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Depression

Depression is characterized by an extended period of low mood, anhedonia, and reduction in activity. Dysthymia (persistent depressive disorder) is characterized by a depressed mood that occurs for most of the day, more days than not, and has been present for at least two years. Depression is a heterogeneous condition with many different triggers, presentations, and maintaining factors. Cognitive behavioral therapies (including acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), compassion focused therapy (CFT), and dialectical behavior therapy (DBT)) are effective evidence-based treatment for depression, and mindfulness-based cognitive therapy (MBCT) is an effective intervention for preventing the recurrence of depression. Read more

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22 of 122 resources

Transdiagnostic Processes

A ‘transdiagnostic process’ is the label given to a mechanism which is present across disorders and which is either a risk or maintaining factor f ... https://www.psychologytools.com/resource/transdiagnostic-processes/

Disqualifying Others

This Disqualifying Others information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more eff ... https://www.psychologytools.com/resource/disqualifying-others/

Am I Experiencing Depression?

Depression is a condition characterized by an extended period of low mood, anhedonia, and reduction in activity. Am I Experiencing Depression? is an i ... https://www.psychologytools.com/resource/am-i-experiencing-depression/

Perspective-Taking

Cognitive restructuring techniques in CBT teach clients ways of analyzing situations in ways that might initially be unfamiliar. A simple way of intro ... https://www.psychologytools.com/resource/perspective-taking/

Overgeneralization

The Overgeneralization information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effect ... https://www.psychologytools.com/resource/overgeneralization/

Arbitrary Inference

Arbitrary inference is one of the earliest and broadest cognitive disotortions described in CBT. Beck defines it as "the process of forming an interpr ... https://www.psychologytools.com/resource/arbitrary-inference/

Exercise For Mental Health

Exercise is an evidence-based treatment for depression and anxiety and research suggests that, in the treatment of depression, exercise interventions ... https://www.psychologytools.com/resource/exercise-for-mental-health/

Psychology Tools For Living Well

Cognitive behavioral therapy can help your clients to live happier and more fulfilling lives. Psychology Tools for Living Well is a self-help course ... https://www.psychologytools.com/resource/psychology-tools-for-living-well/

Daily Monitoring Form

Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ... https://www.psychologytools.com/resource/daily-monitoring-form/

Activity Selection

Activity selection is a technique for rating the difficulty of different activities. It is a helpful tool when clients have difficulty choosing betwee ... https://www.psychologytools.com/resource/activity-selection/

Mindfulness In Everyday Life (Audio)

Mindfulness In Everyday Life is a short mindfulness exercise which guides clients how to bring present-moment awareness into everyday life. This audio ... https://www.psychologytools.com/resource/mindfulness-in-everyday-life-audio/

Mindfulness Of Breath (Long Version) (Audio)

Mindfulness Of Breath (Long version) is a mindfulness exercise encouraging present-moment awareness, using the breath as an anchor for the attention. ... https://www.psychologytools.com/resource/mindfulness-of-breath-long-version-audio/

Mindfulness Of Sounds And Thoughts (Audio)

Mindfulness Of Sounds And Thoughts is a mindfulness practice exercise that encourages relating to thoughts as ‘just thoughts’ that come and go in ... https://www.psychologytools.com/resource/mindfulness-of-sounds-and-thoughts-audio/

Thinking Versus Sensing (Audio)

Thinking Versus Sensing is a short mindfulness exercise to demonstrate the difference between thinking about our experience and sensing it directly. E ... https://www.psychologytools.com/resource/thinking-versus-sensing-audio/

Task Planning And Achievement Record

The Task Planning and Achievement Record can be used to plan daily tasks and record goal attainment. It is most suited for encouraging frequent or rep ... https://www.psychologytools.com/resource/task-planning-and-achievement-record/

What Does Exercise Do For the Mind And Body?

