cover

Contents

Cover

Clinician's Guide to Evidence-Based Practice Series

Title Page

Copyright

Series Introduction

Acknowledgments

About the Editors

About the Contributors

Chapter 1: Introduction: Evidence-Based Practice for Major Depressive Disorder

Major Depressive Disorder: Definition, Epidemiology, and Course

Assessment of Depression

Evidence-Based Treatment for Depression: Interventions Not Included in This Volume

Evidence-Based Treatment for Depression: Interventions Included in This Volume

References

Chapter 2: Cognitive Behavior Therapy Treatment for Adolescents

Two Cognitive Behavior Therapy Interventions

The General Structure of Cognitive Behavior Therapy Sessions

Parent Participation

Stages of Cognitive Behavior Therapy

Core Depression Cognitive Behavior Therapy Skills

Treatment Rationale and Goal Setting

Mood Monitoring

Clinical Example: Mood Monitoring Review in Group CBT

Increasing Fun Activities: Behavioral Activation

Clinical Example: Generating Fun Activities in Group CBT

Cognitive Distortions and Realistic Counter-Thoughts: Cognitive Restructuring

Clinical Example: Explaining the CAB Method in Group CBT

Clinical Example: Practice Developing Counter-Thoughts in Group CBT

Clinical Example: Working With Personal Examples in Group CBT, Part 1

Clinical Example: Working With Personal Examples, Part 2

Optional CBT Skills

Problem Solving

Social Skills

Relaxation

Communication

Affect Regulation

Skill Integration/Relapse Prevention

Indications and Contraindications for Cognitive Behavior Therapy With Depressed Adolescents

Additional Readings and Continued Training

References

Chapter 3: Cognitive Behavior Therapy for Depressed Adults

Introduction

The Cognitive-Behavioral Model of Depression

Case Conceptualization

Techniques

The Role of Homework in Cognitive Behavior Therapy for Depression

Applying Cognitive Behavior Therapy With the Suicidal Client

Special Issues

Conclusion

References

Chapter 4: Behavioral Activation for Depression

Introduction

Theoretical Considerations

General Principles of Behavioral Activation

Assessment in Behavioral Activation

The Therapy Relationship in Behavioral Activation

The Structure of Behavioral Activation

Providing a Rationale in Behavioral Activation

Assessment: Obtaining Information to Guide Activity Scheduling

Activity Scheduling

Reviewing Homework

Additional Behavioral Activation Strategies

Termination

References

Chapter 5: Cognitive Behavioral Analysis System of Psychotherapy for Chronic Depression

Introduction

Case of Sam Smith

End of Therapy Assessment

Summary

References

Chapter 6: One Size Does Not Fit All: Cultural Considerations in Evidence-Based Practice for Depression

How Do We Define Diverse Populations?

Research Evidence for EBP for Depression With Diverse Cultural Groups

How Should EBP Be Adapted for Diverse Populations?

Recommendations for Applying EBP With Diverse Populations

Concluding Thoughts

References

Afterword

Reference

Appendix A: Research Providing the Evidence Base for the Interventions in This Volume

Cognitive Behavioral Treatment for Adolescent Depression

Cognitive Behavioral Treatment for Adult Depression

Behavioral Activation

Cognitive Behavioral Analysis System of Psychotherapy for Depression

References

Appendix B: The Evidence-Based Practice Process

Step 1. Formulate a Question

Step 2. Search for Evidence

Step 3. Critically Appraise the Evidence

Step 4. Integration, Selection, and Implementation

Step 5. Monitor/Evaluate Outcome

References

Professional Resources and Recommended Reading

Author Index

Subject Index

Study Package Continuing Education Credit Information

Clinician's Guide to Evidence-Based Practice Series

Treatment of Traumatized Adults and Children

Allen Rubin and David W. Springer, Editors

Substance Abuse Treatment for Youth and Adults

David W. Springer and Allen Rubin, Editors

Psychosocial Treatment of Schizophrena

Allen Rubin, David W. Springer, and Kathi Trawver, Editors

Treatment of Depression in Adolescents and Adults

David W. Springer, Allen Rubin, and Christopher G. Beevers, Editors

Title Page

Series Introduction

One of the most daunting challenges to the evidence-based practice (EBP) movement is the fact that busy clinicians who learn of evidence-based interventions are often unable to implement them because they lack expertise in the intervention and lack the time and resources to obtain the needed expertise. Even if they want to read about the intervention as a way of gaining that expertise, they are likely to encounter materials that are either much too lengthy in light of their time constraints or much too focused on the research support for the intervention, with inadequate guidance to enable them to implement it with at least a minimally acceptable level of proficiency.

