Zgryźliwość kojarzy mi się z radością, która źle skończyła.
COGNITIVE THERAPY FOR
CHRONIC AND PERSISTENT
DEPRESSION
Richard G. Moore
Addenbrooke’s Hospital, Cambridge
and
Anne Garland
Nottingham Psychotherapy Unit
The Wiley Series in
CLINICAL PSYCHOLOGY
Richard G. Moore
Cognitive Therapy for Chronic
and Anne Garland
and Persistent Depression
Ross G. Menzies
Obsessive-Compulsive Disorder:
and Padmal de Silva (Editors)
Theory, Research and Treatment
David Kingdon
The Case Study Guide to Cognitive Behaviour
and Douglas Turkington
Therapy of Psychosis
(Editors)
Hermine L. Graham,
Substance Misuse in Psychosis: Approaches to
Alex Copello,
Treatment and Service Delivery
Max J. Birchwood
and Kim T. Mueser (Editors)
Jenny A. Petrak
The Trauma of Sexual Assault: Treatment,
and Barbara Hedge (Editors)
Prevention and Practice
Gordon J.G. Asmundson,
Health Anxiety: Clinical and Research
Steven Taylor
Perspectives on Hypochondriasis and
and Brian J. Cox (Editors)
Related Conditions
Kees van Heeringen
Understanding Suicidal Behaviour:
(Editor)
The Suicidal Process Approach to Research,
Treatment and Prevention
Craig A. White
Cognitive Behaviour Therapy for Chronic
Medical Problems: A Guide to Assessment
and Treatment in Practice
Steven Taylor
Understanding and Treating Panic Disorder:
Cognitive-Behavioural Approaches
Alan Carr
Family Therapy: Concepts, Process and Practice
Max Birchwood,
Early Intervention in Psychosis:
David Fowler
A Guide to Concepts, Evidence and
and Chris Jackson (Editors)
Interventions
Dominic H. Lam,
Cognitive Therapy for Bipolar Disorder:
Steven H. Jones,
A Therapist’s Guide to Concepts, Methods
Peter Hayward
and Practice
and Jenifer A. Bright
A list of earlier titles in the series follows the index.
COGNITIVE THERAPY FOR
CHRONIC AND PERSISTENT
DEPRESSION
Richard G. Moore
Addenbrooke’s Hospital, Cambridge
and
Anne Garland
Nottingham Psychotherapy Unit
Copyright
C
_
2003 John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester,
West Sussex PO19 8SQ, England
Telephone (+44) 1243 779777
Email (for orders and customer service enquiries): cs-books@wiley.co.uk
Visit our Home Page on www.wileyeurope.com or www.wiley.com
All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval
system or transmitted in any form or by any means, electronic, mechanical, photocopying,
recording, scanning or otherwise, except under the terms of the Copyright, Designs and
Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency
Ltd, 90 Tottenham Court Road, London W1T 4LP, UK, without the permission in writing of
the Publisher. Requests to the Publisher should be addressed to the Permissions
Department, John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex
PO19 8SQ, England, or emailed to permreq@wiley.co.uk, or faxed to (+44) 1243 770620.
This publication is designed to provide accurate and authoritative information in regard to
the subject matter covered. It is sold on the understanding that the Publisher is not engaged
in rendering professional services. If professional advice or other expert assistance is
required, the services of a competent professional should be sought.
OtherWiley Editorial Offices
John Wiley & Sons Inc., 111 River Street, Hoboken, NJ 07030, USA
Jossey-Bass, 989 Market Street, San Francisco, CA 94103-1741, USA
Wiley-VCH Verlag GmbH, Boschstr. 12, D-69469 Weinheim, Germany
John Wiley & Sons Australia Ltd, 33 Park Road, Milton, Queensland 4064, Australia
John Wiley & Sons (Asia) Pte Ltd, 2 Clementi Loop #02-01, Jin Xing Distripark, Singapore
129809
John Wiley & Sons Canada Ltd, 22 Worcester Road, Etobicoke, Ontario, Canada M9W 1L1
Wiley also publishes its books in a variety of electronic formats. Some content that appears
in print may not be available in electronic books.
Library of Congress Cataloging-in-Publication Data
Moore, Richard, 1936–
Cognitive therapy for chronic and persistent depression/Richard G. Moore and
Anne Garland.
p. cm.
Includes bibliographical references and index.
