CBT Depression Treatment Applications 3 — Questions and Answers
Question 1: In CBT for depression, 'pleasant events scheduling' is primarily derived from which theoretical framework?
- Schema therapy
- Lewinsohn's behavioral model (Correct answer)
- Beck's cognitive model
- Acceptance and Commitment Therapy
Correct answer: Lewinsohn's behavioral model
Lewinsohn's model links depression to low rates of response-contingent positive reinforcement, making pleasant events scheduling a core intervention.
Question 2: A CBT therapist uses role-playing to help a depressed client practice assertiveness. This technique primarily targets:
- Automatic thoughts
- Interpersonal skill deficits (Correct answer)
- Somatic symptoms
- Negative core beliefs only
Correct answer: Interpersonal skill deficits
Role-playing behavioral rehearsal addresses interpersonal skill deficits that often maintain depression through social withdrawal and conflict.
Question 3: Which of the following best describes 'rumination' in the context of depression treatment?
- Purposeful reflection to solve problems
- Repetitive passive focus on distress and its causes (Correct answer)
- Active coping through cognitive restructuring
- Deliberate mindfulness of negative emotions
Correct answer: Repetitive passive focus on distress and its causes
Rumination is a maladaptive repetitive thinking style that maintains and exacerbates depression without moving toward problem-solving.
Question 4: A therapist using CBT for depression introduces 'activity monitoring' in the first two sessions. The PRIMARY purpose is to:
- Assign homework for compliance
- Establish a baseline of activity and mood patterns (Correct answer)
- Teach relaxation skills
- Challenge negative automatic thoughts
Correct answer: Establish a baseline of activity and mood patterns
Activity monitoring establishes a behavioral baseline revealing connections between activities, mood, mastery, and pleasure before intervention begins.
Question 5: Which schema is MOST commonly associated with chronic depression in Young's schema therapy framework?
- Entitlement/Grandiosity
- Emotional deprivation (Correct answer)
- Approval-seeking
- Punitiveness only in OCD
Correct answer: Emotional deprivation
The emotional deprivation schema — the belief that one's emotional needs will never be met — is strongly linked to chronic depressive presentations.
Question 6: When treating comorbid depression and anxiety with CBT, the therapist should generally:
- Treat anxiety first because it is more impairing
- Assess which disorder is primary and sequence treatment accordingly (Correct answer)
- Treat depression first in all cases
- Refer to a specialist for the second diagnosis
Correct answer: Assess which disorder is primary and sequence treatment accordingly
Clinical judgment about which disorder is primary, most impairing, or maintaining the other should guide sequencing in comorbid presentations.
Question 7: A depressed client identifies 'mind reading' as a frequent cognitive distortion. An appropriate homework assignment would be:
- Write a pros/cons list of the belief
- Test the assumption by asking others directly (Correct answer)
- Practice deep breathing when the thought occurs
- Avoid situations triggering the thought
Correct answer: Test the assumption by asking others directly
Behavioral experiments that gather real data — such as asking others directly — test and challenge mind-reading assumptions effectively.
CBT Depression Treatment Applications 3
In CBT for depression, 'pleasant events scheduling' is primarily derived from which theoretical framework?