Depression in Context

Book excerpt: This book represents one of the last contributions of Neil Jacobson to the study of depression. At the time of his death he, Christopher Martell, and Michael Addis had just begun writing. In fact, they had spent several years discussing behavioral approaches to treating depression and had been collaborating on one of the largest clinical trials for depression comparing behavioral activation to cognitive therapy and medication. Preliminary findings suggest that treating depression by helping to activate people (behavioral activation) is just as effective as helping them to change their thinking (cognitive therapy). Behavioral activation is a positive approach to treating depression. Within this framework, the therapist helps clients to see depression not as something inside of them but as a natural consequence of the way they cope with the shifting contexts of daily life. There is no search for mental illness, skill deficits or distortions in thinking. Rather, the therapist coaches the client to engage in activities that will lead to a more rewarding life. This book is arranged in three parts. Part I reviews theories of depression and various treatments for depression, particularly pharmacological treatments, cognitive therapy and behavioral therapy. Part II describes the behavioral activation treatment approach and provides ample case transcript material. Part III looks at problems that can arise in therapy and at future opportunities for the use of behavioral activation.