ISBN 0-471-89278-5 (Cloth)–ISBN 0-471-89279-3 (Paper : alk. paper)
1. Depression, Mental–Treatment. 2. Cognitive therapy. I. Garland, Anne. II. Title.
RC537 .M668 2003
616.85
_
2706–dc21 2003006736
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
ISBN 0-471-89278-5 (hbk)
ISBN 0-471-89279-3 (pbk)
Typeset in 10/12pt Palatino by TechBooks, New Delhi, India
Printed and bound in Great Britain by TJ International, Padstow, Cornwall
This book is printed on acid-free paper responsibly manufactured from sustainable forestry
in which at least two trees are planted for each one used for paper production.
CONTENTS
About the Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
Introduction The Challenge of Persistent Depression 1
Chapter 1 The Cognitive Model of Persistent
Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Chapter 2 The Foundations of Therapy:
Therapeutic Relationship, Style
and Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Chapter 3 Initial Assessment and Formulation . . 94
Chapter 4 Initiating Therapy: Socialisation and
Setting Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Chapter 5 Using Standard Behavioural
Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Chapter 6 Working with Automatic Thoughts . . . 198
Chapter 7 Recognising Underlying Beliefs and
Their Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231
Chapter 8 Modifying Underlying Beliefs . . . . . . . . . 257
Chapter 9 Working with Some Typical Themes
in Persistent Depression . . . . . . . . . . . . . . . 291
Chapter 10 Beyond Therapy: Preventing Relapse
and Furthering Progress . . . . . . . . . . . . . . . 319
Chapter 11 Delivering Treatment . . . . . . . . . . . . . . . . . . 341
Chapter 12 Outcomes and Processes of Therapy . . 354
CONTENTS
Appendix 1 Meet the Patients . . . . . . . . . . . . . . . . . . . . . . . 372
Appendix 2 Handouts for Patients . . . . . . . . . . . . . . . . . 381
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 397
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 407
COGNITIVE THERAPY FOR
CHRONIC AND PERSISTENT
DEPRESSION
Richard G. Moore
Addenbrooke’s Hospital, Cambridge
and
Anne Garland
Nottingham Psychotherapy Unit
COGNITIVE THERAPY FOR
CHRONIC AND PERSISTENT
DEPRESSION
The Wiley Series in
CLINICAL PSYCHOLOGY
Richard G. Moore
Cognitive Therapy for Chronic
and Anne Garland
and Persistent Depression
Ross G. Menzies
Obsessive-Compulsive Disorder:
and Padmal de Silva (Editors)
Theory, Research and Treatment
David Kingdon
The Case Study Guide to Cognitive Behaviour
and Douglas Turkington
Therapy of Psychosis
(Editors)
Hermine L. Graham,
Substance Misuse in Psychosis: Approaches to
Alex Copello,
Treatment and Service Delivery
Max J. Birchwood
and Kim T. Mueser (Editors)
Jenny A. Petrak
The Trauma of Sexual Assault: Treatment,
and Barbara Hedge (Editors)
Prevention and Practice
Gordon J.G. Asmundson,
Health Anxiety: Clinical and Research
Steven Taylor
Perspectives on Hypochondriasis and
and Brian J. Cox (Editors)
Related Conditions
Kees van Heeringen
Understanding Suicidal Behaviour:
(Editor)
The Suicidal Process Approach to Research,
Treatment and Prevention
Craig A. White
Cognitive Behaviour Therapy for Chronic
Medical Problems: A Guide to Assessment
and Treatment in Practice
Steven Taylor
Understanding and Treating Panic Disorder:
Cognitive-Behavioural Approaches
Alan Carr
Family Therapy: Concepts, Process and Practice
Max Birchwood,
Early Intervention in Psychosis:
David Fowler
A Guide to Concepts, Evidence and
and Chris Jackson (Editors)
Interventions
Dominic H. Lam,
Cognitive Therapy for Bipolar Disorder:
Steven H. Jones,
A Therapist’s Guide to Concepts, Methods
Peter Hayward
and Practice
and Jenifer A. Bright
A list of earlier titles in the series follows the index.
