and/or can act as a catalyst for distress.  One component of both therapies involves helping folks change their thinking habits so they are less vulnerable to high levels of distress and are less prone to engaging in ineffective behaviors. One way to challenge ineffective thinking is to engage in self-validation. There are six levels of validation, for this post we’re going to focus on …

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