This is the fourth in a series of edited volumes that attempt to alleviate that problem and thus make learning how to provide evidence-based interventions more feasible for such clinicians. Each volume is a how-to guide for practitioners—not a research-focused review. Each contains in-depth chapters detailing how to provide clinical interventions whose effectiveness is being supported by the best scientific evidence.

The chapters differ from chapters in other reference volumes on empirically supported interventions in both length and focus. Rather than covering in depth the research support for each intervention and providing brief overviews of the practice aspects of the interventions, our chapters are lengthier and more detailed practitioner-focused how-to guides for implementing the interventions. Instead of emphasizing the research support in the chapters, that support is summarized in Appendix A. Each chapter focuses on helping practitioners learn how to begin providing an evidence-based intervention that they are being urged by managed care companies (and others) to provide, but with which they may be inexperienced. Each chapter is extensive and detailed enough to enable clinicians to begin providing the evidence-based intervention without being so lengthy and detailed that reading it is too time consuming and overwhelming. The chapters also identify resources for gaining more advanced expertise in the interventions.

We believe that this series is unique in its focus on the needs of practitioners and in making empirically supported interventions more feasible for them to learn about and provide. We hope that you will agree and that you will find this volume and this series to be of value in guiding your practice and in maximizing your effectiveness as an evidence-based practitioner.

Allen Rubin, Ph.D.
David W. Springer, Ph.D.

Acknowledgments

Special thanks go to four Wiley staff members who helped make this series possible. In alphabetical order they are: Peggy Alexander, vice president and publisher; the late Lisa Gebo, senior editor; Sweta Gupta, editorial program coordinator; and Rachel Livsey, senior editor.

About the Editors

David W. Springer, PhD, LCSW, is the associate dean for academic affairs and a university distinguished teaching professor in the School of Social Work at the University of Texas at Austin, where he is also investigator of the Inter-American Institute for Youth Justice and holds a joint appointment with the Department of Psychology. Dr. Springer received his PhD in Social Work from Florida State University, where he also received a Master of Social Work degree and a Bachelor of Arts in Psychology. Dr. Springer's social work practice experience has included work as a clinical social worker with adolescents and their families in inpatient and outpatient settings and as a school social worker in an alternative learning center with youth recommended for expulsion for serious offenses. His interest in developing and implementing effective clinical interventions continues to drive his work. His areas of interest include: evidence-based substance abuse and mental health treatment with youth; forensic social work with juvenile delinquents; intervention research with adolescents; and applied psychometric theory and scale development. He currently serves on the editorial board of several professional journals and on the National Scientific and Policy Advisory Council of the Hogg Foundation for Mental Health. Dr. Springer has co-authored or co-edited several other books, including: Substance Abuse Treatment for Criminal Offenders: An Evidence-Based Guide for Practitioners; Developing and Validating Rapid Assessment Instruments; Social Work in Juvenile and Criminal Justice Settings (3rd ed.); and Handbook of Forensic Mental Health with Victims and Offenders: Assessment, Treatment, and Research. Dr. Springer recently served as chair of a Blue Ribbon Task Force consisting of national and regional leaders, which was charged with making recommendations for reforming the juvenile justice system in Texas. In recognition of his work with the Blue Ribbon Task Force, the National Association of Social Workers (NASW), Texas Chapter/Austin Branch, selected Dr. Springer as the 2008 Social Worker of the Year.

