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Cognitive-behavioral therapies (CBTs) are grounded in the belief that our thoughts profoundly influence our emotions and actions. Advocates of CBT emphasize three core assumptions: first, that cognitions are identifiable and measurable; second, that they are central to psychological functioning; and third, that irrational or maladaptive beliefs can be replaced with rational and adaptive ones. This transformative approach to therapy has paved the way for specific models such as Albert...
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Related Experiment Video

Updated: Jul 30, 2025

Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging
09:14

Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging

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CBT for difficult-to-treat depression: self-regulation model.

Stephen B Barton1,2, Peter V Armstrong1, Lucy J Robinson1

  • 1School of Psychology, Newcastle University, Dame Margaret Barbour Building, Newcastle upon TyneNE2 4DR, UK.

Behavioural and Cognitive Psychotherapy
|May 12, 2023
PubMed
Summary
This summary is machine-generated.

A new self-regulation model of depression targets difficult-to-treat cases. This cognitive behavioural therapy (CBT) approach focuses on self-regulation skills and identity restructuring for improved outcomes in complex depression.

Keywords:
cognitive behavioural therapycomplex casesdepressionself-regulation

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Area of Science:

  • Psychology
  • Clinical Psychology
  • Psychotherapy Research

Background:

  • Cognitive Behavioural Therapy (CBT) is effective for depression but fails some individuals.
  • A significant minority of clients do not complete therapy, respond, or relapse, often due to complex factors like adverse childhood experiences and comorbidities.
  • This heterogeneous group presents challenges for current treatment models.

Purpose of the Study:

  • To develop an integrated Cognitive Behavioural Therapy (CBT) model tailored for difficult-to-treat depression.
  • To address the needs of individuals who have not responded to standard CBT interventions.

Main Methods:

  • Unified theory, evidence, and clinical strategies within CBT to create an integrated model.
  • Employed single-case methods for the development of specific treatment components.
  • Developed a self-regulation model based on interlocking processes maintaining depression.

Main Results:

  • A self-regulation model of depression was developed, proposing maintenance through interconnected disruptions in self-identity, motivation, engagement, rumination, intrusive memories, and life goals.
  • Treatment focuses on building self-regulation skills and restructuring self-identity, moving beyond targeting negative beliefs.
  • A personalized therapy plan comprising ten components was created, guided by individual case formulation.

Conclusions:

  • A novel self-regulation model of depression is proposed, integrating CBT theory, evidence, and practice.
  • The model is specifically designed for difficult-to-treat depression cases.
  • Further empirical testing is underway, with a case example detailed in a concurrent publication.