Feeling Good: The New Mood Therapy (90 page)
Read Feeling Good: The New Mood Therapy Online
Authors: David D. Burns
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Copyright © 1980 by David D. Burns, M.D.
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ISBN 978-0-380-81033-8
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No current treatment is a panacea, including cognitive therapy. Another new short-term therapy, called interpersonal therapy, has also shown some promise for patients with eating disorders. In the future, studies like those conducted by Dr. Agras and his colleagues will undoubtedly lead to more powerful and specific treatments for eating disorders.
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The idea that your thinking patterns can profoundly influence your moods has been described by a number of philosophers in the past 2500 years. More recently, the cognitive view of emotional disturbances has been explored in the writings of many psychiatrists and psychologists including Alfred Adler, Albeit Ellis, Karen Homey, and Arnold Lazarus, to name just a few. A history of this movement has been described in Ellis, A.,
Reason and Emotion in Psychotherapy
. New York: Lyle Stuart, 1962.
*
Table 1–1 was adapted from Rush, A. J., Beck, A. T., Kovacs, M., and Hollon, S. “Comparative Efficacy of Cognitive Therapy and Pharmacotherapy in the Treatment of Depressed Outpatients.”
Cognitive Therapy and Research
, Vol. 1, No. I, March 1977, pp. 17–38.
*
Blackburn, I. M., Bishop, S, Glen, A. I. M., Whalley, L. J. and Christie, J. E. “The Efficacy of Cognitive Therapy in Depression. A Treatment Trial Using Cognitive Therapy and Pharmacotherapy, Each Alone and in Combination.”
British Journal of Psychiatry
, Vol. 139, January 1981, pp. 181–189.
*
Some readers may recall that I included the Beck Depression Inventory (BDI) in the 1980 edition of
Feeling Good
. The BDI is a time-honored instrument that has been used in hundreds of research studies on depression. Dr. Aaron Beck, the creator of this test, deserves a great deal of credit for creating the BDI during the early 1960s. It was one of the first instruments for measuring depression in clinical and research settings, and I was grateful for his permission to reproduce it in the earlier edition of
Feeling Good
.
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Mental health professionals may be interested to learn that the psychometric properties of the BDC are excellent. The reliability of the twenty-five-item BDC has been assessed in a group of ninety depressed outpatients seeking treatment at the Center for Cognitive Therapy in Oakland, California, and in a group of 145 outpatients seeking treatment at a Kaiser facility in Atlanta, Georgia. The reliability was extremely high and identical in both groups (Cronbach’s coefficient alpha = 95%). The high correlation between the BDC and the BDI
r
(68) = .88,
p
< .01 in the Oakland group indicates that these two scales assess a similar if not identical construct. When both instruments were purged of errors of measurement using structural equation modeling techniques, the correlation between the scales was not significantly different from 1.0. The BDC was also normed against the widely used depression subscale of the Hopkins Symptom Checklist-90 in the Atlanta, Georgia, sample. The extremely high correlation between the two measures
r
(131) = .90,
p
< .01 further confirmed the validity of the BDC.
Extensive clinical experience with the BDC in a variety of treatment settings indicates it is well accepted by patients. Many have commented that the test is easy to complete and score and helpful for tracking changes in symptoms over time. A brief, five-item BDC with outstanding psychometric properties has also been developed. The brief BDC is ideal for testing patients on a session-by-session basis because patients can complete it in less than one minute. It has performed well with adults and adolescents in a variety of psychiatric and medical settings, including recently arrested juveniles in the California judicial system. Mental health professionals who are interesting in learning more about these and many other assessment instruments that can be used in clinical or research settings (including an electronic patient testing module) are cordially invited to visit my Web site at www.FeelingGood.com
*
Beck, Aaron T.
Depression: Clinical, Experimental, & Theoretical Aspects
. New York: Hoeber, 1967. (Republished as
Depression: Causes and Treatment
. Philadelphia: University of Pennsylvania Press, 1972, pp. 17–23.)
*
Freud, S.
Collected Papers
, 1917. (Translated by Joan Riviere, Vol. IV, Chapter 8, “Mourning and Melancholia,” pp. 155–156. London: Hogarth Press Ltd., 1952.)
*
Dr. Wayne W. Dyer,
Your Erroneous Zones
(New York: Avon Books, 1977), p. 173.
**
Ibid
., pp. 218-220.
*
Adaptive means useful and self-enhancing; maladaptive means useless and self-destructive.
*
Copyright 1978, Arlene Weissman.
*
This is a purely imaginary dialogue having no bearing on the real Helen Gurley Brown.
*
Beck, Aaron T.
Depression: Causes and Treatment
. Philadelphia: University of Pennsylvania Press, 1972, pp. 30–31.
*
Some of the newer forms of psychiatric treatment, such as cognitive therapy, allow for a natural fifty-fifty dialogue between the client and therapist, who work together as equal members of a team.
*
I would like to thank Joe Bellenoff, M.D., a psychopharmacology fellow at Stanford University Medical School, and Greg Tarasoff, M.D., a senior psychiatric resident at Stanford, for helpful suggestions during the revision of this chapter. In addition, much useful information was obtained form the excellent
Manual of Clinical Psychopharmacology
, Third Edition, by Alan F Schatzberg, M.D., Jonathan Cole, M.D., and Charles DeBattista, D.M.H., M.D. (Washington: American Psychiatric Press, 1997). This scholarly but highly readable book is an invaluable reference. I highly recommend it for individuals who would like more information on the medications currently used in the treatment of emotional problems.