Allen Rubin, PhD, is the Bert Kruger Smith Centennial Professor in the School of Social Work at the University of Texas at Austin, where he has been a faculty member since 1979. While there, he worked as a therapist in a child guidance center and developed and taught a course on the assessment and treatment of traumatized populations. Earlier in his career he worked in a community mental health program providing services to adolescents and their families. He is internationally known for his many publications pertaining to research and evidence-based practice. In 1997 he was a co-recipient of the Society for Social Work and Research Award for Outstanding Examples of Published Research for a study on the treatment of male batterers and their spouses. His most recent studies have been on the effectiveness of EMDR and on practitioners’ views of evidence-based practice. Among his 12 books, his most recent is Practitioner's Guide to Using Research for Evidence-Based Practice. He has served as a consulting editor for seven professional journals. He was a founding member of the Society for Social Work and Research and served as its president from 1998 to 2000. In 1993 he received the University of Pittsburgh, School of Social Work's Distinguished Alumnus Award. In 2007 he received the Council on Social Work Education's Significant Lifetime Achievement in Social Work Education Award.

Christopher G. Beevers, PhD, is an associate professor and director of the Mood Disorders Laboratory (http://www.psy.utexas.edu/MDL) in the Department of Psychology at the University of Texas at Austin. He is also a licensed psychologist in the state of Texas. Dr. Beevers received his PhD in Clinical Psychology from the University of Miami and completed his post-doctoral training in mood disorders research in the Department of Psychiatry and Human Behavior at Brown University. Dr. Beevers’ research examines the etiology, maintenance, and treatment of depression. His most recent work examines the effectiveness of a cognitive bias modification program as an adjunctive treatment for depression. He is also currently investigating genetic, neural, and behavioral associations with cognitive vulnerability to depression. Dr. Beevers has received research funding from the National Institute of Mental Health (NIMH) and the Department of Defense. He currently serves on the editorial board of several leading journals in his area of research, including the Journal of Consulting and Clinical Psychology, Behavior Therapy, and Cognitive Therapy and Research. He has been a grant reviewer for national and international organizations, including the National Institutes of Health, Swiss National Science Foundation, Netherlands Organization for Scientific Research, and the National Institute for Health Research (United Kingdom). In 2006 he received the President's New Researcher Award from the Association of Behavioral and Cognitive Therapies. In 2009 he was a Beck Scholar at the Beck Institute for Cognitive Therapy and Research.

About the Contributors

David Baruch, MA, is a PhD student in clinical psychology at the University of Wisconsin–Milwaukee. His clinical interests include the treatment of depression and the integration of spirituality to enhance treatment efficacy of ESTs. David's primary research interests include the development of protocols to maximize homework completion in therapy, to integrate spirituality into ESTs for depression, and to design novel means of training therapists in ESTs.

William Bowe is a PhD student in clinical psychology at the University of Wisconsin–Milwaukee. His clinical interests include the treatment of depression, borderline personality disorder, and impulse control disorders using empirically supported interventions. In line with his clinical work, William's primary research interests are the development and dissemination of empirically supported treatments for depression that are culturally adapted for underserved ethnic minority populations.

Andrew Busch is a postdoctoral fellow at the Centers for Behavioral and Preventive Medicine at the Alpert Medical School of Brown University. His research interests include behavioral treatments for depression and the adaptation of Behavioral Activation for novel populations.

Esteban V. Cardemil is an associate professor at Clark University in Worcester Massachusetts. He received his PhD in clinical psychology from the University of Pennsylvania. His research focuses on the effects of race, ethnicity, and social class on psychopathology, and he has developed a particular focus on the development of prevention interventions for depression. Dr. Cardemil has written extensively about the process of adapting evidence-based practice for different cultural groups, and he is currently the principal investigator of a National Institute of Mental Health–funded grant to examine the help-seeking process for depression among Latino men.

