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Depression: Paving the Road to Recovery
A British study suggests that people suffering from depression can be helped by a program that teaches them to see themselves and the world through a slightly different lens.
Concreteness training (CNT), as the program is called, can reduce depression within two months and only requires minimal contact with therapists, one visit and a few phone calls. It's essentially a self-help program. And because it's also inexpensive, it may be an option for people who can't currently find or afford other treatments.
The program works by focusing on two types of thinking that often keep depressed individuals trapped in a frustrating cycle: overgeneralization and rumination.
Everybody is guilty of overgeneralizing sometimes. People with depression take it to an extreme, globalizing isolated incidents or the daily stress in their lives and seeing a single mistake or unpleasant personal encounter as one more sign that they are worthless or useless people. Even a frown from the checkout cashier or a spilled cup of coffee is seen as a confirmation of their essential inadequacy.
They also tend to ruminate, repetitively thinking about the causes and implications of problems and upsetting events. While being analytical can certainly be a useful trait, once again depressed individuals can take it to an extreme, spending an enormous amount of time in fruitless rehashing of negative events, usually with a large side of self-blame mixed in. Often, there is no good answer to the question "Why me?" Endlessly searching for one only leads to more unhappiness.
It's one thing to understand this and another to actually change it. CNT helps people change it by showing them to how to think more specifically (concretely) about problems and to keep minor mistakes and unpleasant events in perspective.
It does this through at-home exercises. People focus on a recent event that they found mildly to moderately upsetting. Guided by a CD and workbook, they go through the event and their role in it step by step and are shown how to see it in a more helpful and less negative manner. They also explore the best way to move forward: how to prevent the event from reoccurring or how to make it seem less upsetting.
The goal is to make this more productive perception and style of thinking a habit.
In the study, people who received CNT showed fewer symptoms of depression two months after starting it, an improvement that lasted till the end of the eight-month study. The study found CNT to be as effective or better at improving depression as relaxation training.
The study looked at 121 British adults who had been diagnosed with depression and were being treated for it by a primary care physician. They were split into three groups. One group continued with their usual treatment (which varied), the second group added CNT to their usual treatment and the third group added relaxation training to their usual treatment.
All patients were evaluated two, five and eight months after the start of the trial. CNT consisted of one initial 1.5 hour meeting with a therapist, at home training exercises using a CD and workbook for 15-30 minutes daily for at least six weeks, and up to three telephone calls to the therapist.
Both CNT and relaxation training helped relieve depression. But only CNT helped reduce the negative thinking that often accompanies depression and may be a major cause of it.
Depression is notoriously difficult to treat. It has no proven biological cause and the type of treatment that's most effective varies from individual to individual. The two most common treatments, antidepressants and cognitive behavioral therapy, both have drawbacks. With estimates that about 16% of the U.S. population will experience a major depressive episode during their lifetime, there's a definite need for other effective treatments.
Concreteness training is one more weapon in the arsenal.
An article on the study was published online by Psychological Medicine.
January 2, 2012