Articles of Interest - April 20, 2010

This week's articles relate to depression/suicide.

"Responding to Suicide Risk", chapter 17 of Ethics in Psychotherapy and Counseling: A Practical Guide by Kenneth Pope, Jossey-Bass, 2007. Access here: http://kspope.com/suicide/index.php#copy

Summary: This book chapter, which gives the obligatory suicide warning signs, also offers concrete steps that hospital staff can take to reduce suicide risk in their hospitals. It gives 10 steps that staff can take in that regard, and also gives suggestions provided the experts (Linehan, etc.).

The Library has a book entitled Metacognitive Therapy for Anxiety and Depression by Adrian Wells which discusses a relatively new form of psychotherapy called Metacognitive Therapy. This kind of therapy, although owing a great deal to Cognitive Behavior Therapy, has rather a different focus than CBT--thinking about thinking rather than challenging faulty or irrational thoughts. It can be effective for those who traditional CBT doesn't reach as the following article indicates.

"Metacognitive Therapy in Recurrent and Persistent Depression: A Multiple-Baseline Study of a New Treatment"
Cogn Ther Res (2009) 33:291–300



Abstract:


"Metacognitive Therapy (MCT) for depression is a formulation-driven treatment grounded in the Wells and Matthews (Attention and emotion: A clinical perspective, 1994) self-regulatory model. Unlike traditional CBT it does not focus on challenging the content of depressive thoughts or on increasing mastery and pleasure. Instead it focuses on reducing unhelpful cognitive processes and facilitates metacognitive modes of processing. MCT enables patients to interrupt rumination, reduce unhelpful self-monitoring tendencies, and establish more adaptive styles of responding to thoughts and feelings. An important component of treatment is modification of positive and negative metacognitive beliefs about rumination. MCT was evaluated in 6–8 sessions of up to 1 h each across 4 patients with recurrent and/or chronic major depressive disorder. A non-concurrent multiple-baseline with follow-up at 3 and 6 months was used. Patients were randomly allocated to different length baselines and outcomes were assessed via self-report and assessor ratings. Treatment was associated with large and clinically significant improvements in depressive symptoms, rumination and metacognitive beliefs and gains were maintained over follow-up. The small number of cases limits generalisability but continued evaluation of this new brief treatment is clearly indicated."

If you are interested in reading this article, please drop me a line.