Jonathan W. Kanter, PhD, is associate professor, director of the Depression Treatment Specialty Clinic, and Psychology Department Clinic Coordinator at the Department of Psychology at the University of Wisconsin–Milwaukee. He is also a core scientist with the Center for Addictions and Behavioral Health Research at the University of Wisconsin-Milwaukee. Dr. Kanter has published more than 50 articles and chapters on behavioral activation, behavioral theory of depression, and using the therapeutic relationship in behavior therapy and has presented numerous workshops and talks on these topics. Currently, Dr. Kanter is funded by the National Institute of Mental Health to develop Behavioral Activation for Latinos with depression and is the recipient of an NIMH award to his clinical training program as a Program of Excellence in Empirically Validated Behavioral Treatments.

James P. McCullough Jr., PhD, is distinguished professor of psychology and psychiatry at Virginia Commonwealth University where he has worked since 1972. He developed the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) during the early 1970s, the only psychotherapy model constructed specifically for the treatment of the chronically depressed patient. He has conducted psychotherapy research with the chronic patient for almost four decades. Dr. McCullough has served as a principal investigator in three national randomized clinical trials involving more than 2,200 chronically depressed outpatients. In addition, he has participated in the American Psychiatric Association's revisions of the DSM-IV and DSM-V unipolar mood disorder nomenclature.

Oswaldo Moreno is a clinical psychology doctoral student at Clark University in Worcester, Massachusetts. He serves as a graduate research assistant on an NIMH-funded mixed-methods investigation of help-seeking for depression among Latino men. His research interests are in the area of mental health disparities and mental health care in Latinos, as well as religiosity/spirituality among Latinos.

Cory F. Newman, PhD, ABPP, is director of the Center for Cognitive Therapy, and associate professor of psychology in psychiatry at the University of Pennsylvania School of Medicine. Dr. Newman is a diplomate of the American Board of Professional Psychology, with a specialty in behavioral psychology, and a founding fellow of the Academy of Cognitive Therapy. Dr. Newman has served as both a protocol therapist and protocol supervisor in a number of large-scale psychotherapy outcome studies, including the Penn-Vanderbilt-Rush Treatment of Depression Projects. Dr. Newman is also an international lecturer, having presented scores of cognitive therapy workshops and seminars across the United States and Canada, as well as 13 countries in Europe, South America, and Asia. Dr. Newman is the author of dozens of articles and chapters on cognitive therapy for a wide range of disorders and has co-authored four books, including Bipolar Disorder: A Cognitive Therapy Approach (APA, 2001).

J. Kim Penberthy, PhD, is director of training for the Center for Addiction Research and Education and associate professor in the Department of Psychiatry & Neurobehavioral Sciences at the University of Virginia School of Medicine. She is the North American representative for the CBASP Network International and co-investigator on over ten large NIH-funded psychopharmacotherapy trials for depression and/or addiction. Dr. Penberthy's research focus is on development and implementation of evidence-based treatments for chronic depression as well as for addictions and co-occurring disorders, with a focus on acquisition learning. She conducts and supervises clinical research and practice. In addition, Dr. Penberthy publishes and lectures internationally on these and related topics.

Paul Rohde, PhD, is a senior research scientist at Oregon Research Institute (ORI) and has 22 years of experience as a research scientist with a substantive focus on the etiology, treatment, and prevention of adolescent depression and comorbid psychopathologies. Dr. Rohde received his PhD from the University of Oregon in 1988 and has been a licensed psychologist since 1990. He has directed or co-directed 21 federally funded research projects, including five randomized controlled trials (RCTs) evaluating adolescent depression treatment interventions and two RCTs evaluating adolescent depression prevention interventions. His most recent adolescent depression treatment research includes participation in TADS (Treatment for Adolescents with Depression Study), which evaluated the effectiveness of Cognitive Behavioral Therapy (CBT) and fluoxetine for the treatment of adolescent major depression, and his direction of a NIDA-funded study evaluating service delivery methods for integrating CBT and family-based treatment for adolescents with comorbid depressive and substance use disorders.

Monica Sanchez is a clinical psychology doctoral student at Clark University in Worcester, Massachusetts. She completed her undergraduate work at the University of California, Berkeley. Using a community participatory approach, her research focuses on understanding the particular mental health needs of minority and disadvantaged communities. She is currently studying the role that cultural definitions of mental illness, in addition to cognitive factors, play in mental health help-seeking for Latinos.