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Early intervention for adults at high risk of recurrent/chronic depression: Cognitive model and clinical case series

Lookup NU author(s): Dr Stephen Barton, Paul Armstrong, Professor Mark FreestonORCiD



This paper describes a cognitive model for first/second onset depression that has been precipitated by major life stress, entrenched for several months and is unresponsive to pharmacotherapy. These conditions create high risks for recurrent/chronic depression and early intervention is proposed to identify, treat and protect against relapse/recurrence. Severe life stress interacts with an individual's core self-representations and personal values, identity is disrupted and depression is maintained by dysfunctional goal engagement and disengagement. Treatment aims to restore functional self-regulation by increasing self-diversification and creating balanced goal investments. Outcome and follow-up data are reported in a case series of five consecutive patients. There was good therapist adherence to the prescribed targets and pre-post effect sizes were comparable or larger than published outcome studies. At the 12 month follow-up, three of the four treatment completers (75%) had made reliable and clinically significant changes and were in full remission. This provides encouraging preliminary evidence for the model's validity and the therapy's efficacy. © 2008 British Association for Behavioural and Cognitive Psychotherapies.

Publication metadata

Author(s): Barton S, Armstrong P, Freeston M, Twaddle V

Publication type: Article

Publication status: Published

Journal: Behavioural and Cognitive Psychotherapy

Year: 2008

Volume: 36

Issue: 3

Pages: 263-282

Date deposited: 16/03/2011

ISSN (print): 1352-4658

ISSN (electronic): 1469-1833

Publisher: Cambridge University Press


DOI: 10.1017/S1352465808004426


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