The second section addresses the adaptation of CT for complex depression. Drs. Fava and Fabbri's chapter on drug-resistant depression provides a helpful and detailed session-by-session timeUne for incorporating CT into the drug tapering regimen. Drs. Jarrett, Vittengle, and Clark provide a very clear and empirically supported explication of a causal model of depression recurrence as a theoretical framework for their use of "continuation phase" CT (C-CT) to prevent depression recurrence. Their explication of the goals and techniques of C-CT is well organised and succinct, and I think clinicians will find particularly helpful their Ust of prerequisite skills clinicians must have to practise C-CT. The other two chapters in this section were relatively weaker. Drs. Dimidjian, MarteU, Coffman, and Hollon provide a clear list and detailed review of four adaptations of CT for severe depression (e.g., more focus on behavioural strategies, more sessions), and I very much appreciated their appeal to the research literature. However, their case illustration did not highlight the uniqueness of severity in guiding CT process and technique. Finally, while Garland and Scott did address specific obstacles presented by chronically depressed clients (e.g., passivity and avoidant coping), and how to specifically adapt CT to address these issues, they did not support their suggestions with research. Furthermore, I was surprised that no mention was made in their review of Cognitive Behavioural Analysis System of Psychotherapy (CBASP), despite its long-standing use specifically for this population and its implementation in the most large-scale trial to date of chronic depression.
Adapting Cognitive Therapy for Depression Kate L Harkness Canadian Psychology; May 2009; 50, 2; Docstoc pg. 108 Reproduced with permission of the copyrigh
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