COGNITIVE THERAPY FOR
CHRONIC AND PERSISTENT
DEPRESSION
Richard G. Moore
Addenbrooke’s Hospital, Cambridge
and
Anne Garland
Nottingham Psychotherapy Unit
Copyright
C
_
2003 John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester,
West Sussex PO19 8SQ, England
Telephone (+44) 1243 779777
Email (for orders and customer service enquiries): cs-books@wiley.co.uk
Visit our Home Page on www.wileyeurope.com or www.wiley.com
All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval
system or transmitted in any form or by any means, electronic, mechanical, photocopying,
recording, scanning or otherwise, except under the terms of the Copyright, Designs and
Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency
Ltd, 90 Tottenham Court Road, London W1T 4LP, UK, without the permission in writing of
the Publisher. Requests to the Publisher should be addressed to the Permissions
Department, John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex
PO19 8SQ, England, or emailed to permreq@wiley.co.uk, or faxed to (+44) 1243 770620.
This publication is designed to provide accurate and authoritative information in regard to
the subject matter covered. It is sold on the understanding that the Publisher is not engaged
in rendering professional services. If professional advice or other expert assistance is
required, the services of a competent professional should be sought.
OtherWiley Editorial Offices
John Wiley & Sons Inc., 111 River Street, Hoboken, NJ 07030, USA
Jossey-Bass, 989 Market Street, San Francisco, CA 94103-1741, USA
Wiley-VCH Verlag GmbH, Boschstr. 12, D-69469 Weinheim, Germany
John Wiley & Sons Australia Ltd, 33 Park Road, Milton, Queensland 4064, Australia
John Wiley & Sons (Asia) Pte Ltd, 2 Clementi Loop #02-01, Jin Xing Distripark, Singapore
129809
John Wiley & Sons Canada Ltd, 22 Worcester Road, Etobicoke, Ontario, Canada M9W 1L1
Wiley also publishes its books in a variety of electronic formats. Some content that appears
in print may not be available in electronic books.
Library of Congress Cataloging-in-Publication Data
Moore, Richard, 1936–
Cognitive therapy for chronic and persistent depression/Richard G. Moore and
Anne Garland.
p. cm.
Includes bibliographical references and index.
ISBN 0-471-89278-5 (Cloth)–ISBN 0-471-89279-3 (Paper : alk. paper)
1. Depression, Mental–Treatment. 2. Cognitive therapy. I. Garland, Anne. II. Title.
RC537 .M668 2003
616.85
_
2706–dc21 2003006736
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
ISBN 0-471-89278-5 (hbk)
ISBN 0-471-89279-3 (pbk)
Typeset in 10/12pt Palatino by TechBooks, New Delhi, India
Printed and bound in Great Britain by TJ International, Padstow, Cornwall
This book is printed on acid-free paper responsibly manufactured from sustainable forestry
in which at least two trees are planted for each one used for paper production.
CONTENTS
About the Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
Introduction The Challenge of Persistent Depression 1
Chapter 1 The Cognitive Model of Persistent
Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Chapter 2 The Foundations of Therapy:
Therapeutic Relationship, Style
and Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Chapter 3 Initial Assessment and Formulation . . 94
Chapter 4 Initiating Therapy: Socialisation and
Setting Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Chapter 5 Using Standard Behavioural
Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Chapter 6 Working with Automatic Thoughts . . . 198
Chapter 7 Recognising Underlying Beliefs and
Their Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231
Chapter 8 Modifying Underlying Beliefs . . . . . . . . . 257
Chapter 9 Working with Some Typical Themes
in Persistent Depression . . . . . . . . . . . . . . . 291
Chapter 10 Beyond Therapy: Preventing Relapse
and Furthering Progress . . . . . . . . . . . . . . . 319
Chapter 11 Delivering Treatment . . . . . . . . . . . . . . . . . . 341
Chapter 12 Outcomes and Processes of Therapy . . 354
vi CONTENTS
Appendix 1 Meet the Patients . . . . . . . . . . . . . . . . . . . . . . . 372
Appendix 2 Handouts for Patients . . . . . . . . . . . . . . . . . 381
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 397
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 407
ABOUT THE AUTHORS
Richard Moore
works as a clinical psychologist in the Department of
Cognitive and Behavioural Psychotherapies at Addenbrooke’s Hospital
in Cambridge. After obtaining an M.A. and a Ph.D. from the University
of Cambridge and completing his clinical psychology training at the University
