Psychological exercises for depression: explain in detail
Psychotherapy for depressive disorders in children and adolescents – methods, principles
Depressive disorders depth-oriented therapy methods . Most psychoanalytic theories assume that the cause of depression is a real or imagined loss (Finch, Saylor). The nature of this loss and the intrapsychic level at which it is processed are evaluated differently in different theoretical frameworks, depending on the stage at which depression first manifests itself.
For example, Freud postulated as the main mechanism of depression the introjection of a lost object and the re-direction of ambivalence originally attributable to the object toward that internalized object as part of the self. In contrast, Bibring proposed a conflict between the Self and the Super-Self, which explains the onset of depression as early as age 6 or 7.
Earlier traumatic experiences persist in the unconscious and manifest themselves as pronounced vulnerability with a tendency to interpret even minor conflicts as a manifestation of their own failure.
The psychoanalytic method is characterized in a broad sense by the fact that in the course of psychotherapy, the patient becomes aware of the origin of aggressive impulses directed at him or herself, learns to integrate them and experiences the return of a sense of self-esteem. While treatment of adolescents, as well as adults, is carried out in the form of conversations, play therapy is chosen for children in most cases.
Behavioral therapy and cognitive models of depressive disorders
Behavioral therapy (Lewinson et al.) defines depression in terms of reinforcement psychology: depression results from an individual’s inability to positively reinforce his or her own behavior with environmental factors. Changes in the patient’s activity level and social skills are at the center of the therapeutic efforts. It has been hypothesized (Kashani et al.) that, according to this model, a lack of social competence and social skills leads to the development of depression in childhood.
Of particular importance among cognitive concepts are the model of “acquired helplessness” (Seligman) and the model of “cognitive distortion” (Beck). According to the first of these models, a depressed person experiences success and failure as phenomena completely independent of his or her own activity and behavior, which generates a sense of complete helplessness and a negative attitude toward future events. Depressed individuals live in constant anticipation of negative events that they cannot control.
The concept of acquired helplessness implies a specific attributional style, which, unlike that of a healthy person, is characterized by constantly attributing failures in things to one’s own mistakes, attributing generalized rather than particular significance to them, extending their negative significance to other situations and underestimating the positive components.
Beck has described his cognitive behavioral therapy for depression as “an active, directive, time-limited and structured form of psychotherapy based on the theoretical assumption that an individual’s affects and behavior are determined in large part by the way that individual imagines the world around him. In the treatment of adults, this therapeutic concept plays a major role and has repeatedly been appropriately evaluated.
There are promising attempts to use it in the treatment of adolescents, and possibly children as well, so it should be examined here in detail (see also Stark).
The Beck model of depression (Beck et al.) is based on three hypotheses (the cognitive triad) that explain the development and persistence of depressive symptoms: 1) the patient underestimates his own personality (negative self-esteem); 2) he sees only failures, resentments and disappointments in his interactions with the world around him (a negative world view); and 3) he assumes that his failures and frustrations will never end (negative future expectation).
These typical attitudes lead the depressed patient to interpret both past and present experiences in terms of negative, fixed, irreducible mental schemes that exclude the possibility of alternative, constructively optimistic courses of action.
Such dysfunctional beliefs, which form into a negative picture of oneself, the world and the future, have also come to light in studies of children and adolescents (Kovacs, Beck, Kazdin et al.).
Affective training for depressive disorders in children and adolescents
Children and adolescents should become familiar with a wide range of emotional experiences both in themselves and in others (e.g., the mood continuum: joyful-indifferent-sad-sad). In therapy, feelings can be identified through facial expressions or gestures and through play (e.g., by opening cards) (Stark et al.).
Self-Monitoring Techniques for Depressive Disorders in Children and Adolescents
Based on Rehm’s (Renin) concept, the cognitive processes typical of depression must be modified through self-observation, self-assessment, and self-reinforcement.
Through self-observation, stressors and negatively fixed thought patterns in the child’s everyday life can be identified and the effectiveness of therapy can be evaluated. With self-assessment training, children learn to see themselves more realistically and optimistically, to recognize their own strengths, and to notice positive changes. As part of self reinforcement, the child rewards himself or herself for positive problem-solving strategies (review: Stark et al.).
Patient Activation in Depressive Disorders
When treating depressed children or adolescents, an activity plan that includes activities and events that are enjoyable for the child is highly recommended. They counteract the tendency toward withdrawal, passivity and decreased motivation typical of depression and promote positive experiences and improved moods.
Acquiring and reinforcing social skills
Social skills training should address both verbal and non-verbal modes of behavior (e.g., eye contact, smiling) essential to the expression and acceptance of both negative and positive emotions. It includes instructional techniques, model training and playing (practical use) of socially appropriate modes of behavior with feedback from the therapist. The child has to learn to think through the problem first, to develop strategies to solve it and to anticipate the consequences of possible actions.
Problems in the treatment of depressive disorders in children and adolescents
In the process of psychotherapy for depressed children and adolescents, problems often arise. For example, the cognitive-behavioral concept assumes that the patient is actively involved in treatment, but depressed patients are often passive and silent during therapy, so even the verbal exchange of information is difficult. Hopelessness and anhedonia in a child or teenager, typical for depression, sometimes already from the very beginning make it impossible for them to count on the success of therapy (“it all makes no sense”).
