Cognitive Behavioral Therapy for Depression, John E. Burkhardt II, Psy. D Wellness Solutions of Tennessee

In today's society, the treatment of depression typically takes on a "multimodal" approach, which means it includes a combination of psychotherapy and psychopharmacology (e.g. antidepressant medication). However, it is not uncommon to treat an individual diagnosed with depression using a single method approach depending on the patients' needs and history. Wellness Solutions' integrative wellness assessment facilitates our methodology and treatment protocols.

My therapeutic focus centers on Cognitive Behavioral Therapy or CBT. I've chosen this approach as a cornerstone in my psychotherapeutic practice as it takes a pragmatic, present-centered approach to a patients' treatment for depression. It provides a practical tool of empowerment in integrative wellness, as it can be combined with other treatment modalities, and can be drawn upon at any point during one's lifetime.

Cognitive Behavioral Therapy is currently used to treat a plethora of psychiatric illnesses, but has its roots in the treatment of major depression, which is characterized by depressed mood; irritable mood in children; loss of interest or pleasure in activities; weight loss/gain; insomnia / hypersomnia (sleeping too much); fatigue or loss of energy; feeling worthless or hopeless; guilt; difficulty concentrating or thinking, and recurrent thoughts of death or suicide. CBT posits that depression can be viewed or conceptualized by dysfunctional thoughts, schemas (an outlook an individual has that endures despite objective reality), and core beliefs the individual has formed. Individuals with depression typically have a negative view of themselves, world/others, and the future (this is known as the depressive triad). These individuals will also have automatic thoughts that often include dichotomous thinking (a.k.a. black and white thinking), discounting the positive, over-generalization, catastrophizing, maximizing/minimizing, and personalization. All of which maintain their depression and will be the psychotherapeutic focus.

In comparison to other forms of psychotherapy, Cognitive Behavioral Therapy has been described as more time-limited, problem-solving oriented, and focused on the present. It is a collaborative and educational effort between the patient and the therapist (e.g. psychologist, psychiatrist, masters level therapist, and nurse practitioner etc.), and dovetails with other integrative wellness methods. Treatment length varies depending on the individual's needs and current level of functioning.

During treatment, I use what is known as "Socratic" questioning (a facet of CBT) to help my patients identify and evaluate their automatic thoughts, false beliefs, and schemas. I then help them "test out" the faulty cognitions that are maintaining their identified problems. When patients' thoughts are valid, I problem solve, evaluate their conclusions, and work with them to accept their difficulties. All of this is done in a supportive and nurturing environment to help empower my patients in attaining their goal of emotional wellness.
A. Reference: http://www.beckinstitute.org/beck-cbt/