of Edinburgh, he trained as a cognitive therapist at the Center for
Cognitive Therapy in Philadelphia. He has been a therapist on major controlled
trials of cognitive therapy for recurrent and residual depression in
Edinburgh and in Cambridge. Through this and his subsequent experience
working with depressed patients in the NHS, Richard has acquired
expertise in providing cognitive therapy for both in- and out-patients
with chronic and recurrent depressive disorders that have not responded
fully to previous treatment. He is experienced at teaching practical clinical
zanotowane.pl doc.pisz.pl pdf.pisz.pl hannaeva.xlx.pl
CHRONIC AND PERSISTENT
DEPRESSION
Richard G. Moore
Addenbrooke’s Hospital, Cambridge
and
Anne Garland
Nottingham Psychotherapy Unit
The Wiley Series in
CLINICAL PSYCHOLOGY
Richard G. Moore
Cognitive Therapy for Chronic
and Anne Garland
and Persistent Depression
Ross G. Menzies
Obsessive-Compulsive Disorder:
and Padmal de Silva (Editors)
Theory, Research and Treatment
David Kingdon
The Case Study Guide to Cognitive Behaviour
and Douglas Turkington
Therapy of Psychosis
(Editors)
Hermine L. Graham,
Substance Misuse in Psychosis: Approaches to
Alex Copello,
Treatment and Service Delivery
Max J. Birchwood
and Kim T. Mueser (Editors)
Jenny A. Petrak
The Trauma of Sexual Assault: Treatment,
and Barbara Hedge (Editors)
Prevention and Practice
Gordon J.G. Asmundson,
Health Anxiety: Clinical and Research
Steven Taylor
Perspectives on Hypochondriasis and
and Brian J. Cox (Editors)
Related Conditions
Kees van Heeringen
Understanding Suicidal Behaviour:
(Editor)
The Suicidal Process Approach to Research,
Treatment and Prevention
Craig A. White
Cognitive Behaviour Therapy for Chronic
Medical Problems: A Guide to Assessment
and Treatment in Practice
Steven Taylor
Understanding and Treating Panic Disorder:
Cognitive-Behavioural Approaches
Alan Carr
Family Therapy: Concepts, Process and Practice
Max Birchwood,
Early Intervention in Psychosis:
David Fowler
A Guide to Concepts, Evidence and
and Chris Jackson (Editors)
Interventions
Dominic H. Lam,
Cognitive Therapy for Bipolar Disorder:
Steven H. Jones,
A Therapist’s Guide to Concepts, Methods
Peter Hayward
and Practice
and Jenifer A. Bright
A list of earlier titles in the series follows the index.
COGNITIVE THERAPY FOR
CHRONIC AND PERSISTENT
DEPRESSION
Richard G. Moore
Addenbrooke’s Hospital, Cambridge
and
Anne Garland
Nottingham Psychotherapy Unit
Copyright
C
_
2003 John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester,
West Sussex PO19 8SQ, England
Telephone (+44) 1243 779777
Email (for orders and customer service enquiries): cs-books@wiley.co.uk
Visit our Home Page on www.wileyeurope.com or www.wiley.com
All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval
system or transmitted in any form or by any means, electronic, mechanical, photocopying,
recording, scanning or otherwise, except under the terms of the Copyright, Designs and
Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency
Ltd, 90 Tottenham Court Road, London W1T 4LP, UK, without the permission in writing of
the Publisher. Requests to the Publisher should be addressed to the Permissions
Department, John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex
PO19 8SQ, England, or emailed to permreq@wiley.co.uk, or faxed to (+44) 1243 770620.
This publication is designed to provide accurate and authoritative information in regard to
the subject matter covered. It is sold on the understanding that the Publisher is not engaged
in rendering professional services. If professional advice or other expert assistance is
required, the services of a competent professional should be sought.
OtherWiley Editorial Offices
John Wiley & Sons Inc., 111 River Street, Hoboken, NJ 07030, USA
Jossey-Bass, 989 Market Street, San Francisco, CA 94103-1741, USA
Wiley-VCH Verlag GmbH, Boschstr. 12, D-69469 Weinheim, Germany
John Wiley & Sons Australia Ltd, 33 Park Road, Milton, Queensland 4064, Australia
John Wiley & Sons (Asia) Pte Ltd, 2 Clementi Loop #02-01, Jin Xing Distripark, Singapore
129809
John Wiley & Sons Canada Ltd, 22 Worcester Road, Etobicoke, Ontario, Canada M9W 1L1
Wiley also publishes its books in a variety of electronic formats. Some content that appears
in print may not be available in electronic books.
Library of Congress Cataloging-in-Publication Data
Moore, Richard, 1936–
Cognitive therapy for chronic and persistent depression/Richard G. Moore and
Anne Garland.
p. cm.
Includes bibliographical references and index.
