Bite-Sized CPD
A series of 4 on demand webinars
Dr Stephen Barton,
University of Newcastle
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CBT for Difficult-to-treat Depression
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Webinars £25.00
Series of 4, £87.50
This webinar series is designed for every CBT therapist who has struggled to collaborate with and fully engage depressed people in CBT.
The symptoms of depression create major barriers to the delivery of CBT - this webinar series, based on years of careful clinical research, will give you new insights and skills to help you and your clients to tackle and overcome these barriers.
Each workshop is independent but we recommend you register for all 4 (click link below). To access individual workshops scroll down and click link on workshop of your choice
Webinars were delivered live on 18th & 25th January, 1st & 8th February 2023
Now available 'on demand' via our secure portal. Watch when you like and download all the resources
CBT for difficult-to-treat depression
Dr Stephen Barton,
University of Newcastle, UK
Abstract
Depression is often difficult to treat; it’s a recurrent disorder and many clients have lapses or relapses after making therapeutic gains. This is particularly true when clinical complexity is high, for example, when clients have adverse childhood experiences, co-morbidities, interpersonal problems and/or heightened risk.
For all clients, depression can get in the way of its own treatment. For example, CBT is unlikely to be fully delivered, or received, when clients:
- are passive in the therapeutic relationship;
- are having therapy to please someone else;
- go through the motions rather than engage in activities or experiments;
- ruminate about thoughts rather than reflect on them and test them out
This webinar series will explore four common types of difficulty with two combined aims:
Increase understanding of the client’s experience within the difficulty;
Consider different therapeutic strategies and responses.
The series will explore interpersonal, motivational, behavioural and cognitive factors, and the overarching message is that difficulties need to be understood and tackled pro-actively to stop them becoming therapeutic tensions and barriers to change. Video demonstrations will be used throughout to illustrate different therapeutic strategies.
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References
Barton, S., Armstrong, P., Wicks, L., Freeman, E. & Meyer, T.D. (2017) Treating complex depression with cognitive behavioural therapy. The Cognitive Behaviour Therapist. Vol. 10. http://dx.doi:10.1017/S1754470X17000149
Barton, S. & Armstrong, P. (2019) CBT for Depression: An Integrated Approach. Sage
Barton, S.B., Armstrong, P.V., Robinson, L. & Bromley, E.C.H. (in press, 2022). CBT for Difficult-to-Treat Depression: Self-Regulation Model. Cognitive and Behavioural Psychotherapy
Barton, S.B., Armstrong, P.V., Holland, S. & Tyson-Adams, H. (in press, 2022). CBT for Difficult-to-Treat Depression: Single Complex Case. The Cognitive Behavioural Therapist
Building an alliance that works
On demand £25.00
A good-enough working alliance is essential for CBT to be effective. This webinar will explore some of the interpersonal consequences of depression, such as keeping people at a distance, giving others responsibility, or excessive re-assurance seeking. Without an appropriate therapeutic response, these can become barriers to collaboration. Therapists need to adjust their interpersonal style accordingly, based on client need, optimizing the balance of support and change in different situations. This can mean acting against the interpersonal ‘pull’ of the client, sometimes risking the alliance rather than protecting it at all costs.
Overcoming problems with motivation
On demand £25.00
Depression impairs motivation but it’s not always as simple as having less energy or feeling un-motivated. Some motivational impulses are stronger in depression, for example, the urge to avoid tasks, to hide from others or to follow internal ‘shoulds, oughts and musts’. Conflicting motivational states are common. This webinar will explore ways of helping your client reflect on their motivation and learn more about it. The aim is to strengthen approach impulses, the urges that provoke goal-directed activity. For some clients, activating behaviour is sufficient to build motivation, but for others their self-identity and life-goals need to be engaged more explicitly.
Getting more out of behavioural experiments
On demand £25.00
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Most experiments with depressed clients elicit their predictions and wait to see if the outcomes are as negative as expected. This can be a powerful source of cognitive change, but it is only one approach. It relies on disconfirmation: that events will be less negative than the client predicts. An alternative approach relies on confirmation, encouraging the client to influence preferred outcomes. When this is effective, clients learn that they can influence what they would like to happen. This webinar will explore the pros and cons of testing predictions versus influencing preferences, with the aim is to increase the range of therapeutic options available to therapists.
Overcoming rumination with mental freedom
On demand £25.00
Traditional cognitive therapy targets thought-content: what the client believes and how strongly they believe it. But depressed clients don’t just believe negative thoughts; they engage in unhelpful thought-cycles about them, sometimes called rumination. Rumination maintains depression and is a barrier to paying attention, processing information in depth and creating new memories. It impedes the learning needed for CBT to work. Mental freedom is a meta-cognitive approach: it explores the client’s relationship with their mind. Instead of challenging thoughts and beliefs, it seeks to maximise self-mind co-operation. In practice, this means conducting experiments across a range of cognitive processes to find out what works best in different situations. When mental freedom increases, rumination and other unhelpful processes decrease.
Dr Stephen Barton
Dr Stephen Barton is Consultant Clinical Psychologist at the Regional Affective Disorders Service in Newcastle.  He is former director of the Newcastle CBT Diploma and has a longstanding interest in CBT for complex mood disorders.  He is currently conducting clinical trials of Self-Regulation CBT for difficult-to-treat depression.  His other interests include clinical complexity, interpersonal processes, supervision and personal development.