Exercise is an evidence-based treatment for depression and anxiety and research suggests that in the treatment of depression, exercise interventions l ... https://www.psychologytools.com/resource/what-does-exercise-do-for-the-mind-and-body/

Mindful Attention (Audio)

The Mindful Attention exercise is an audio track from the Psychology Tools For Overcoming PTSD Audio Collection. This audio track was originally recor ... https://www.psychologytools.com/resource/mindful-attention-audio/

Raisin Exercise (Audio)

The Raisin Exercise is a short mindfulness exercise encouraging present-moment awareness of the senses, connecting with taste, touch and smell while y ... https://www.psychologytools.com/resource/raisin-exercise-audio/

Rumination Diary (Archived)

NOTE: An improved version of this resource is available here: Rumination – Self-Monitoring Record. Older versions of a resource may be archived ... https://www.psychologytools.com/resource/rumination-diary-archived/

Self-Criticism Self-Monitoring Record (Archived)

NOTE: An improved version of this resource is available here: Self-Criticism Self-Monitoring Record. Older versions of a resource may be archived in t ... https://www.psychologytools.com/resource/self-criticism-self-monitoring-record-archived/

Things To Do List

The Things To Do List is a form of activity record. Clients are instructed to generate a list of planned activities, assign a priority rating to each ... https://www.psychologytools.com/resource/things-to-do-list/

Rumination Self-Monitoring Record (Archived)

NOTE: An improved version of this resource is available here: Rumination Self-Monitoring Record. Older versions of a resource may be archived in the e ... https://www.psychologytools.com/resource/rumination-self-monitoring-record-archived/

Links to external resources

Psychology Tools makes every effort to check external links and review their content. However, we are not responsible for the quality or content of external links and cannot guarantee that these links will work all of the time.

Assessment

  • Valued Living Questionnaire (Version 2) | Wilson, Groom | 2002
  • Ruminative responses scale | Treynor, Gonzalez, Nolen-Hoeksema | 2003
  • Clinically Useful Depression Outcome Scale (CUDOS) | Zimmerman, Chelminski, McGlinchey, Posternak | 2008
    • Scale
    • Zimmerman, M., Chelminski, I., McGlinchey, J. B., & Posternak, M. A. (2008). A clinically useful depression outcome scale. Comprehensive psychiatry, 49(2), 131-140.
  • Zung Self-Rating Depression Scale | Zung | 1965
    • Scale
    • Reference Zung, W. W. (1965). A self-rating depression scale. Archives of General Psychiatry, 12(1), 63-70.
  • Severity Measure For Depression – Adult (Adapted from the Patient Health Questionnaire–9 (PHQ-9)) | APA (Spitzer, Williams, Kroenke and colleagues)
  • Patient Health Questionnaire 9 (PHQ-9) | Kroenke, Spitzer | 2002
    • Scale phqscreeners.com
    • Kroenke, K., & Spitzer, R. L. (2002). The PHQ-9: a new depression diagnostic and severity measure. Psychiatric annals, 32(9), 509-515.
  • Montgomery & Asberg Depression Rating Scale (MADRS) | Montgomery, Asberg | 1979
    • Scale
    • MADRS Score Card
    • Montgomery, S.A., Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134 (4): 382–89.
  • Hamilton Rating Scale For Depression (HAM-D) | Hamilton | 1960
    • Scale
    • Hamilton M. (1960). A rating scale for depression. J Neurol Neurosurg Psychiatry, 23, 56–62.
  • Edinburgh Post Natal Depression Scale (EPDS) | Cox, Holden, Sagovsky | 1987
    • Scale
    • Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. The British Journal of Psychiatry, 150(6), 782-786.