ISBN 0-471-89278-5 (Cloth)–ISBN 0-471-89279-3 (Paper : alk. paper)
1. Depression, Mental–Treatment. 2. Cognitive therapy. I. Garland, Anne. II. Title.
RC537 .M668 2003
616.85
_
2706–dc21 2003006736
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
ISBN 0-471-89278-5 (hbk)
ISBN 0-471-89279-3 (pbk)
Typeset in 10/12pt Palatino by TechBooks, New Delhi, India
Printed and bound in Great Britain by TJ International, Padstow, Cornwall
This book is printed on acid-free paper responsibly manufactured from sustainable forestry
in which at least two trees are planted for each one used for paper production.
CONTENTS
About the Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
Introduction The Challenge of Persistent Depression 1
Chapter 1 The Cognitive Model of Persistent
Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Chapter 2 The Foundations of Therapy:
Therapeutic Relationship, Style
and Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Chapter 3 Initial Assessment and Formulation . . 94
Chapter 4 Initiating Therapy: Socialisation and
Setting Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Chapter 5 Using Standard Behavioural
Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Chapter 6 Working with Automatic Thoughts . . . 198
Chapter 7 Recognising Underlying Beliefs and
Their Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231
Chapter 8 Modifying Underlying Beliefs . . . . . . . . . 257
Chapter 9 Working with Some Typical Themes
in Persistent Depression . . . . . . . . . . . . . . . 291
Chapter 10 Beyond Therapy: Preventing Relapse
and Furthering Progress . . . . . . . . . . . . . . . 319
Chapter 11 Delivering Treatment . . . . . . . . . . . . . . . . . . 341
Chapter 12 Outcomes and Processes of Therapy . . 354
CONTENTS
Appendix 1 Meet the Patients . . . . . . . . . . . . . . . . . . . . . . . 372
Appendix 2 Handouts for Patients . . . . . . . . . . . . . . . . . 381
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 397
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 407
COGNITIVE THERAPY FOR
CHRONIC AND PERSISTENT
DEPRESSION
Richard G. Moore
Addenbrooke’s Hospital, Cambridge
and
Anne Garland
Nottingham Psychotherapy Unit
COGNITIVE THERAPY FOR
CHRONIC AND PERSISTENT
DEPRESSION
The Wiley Series in
CLINICAL PSYCHOLOGY
Richard G. Moore
Cognitive Therapy for Chronic
and Anne Garland
and Persistent Depression
Ross G. Menzies
Obsessive-Compulsive Disorder:
and Padmal de Silva (Editors)
Theory, Research and Treatment
David Kingdon
The Case Study Guide to Cognitive Behaviour
and Douglas Turkington
Therapy of Psychosis
(Editors)
Hermine L. Graham,
Substance Misuse in Psychosis: Approaches to
Alex Copello,
Treatment and Service Delivery
Max J. Birchwood
and Kim T. Mueser (Editors)
Jenny A. Petrak
The Trauma of Sexual Assault: Treatment,
and Barbara Hedge (Editors)
Prevention and Practice
Gordon J.G. Asmundson,
Health Anxiety: Clinical and Research
Steven Taylor
Perspectives on Hypochondriasis and
and Brian J. Cox (Editors)
Related Conditions
Kees van Heeringen
Understanding Suicidal Behaviour:
(Editor)
The Suicidal Process Approach to Research,
Treatment and Prevention
Craig A. White
Cognitive Behaviour Therapy for Chronic
Medical Problems: A Guide to Assessment
and Treatment in Practice
Steven Taylor
Understanding and Treating Panic Disorder:
Cognitive-Behavioural Approaches
Alan Carr
Family Therapy: Concepts, Process and Practice
Max Birchwood,
Early Intervention in Psychosis:
David Fowler
A Guide to Concepts, Evidence and
and Chris Jackson (Editors)
Interventions
Dominic H. Lam,
Cognitive Therapy for Bipolar Disorder:
Steven H. Jones,
A Therapist’s Guide to Concepts, Methods
Peter Hayward
and Practice
and Jenifer A. Bright
A list of earlier titles in the series follows the index.
