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Psychotherapy and Counselling for Depression (Counselling in Practice series) PDF

425 Pages·2007·2.83 MB·English
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Gillbert (Counselling)-3525-Prelims.qxd 4/20/2007 9:02 PM Page i Psychotherapy and Counselling for Depression Gillbert (Counselling)-3525-Prelims.qxd 4/20/2007 9:02 PM Page ii Counselling in Practice Series editor: Windy Dryden Associate editor: E. Thomas Dowd Counselling in Practiceis a series of books developed especially for counsellors and students of counselling, which provides practical, accessible guidelines for dealing with clients with specific, but very common, problems. Books in this series have become recognised as classic texts in their field, and include: Career Counselling, second edition Robert Nathan and Linda Hill Counselling Survivors of Childhood Sexual Abuse, third edition Claire Burke Draucker and Donna Martsolf Counselling for Post-Traumatic Stress Disorder, third edition Michael J. Scott and Stephen G. Stradling Counselling for Eating Disorders, second edition Sara Gilbert Counselling for Alcohol Problems, second edition Richard Velleman Counselling for Anxiety Problems, second edition Diana Sanders and Frank Wills Counselling for Family Problems Eddy Street Counselling for Stress Problems Stephen Palmer and Windy Dryden Counselling for Grief and Bereavement Geraldine M. Humphrey and David G. Zimpfer Counselling Couples Donald L. Bubenzer and John D. West Counselling for Psychosomatic Problems Diana Sanders Counselling People on Prescribed Drugs Diane Hammersley Counselling for Fertility Problems Jane Read Counselling People with Communication Problems Peggy Dalton Counselling with Dreams and Nightmares Delia Cushway and Robyn Sewell Gillbert (Counselling)-3525-Prelims.qxd 4/20/2007 9:02 PM Page iii Psychotherapy and Counselling for Depression Third Edition Paul Gilbert Gillbert (Counselling)-3525-Prelims.qxd 4/20/2007 9:02 PM Page iv © Paul Gilbert 1992, 2000, 2007 First published 1992 Reprint four times Second edition published 2000 Reprinted four times This third edition published 2007 Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act 1988, this publicationmay be reproduced, stored or transmitted in any form, or by any means, only with the prior permission in writing of the publishers, or in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers. SAGE Publications Ltd 1 Oliver’s Yard 55 City Road London EC1Y1SP SAGE Publications Inc. 2455 Teller Road Thousand Oaks, California 91320 SAGE Publications India Pvt Ltd B 1/I 1 Mohan Cooperative Industrial Area Mathura Road, New Delhi 110 044 India SAGE Publications Asia-Pacific Pte Ltd 33 Pekin Street #02-01 Far East Square Singapore 048763 British Library Cataloguing in Publication data Acatalogue record for this book is available from the British Library ISBN 978-1-4129-0276-2 ISBN 978-1-4129-0277-9 (pbk) Library of Congress Control Number 2006935792 Typeset by C&M Digitals (P) Ltd., Chennai, India Printed in Great Britain by The Cromwell Press Ltd, Trowbridge, Wiltshire Printed on paper from sustainable resources Gillbert (Counselling)-3525-Prelims.qxd 4/20/2007 9:02 PM Page v To my long enduring family for all your love and support, and my clients who have tried to educate me Gillbert (Counselling)-3525-Prelims.qxd 4/20/2007 9:02 PM Page vi Gillbert (Counselling)-3525-Prelims.qxd 4/20/2007 9:02 PM Page vii Contents Preface to the First Edition ix Preface to the Second Edition x Preface to the Third Edition xii Acknowledgements xiv Part I Understanding the Nature of Depression with a Biopsychosocial Approach 1 1 Depression: The Basics 3 2 Multi-Level Systems in Depression 22 3 The Brain, Threats and Depression 47 4 Behavioural Approaches: Action Matters 63 5 Human Social Needs and Roles: Attachment, Social Connectedness and Defeat 80 6 Thinking, Self-Awareness, Social Goals and the Role of Shame in Depression 112 Part II Processes for the Therapeutic Journey 145 7 The Therapeutic Relationship and Working Alliance 147 8 Beginning the Therapeutic Journey with the Depressed Person 172 9 Thoughts, Beliefs and Safety Strategies: Constructing Formulations 192 10 Helping People Engage and Change: Some Basic Principles 223 11 Developing Self-Compassion 241 12 Focusing Interventions with a Special Reference to Self-Criticism 267 13 Working with Specific