Case Conceptualization / Case Formulation

  • Developing and using a case formulation to guide cognitive behaviour therapy | Persons | 2015
  • Cognitive conceptualisation (excerpt from Basics and Beyond) | J. Beck

Guides and workbooks

  • Mood And Substance Use | NDARC: Mills, Marel, Baker, Teesson, Dore, Kay-Lambkin, Manns, Trimingham | 2011

Information Handouts

Information (Professional)

Self-Help Programmes

Treatment Guide

  • Depression In Adults: Treatment And Management (NICE Guideline) | NICE | 2022
  • Behavioural activation treatment for depression (BATD) manual | Lejuez, Hopko & Hopko | 2001
  • Suicide and self injury: a practitioners guide | Forensic Psychology Practice Ltd | 1999
  • Behavioural activation treatment for depression – revised (BATD-R) manual | Lejuez, Hopko, Acierno, Daughters, Pagoto | 2011
  • Metacognitive Training For Depression (D-MCT) Manual | Jelinek, Schneider, Hauschild, Moritz | 2023
  • Metacognitive Training For Depression | Jelinek, Hauschildt, Moritz & Schneider | 2022
  • Cognitive-behavioral therapy for depression in young people: a modular treatment manual | Orygen | 2015
  • Group therapy manual for cognitive behavioral treatment of depression | Muñoz, Miranda | 1993
  • CBT For Depression In Veterans And Military Service Members – Therapist Manual | Wenzel, Brown, Carlin | 2011
  • Cognitive behaviour therapy for depression in young people: manual for therapists | Improving Mood with Psychoanalytic and Cognitive Therapies (IMPACT) Study CBT Sub-Group | 2010
  • Cognitive-Behavioural Therapy (CBT) Group Program For Depression | Milner, Tischler, DeSena, Rimer
  • Manual for group cognitive-behavioral therapy of major depression: a reality management approach (Instructor’s manual) | Muñoz, Ippen, Rao, Le, Dwyer | 2000
  • Individual therapy manual for cognitive-behavioural treatment of depression | Ricardo Muñoz, Jeanne Miranda | 1996
  • Depression In Adults: Recognition And Management | National Institute for Health and Care Excellence (NICE) guidelines | 2009

Worksheets

Recommended Reading

  • Behavioural activation treatment for depression: returning to contextual roots | Jacobson, Martell, Dimidjian | 2001

What Is Depression?

Signs and Symptoms of Depression

To meet DSM-5 diagnostic criteria for major depressive disorder an individual must have experienced five of the following symptoms for at least two weeks:

  • a depressed mood that is present most of the day, nearly every day
  • diminished interest in activities which were previously experienced as pleasurable
  • fatigue or a loss of energy
  • sleep disturbance (insomnia or hypersomnia)
  • feelings of worthlessness, self-reproach, or excessive guilt
  • a diminished ability to think or concentrate, or indecisiveness
  • recurrent thoughts of death or suicide, or suicidal behavior
  • changes in appetite marked by a corresponding weight change
  • psychomotor agitation or retardation to a degree which is observable by others

Psychological Models and Theory of Depression

Beck’s cognitive theory of depression (Beck, Rush, Shaw, & Emery, 1979) forms the basis for cognitive behavioral approaches for the treatment of depression. Beck’s theory proposes that there are different levels of cognition that can be dysfunctional in depression: core beliefs, rules and assumptions, and negative automatic thoughts. CBT aims to balance negatively biased cognition with more rational and accurate thoughts, beliefs, and assumptions. CBT also systematically aims to increase levels of rewarding activity.

Acceptance and commitment therapy (ACT) proposes that distress, including symptoms of depression, are the result of psychological inflexibility (Hayes, Luoma, Bond, Masuda, & Lillis, 2006). Indicators of psychological inflexibility include:

  • ‘buying in’ to negative thoughts and narratives;
  • engaging in worry or rumination that takes us away from the present moment;
  • losing contact with our values—what is important to us.

Evidence-Based Psychological Approaches for Working with Depression

Many psychological therapies have an evidence base for working with depression:

Resources for Working with Depression

Psychology Tools resources available for working therapeutically with depression may include:

  • psychological models of depression
  • information handouts for depression
  • exercises for depression
  • CBT worksheets for depression
  • self-help programs for depression

References

  • Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.
  • Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. BehaviourResearch and Therapy, 44(1), 1–25.