CBT Depression Treatment Applications 2 — Questions and Answers
Question 1: A client with depression reports believing 'Nothing I do ever works out.' Which CBT technique best addresses this overgeneralization?
- Thought stopping
- Evidence examination (Correct answer)
- Relaxation training
- Free association
Correct answer: Evidence examination
Evidence examination challenges overgeneralization by having clients identify specific instances that contradict their global negative belief.
Question 2: In behavioral activation for depression, scheduling activities is prioritized based on which two dimensions?
- Cost and duration
- Mastery and pleasure (Correct answer)
- Difficulty and frequency
- Social and individual value
Correct answer: Mastery and pleasure
Behavioral activation uses mastery (sense of accomplishment) and pleasure ratings to guide activity scheduling in depressed clients.
Question 3: Which CBT model specifically targets the depressogenic triad of negative views about the self, world, and future?
- Lewinsohn's reinforcement model
- Beck's cognitive triad (Correct answer)
- Seligman's learned helplessness
- Ellis's ABC model
Correct answer: Beck's cognitive triad
Beck's cognitive triad describes the three domains of negative thinking characteristic of depression.
Question 4: A depressed client cancels sessions frequently and avoids homework. The CBT therapist should FIRST:
- Discharge the client for non-compliance
- Explore cognitive and emotional barriers to engagement (Correct answer)
- Assign simpler homework
- Refer to psychiatry immediately
Correct answer: Explore cognitive and emotional barriers to engagement
Exploring barriers addresses the underlying avoidance patterns that are often a core feature of depression itself.
Question 5: When using the downward arrow technique with a depressed client, the therapist aims to uncover:
- Automatic thoughts
- Core beliefs or schemas (Correct answer)
- Safety behaviors
- Compensatory strategies
Correct answer: Core beliefs or schemas
The downward arrow technique drills from surface automatic thoughts down to deeper core beliefs driving depression.
Question 6: A client with depression scores 28 on the PHQ-9 at intake. After 8 CBT sessions the score is 19. How should the therapist interpret this?
- Treatment is a failure and should be discontinued
- Moderate improvement but significant symptoms remain (Correct answer)
- Full remission has been achieved
- The measure is no longer valid to use
Correct answer: Moderate improvement but significant symptoms remain
A PHQ-9 drop from 28 (severe) to 19 (moderate-severe) reflects meaningful but incomplete improvement, warranting continued treatment.
Question 7: Which intervention is MOST consistent with CBT for depression when a client says 'I have to be perfect or I'm a complete failure'?
- Validate the belief as realistic
- Use a continuum technique to challenge all-or-nothing thinking (Correct answer)
- Encourage the client to strive harder
- Prescribe paradoxical intention
Correct answer: Use a continuum technique to challenge all-or-nothing thinking
The continuum technique helps clients see a gradient between perfection and total failure, disrupting dichotomous thinking.
CBT Depression Treatment Applications 2
A client with depression reports believing 'Nothing I do ever works out.' Which CBT technique best addresses this overgeneralization?