Difficulties I: Approval, Achievement, Assertiveness and Rebellion 291 Gillbert (Counselling)-3525-Prelims.qxd 4/20/2007 9:02 PM Page viii viii Psychotherapy and Counselling for Depression 14 Working with Specific Difficulties II: Shame, Guilt, Ideal and Envy 306 15 Overview, Saying Goodbye and Personal Reflections 327 Appendix 1 Formulation and Case Conceptualisation 341 Appendix 2 Behavioural Scheduling 344 Appendix 3 Working with People’s Thinking 346 Appendix 4 Some Useful Things to Reflect on in Regard to Working with Depressing Thoughts 348 Appendix 5 Compassion-Focused Therapy 354 Appendix 6 Building a Compassionate Image (Client Handout) 356 Appendix 7 Using Compassion to Change our Minds (for Therapists) 357 Appendix 8 Compassionate Letter Writing 362 Appendix 9 The Consequences of Becoming Compassionate to Self and Others 366 Appendix 10 Self-Help Material and Useful Websites 367 Bibliography 370 Index 394 Gillbert (Counselling)-3525-Prelims.qxd 4/20/2007 9:02 PM Page ix Preface to the First Edition Cognitive therapy began in America some thirty years ago. Since that time, it has seen enormous developments in the client groups treated and in its therapeutic approach. Two areas that have seen important changes to the early formulations are a renewed focus on the therapeutic relationship (e.g. Beck et al., 1990; Safran and Segal, 1990) and an increased focus on interpersonal cognitive processes (e.g. Bowlby, 1980; Liotti, 1988; Safran and Segal, 1990). Both these concerns are a main focus in this book. In 1988 Trower et al. published Cognitive-behavioural Counselling in Action (London: Sage). They outlined the basic techniques and issues of the cognitive approach. The present volume, for the ‘Counselling in Practice’ series, is designed to build on their introduction. It explores interpersonal counselling with a particular client group – depressed people. The aims of this book are to focus on the interpersonal themes in counselling depressed clients, including those of the therapeutic relationship. The book is divided into two sections of four chapters each. Chapter 1 addresses issues of the nature of depression and the therapeutic relationship. Here I try to capture some- thing of the nature of the depressive experience and focus on important counsellor skills. Chapter 2 explores the central issues of interpersonal approaches, the basic domains of relationships and how these are affected in depression. Chapter 3 out- lines the basic premises of the cognitive approach and why cognitive counsellors are particularly concerned with the construction of internal meaning, ways of attributing causes to things, and basic attitudes and beliefs. Chapter 4 explores the many ways of conceptualising therapeutic interventions and challenging dysfunctional thoughts and attitudes. The second section aims to build on these concepts, and lead the reader through a step-by-step approach to the process of counselling the depressed person. Counselling scenarios are given to illuminate specific points and highlight types of intervention. Most of these scenarios are not derived directly from taped interviews (although some are) but from notes made at the end of sessions. They are not meant to represent exact scenes but rather to indicate and highlight issues. All client names have been changed, and minor alterations introduced in the his- tory, to avoid identification. Chapter 5 outlines the issues that arise during the early parts of the therapy, and how to engage and agree shared understandings and goals of counselling. Chapter 6 explores the kinds of issues that arise in the middle of counselling, as the counsellor and client engage in deeper explorations and seek opportunities for change. Chapter 7 looks at some special problems that arise in depressed clients. Special attention is given to shame, guilt, envy and ide- alising which often figure prominently in depressive experience. Chapter 8 explores termination issues and offers some personal reflections.

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The Third Edition of Counselling and Psychotherapy for Depression is a popular and practical guide to working with people suffering from depression. As well as describing the skills and techniques used by practitioners, the book explores the features and complexities of depressed states including ge
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