The activities conceived as ways of positive reinforcement are not experienced as such because of the depressive attitude of the child. Concentration disorders and difficulties in decision making can also negatively affect the therapeutic process.
Therefore, the therapist in treating depressed children and adolescents should consider the role of factors that strengthen the patient’s compliance (agreement with oneself). These include a pleasant environment and a positive perception of oneself. Often role-playing and pictorial material encourage the patient’s cooperation more than predominantly verbal communication. Therapeutic instructions and supportive attitudes should never be formulated in general terms – they should always be based on the personal life experiences of the child and his or her family.
Editor: Iskander Milewski. Date of publication update: 18.3.2021
Cognitive-behavioral exercises
In difficult life situations, modern people are no longer shy to turn to a psychologist. Often a specialist offers to sort out the causes of problems, disorders or fears with the help of cognitive-behavioral exercises.
What is cognitive behavioral therapy and which exercises will help get rid of depression, insomnia, anxiety and other dangerous conditions – read our article.
Basic principles of CBT
Psychologists say that often the source of the problems lies in the person, in his thoughts and beliefs. From early childhood, we comprehend the rules of conduct in society, we learn to understand what is good and what is bad, we acquire habits – both healthy and harmful, that interfere with a harmonious existence.
Cognitive in psychology refers to a person’s ability to respond to what is happening around him in accordance with his beliefs. When we experience difficulties, we experience fear, helplessness, anger. These negative reactions are our “habit” of perceiving disturbing events that way. And such attitudes can cause us to do rash things, to communicate inadequately with others, to panic. Cognitive-behavioral psychotherapy is what helps us to become aware of these errors in thinking and behavior, and special exercises encourage people to abandon their distorted perception of events as a matter of habit, teach them to look at a problem from a new position and cope with difficulties easily.
Objectives of cognitive-behavioral exercises
CPT is quite popular and has long been successfully used by specialists not only for the prevention and correction of mental disorders, but also as a method capable of changing thinking and behavior into more rational and useful ones.
A psychotherapist teaches patients techniques and exercises that:
Aim to identify negative and disturbing thoughts;
help revise internal stereotypes and attitudes;
- Teach them how to correctly respond to external stimuli and control their emotions;
- Form a life-affirming behavior;
- have a calming effect.
As a result, a person who has mastered the CPT exercises and does them regularly goes through stressful and frightening situations without the usual anxieties.
Learning and developing mental and motor activity.
Who can benefit from CBT exercises and who cannot?
Using a cognitive-behavioral approach can help:
Those who want to understand the causes of their anxieties and fears;
Those seeking to correct behavioral errors;
People suffering from depression, phobias and panic attacks;
patients suffering from various types of addictions (drug addiction, alcoholism, addictive relationships, gambling addiction, eating disorders and others)
people who are prone to psychosomatic illnesses;
wishing to increase stress resistance and self-control;
Those seeking to improve communication with others;
patients with sleep disorders.
Cognitive behavioral therapy and its exercises are not suitable for everyone. People with severe mental disorders (e.g., schizophrenia) need serious treatment, including medication. In such cases, only a doctor can help get rid of the acute psychological symptoms of the disease and prevent dangerous consequences.
The Most Effective Cognitive Behavioral Therapy Exercises
In detail about the method of CBT and its practical techniques told by our teachers in a distance course on this type of psychotherapy. We have gathered for you five of the most effective exercises that are used by helping professionals in psychotherapy, which you can practice on your own, to reduce or completely eliminate destructive and/or inappropriate behavior and cope with psychological discomfort.
Exercise FIRST “Getting rid of anxiety with Gestalt therapy techniques:
This step-by-step exercise will help reduce anxiety symptoms.
1. Ask yourself questions and try to be as honest as possible in your answers:
Does worrying about my future ruin the quality of my present life?
Am I anxious because my problems are big and unsolvable? Or am I doing nothing to solve them?
Can I do the things I’m afraid of right now? (For example, plan a future action or have a serious conversation with someone I’ve been putting off talking to for a long time).
2. After the answers, try to mentally imagine all your excitement today and live it right in the moment.
3. Concentrate on the reality around you.
Think about how you are feeling at the moment, what sounds you hear, colors and smells.
Write down everything you are feeling.
4. Listen to your inner feelings (the rhythm of your heartbeat and breathing) and write down exactly what you feel. Answer the question, “Do I feel all parts of my body?” And if not, try to repeat the analysis of sensations, focusing exactly on that part of the body which was inactive.
This exercise helps you to cope with anxiety, to calm down, and to shift your attention.
Exercise SECOND: “How to overcome fear using the method of psychologist Albert Ellis:
Often our fears arise from false attitudes. What we fear is not a real threat to us. To deal with fears and phobias, you need to:
Laugh at your fears. Think about what you need other people’s approval for, such as a cooked dish. And if the soup turned out to be under-salted or unpalatable, they would say so and not eat it. And if everyone keeps quiet and eats, it means the soup is good. Laugh at yourself and what you expected from your loved ones.
Openly share your fear with a loved one and tell them how you feel about it.
Find the false cause of the fears and transform it into a reasonable cause.
Observe your worries and admit that they are small and insignificant. For example, if you are afraid of appearing weak to others because you feel strongly, you need to confess that you are ashamed of your emotions, and it is an unreasonable fear, because everyone has a right to feel.