COGNITIVE THERAPY FOR
CHRONIC AND PERSISTENT
DEPRESSION
Richard G. Moore
Addenbrooke’s Hospital, Cambridge
and
Anne Garland
Nottingham Psychotherapy Unit
Copyright
C
_
2003 John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester,
West Sussex PO19 8SQ, England
Telephone (+44) 1243 779777
Email (for orders and customer service enquiries): cs-books@wiley.co.uk
Visit our Home Page on www.wileyeurope.com or www.wiley.com
All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval
system or transmitted in any form or by any means, electronic, mechanical, photocopying,
recording, scanning or otherwise, except under the terms of the Copyright, Designs and
Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency
Ltd, 90 Tottenham Court Road, London W1T 4LP, UK, without the permission in writing of
the Publisher. Requests to the Publisher should be addressed to the Permissions
Department, John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex
PO19 8SQ, England, or emailed to permreq@wiley.co.uk, or faxed to (+44) 1243 770620.
This publication is designed to provide accurate and authoritative information in regard to
the subject matter covered. It is sold on the understanding that the Publisher is not engaged
in rendering professional services. If professional advice or other expert assistance is
required, the services of a competent professional should be sought.
OtherWiley Editorial Offices
John Wiley & Sons Inc., 111 River Street, Hoboken, NJ 07030, USA
Jossey-Bass, 989 Market Street, San Francisco, CA 94103-1741, USA
Wiley-VCH Verlag GmbH, Boschstr. 12, D-69469 Weinheim, Germany
John Wiley & Sons Australia Ltd, 33 Park Road, Milton, Queensland 4064, Australia
John Wiley & Sons (Asia) Pte Ltd, 2 Clementi Loop #02-01, Jin Xing Distripark, Singapore
129809
John Wiley & Sons Canada Ltd, 22 Worcester Road, Etobicoke, Ontario, Canada M9W 1L1
Wiley also publishes its books in a variety of electronic formats. Some content that appears
in print may not be available in electronic books.
Library of Congress Cataloging-in-Publication Data
Moore, Richard, 1936–
Cognitive therapy for chronic and persistent depression/Richard G. Moore and
Anne Garland.
p. cm.
Includes bibliographical references and index.
ISBN 0-471-89278-5 (Cloth)–ISBN 0-471-89279-3 (Paper : alk. paper)
1. Depression, Mental–Treatment. 2. Cognitive therapy. I. Garland, Anne. II. Title.
RC537 .M668 2003
616.85
_
2706–dc21 2003006736
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
ISBN 0-471-89278-5 (hbk)
ISBN 0-471-89279-3 (pbk)
Typeset in 10/12pt Palatino by TechBooks, New Delhi, India
Printed and bound in Great Britain by TJ International, Padstow, Cornwall
This book is printed on acid-free paper responsibly manufactured from sustainable forestry
in which at least two trees are planted for each one used for paper production.
CONTENTS
About the Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
Introduction The Challenge of Persistent Depression 1
Chapter 1 The Cognitive Model of Persistent
Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Chapter 2 The Foundations of Therapy:
Therapeutic Relationship, Style
and Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Chapter 3 Initial Assessment and Formulation . . 94
Chapter 4 Initiating Therapy: Socialisation and
Setting Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Chapter 5 Using Standard Behavioural
Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Chapter 6 Working with Automatic Thoughts . . . 198
Chapter 7 Recognising Underlying Beliefs and
Their Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231
Chapter 8 Modifying Underlying Beliefs . . . . . . . . . 257
Chapter 9 Working with Some Typical Themes
in Persistent Depression . . . . . . . . . . . . . . . 291
Chapter 10 Beyond Therapy: Preventing Relapse
and Furthering Progress . . . . . . . . . . . . . . . 319
Chapter 11 Delivering Treatment . . . . . . . . . . . . . . . . . . 341
Chapter 12 Outcomes and Processes of Therapy . . 354
vi CONTENTS
Appendix 1 Meet the Patients . . . . . . . . . . . . . . . . . . . . . . . 372
Appendix 2 Handouts for Patients . . . . . . . . . . . . . . . . . 381
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 397
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 407
ABOUT THE AUTHORS
Richard Moore
works as a clinical psychologist in the Department of
Cognitive and Behavioural Psychotherapies at Addenbrooke’s Hospital
in Cambridge. After obtaining an M.A. and a Ph.D. from the University
of Cambridge and completing his clinical psychology training at the University
of Edinburgh, he trained as a cognitive therapist at the Center for
Cognitive Therapy in Philadelphia. He has been a therapist on major controlled
trials of cognitive therapy for recurrent and residual depression in
Edinburgh and in Cambridge. Through this and his subsequent experience
working with depressed patients in the NHS, Richard has acquired
expertise in providing cognitive therapy for both in- and out-patients
with chronic and recurrent depressive disorders that have not responded
fully to previous treatment. He is experienced at teaching practical clinical