100+ Practical Tools to Defeat Depression
Cognitive Interventions
Dr. Dawn-Elise Snipes, PhD, LPC-MHSP, LMHC
Executive Director, AllCEUs Counseling Education
Podcast Host: Counselor Toolbox, Happiness Isn’t Brain Surgery

Objectives
~ Define cognitive interventions
~ Explore activities to address
~ Perceptions
~ Attributions and Locus of Control
~ Cognitive Distortions
~ ABCs
~ Shoulds
~ Optimism and Cognitive Restructuring
~ Affirmations
~ Time Management
~ Goals Setting

Overview
~ Cognitive interventions are things you do to change how you think about things
~ Is the glass half full? Is it partly sunny?
~ Is this really important to having a rich and meaningful life?
~ What is the yang to this yin?
~ How can this make me stronger, or what can I learn?

Question
~ How do you help clients recognize the impact of their thoughts on their mood?

Perceptions
“Life is 10% reality and 90% what you make of it.”
~ Your past experiences created your schemas
~ Dog charging the fence barking
~ Flying
~ Angry faces
~ Creaking floorboards
~ Individual activity: Coin flip
~ Group activity:
~ On a beachball write 20 things that can be irritating or scary
~ Toss the beachball to a group member. They have to find at least one optimistic or non-threatenting way to look at whatever item they see when they look down at the ball
~ Repeat…

Attributions and Locus of Control

~ Attributions are how you perceive things
~ Internal vs. External
~ Locus of control is where you perceive that your life is controlled from.
~ Do you control your own destiny (internal locus) or does everything just happen to you (external locus)?
~ Which is better?
~ Global or specific.
~ Give examples
~ Stable or changeable
~ Give examples
~ Dialectics: There is nearly always good and bad in everything.
Attributions and Locus of Control

~ Activity
~ Apply those principles to the following statements
~ I believe that I control my own destiny
~ I blame other people for making me unhappy.
~ When I fail at something it means I am stupid
~ I am depressed
Cognitive Distortions
~ What are they?
~ Arbitrary inference: Making assumptions without all the facts
~ Selective abstraction: Only seeing what you want (or don’t want) to see
~ Over generalization: Generalizing things about one situation to all similar situations
~ Magnification and exaggeration: Blowing something out of proportion
~ Personalization: Feeling like everything is your fault or a personal attack.
~ Polarized thinking: All-or-nothing.
~ Activities
~ Individual: Examine current stressors for cognitive distortions
~ Group: Define and identify interventions; Flip chart stations; Apply the solution

Cognitive Distortions Emergency Card
~ Do I have all the facts?
~ Am I seeing the whole situation?
~ Am I using moderate words like sometimes, occasionally or often?
~ Am I making sure not to devote too much attention and energy to something that really won’t matter in a few days or weeks?
~ Have I considered possible explanations besides it being all about me?

ABCs
~ The basic structure is as follows: Fill in “A” activating event and “C” consequence first.
~ A= Activating event or the stimulus (What happened?)
~ B= Your automatic (and often unrealized unhelpful Beliefs)
~ C= The consequence of those beliefs (What was your reaction?)
~ D= Determine if your beliefs and your consequences are rational/constructive.
~ E= Evaluate whether the situation is worth the energy of continuing the reaction
~ Activity (Individual= worksheet, Group= Discussion or Belief stations)
~ Have each person share something that makes them happy or proud, and apply the ABCs
~ Have each person share something that makes them angry or afraid and apply the ABC-DEs

Who Says? Addressing Shoulds & Shouldn’ts
~ People can be miserable because they are doing, feeling and thinking the way they think they “should.”
~ When kids are about 2, they go through the “Why?” phase, and most of the time what they hear is “…because I said so!” or “That’s just the way it is.” This teaches them to not think, just to be passive receptacles of information.
~ Activities
~ Brainstorm a list of should and apply the following questions
~ Should: I should keep a clean house at all times, so people do not look down on me.
~ Who Said: My mother
~ Alternate belief (if any)? A clean house is not the ultimate priority, and needs to be balanced with other life demands.

Optimism and Cognitive Restructuring

~ Optimism is way of changing the perception of a situation.
~ Activity: Describe the day
~ Process how the person feels after being (optimistic/pessimistic) and how the GROUP feels after hearing it
~ Worry and regret are two by-products of pessimism that drain your energy, but serve no functional purpose.
~ Activity (Stations, Beach Ball, Jenga, Pass the Hat)
~ Worry
~ Restatement
~ Regret
~ Restatement
Affirmations
~ Affirmations are positive statements that encourage you to feel empowered and optimistic.
~ I am…
~ I can…
~ I will… / I choose…
~ Examples
~ I’m allowed to take up space.
~ My past is not a reflection of my future.
~ I am smart enough to make my own decisions.
~ I’m in control of how I react to others.
~ I choose peace.

Affirmations
~ Activities
~ Affirmation journal
~ Online affirmation research
~ Affirmation envelope pass (you are, you can, you will)
~ Start each group with a positive affirmation sign in… “It was a tough day, but I made it…” “I am grateful that…”

Time Management
~ Time management seems to be one of the most elusive and devastating of all the coping skills.
~ When you don’t manage your time well, it can lead to poor evaluations at work, friends getting mad at you or failing to take care of something important.
~ How does poor time management affect your life? Your relationships?
~ When you are distressed because you have too many things to do and not enough time, how does it affect you? Do you feel exhausted? Overwhelmed? Powerless?
Time Management
~ Activity
~ Describe the different time management styles and group people accordingly
~ Give them a written description of the characteristics of that style and have them brainstorm solutions
~ Type A
~ Time Juggler
~ Procrastinator
~ Perfectionist
~ Eager to Please
~ Activity
~ Eliminate, Delegate, Combine, Simplify and Prioritize
~ Have someone share their weekly to-dos
Goal Setting
~ Must be purposeful
~ Must be motivated
~ Practice using a decisional balance exercise
~ Benefits of staying the same
~ Drawbacks to change
~ Benefits of change
~ Drawbacks to staying the same
Goal Setting
~ The change I want to make is…
~ Be specific. Include goals that are positive (wanting to increase, improve, do more of something), and not just negative goals (stop, avoid).
~ My main reasons for making this change are…
~ What are the likely consequences of action or inaction?
~ Which motivations for change are most compelling?
~ The first steps I plan to take in changing are…
~ When, where, and how will the steps be taken?
~ Some things that could interfere with my plan are…
~ How will I stick with the plan despite these particular problems or setbacks?
~ Other people could help me in changing in these ways…
~ I will know that my plan is working when…

Summary
~ The way people think and perceive situations has a huge impact on how they feel
~ Helping people embrace the dialectics can help them feel more positive and empowered
~ Just like it is imperative to add happy emotions, it is imperative to add happy thoughts as well
~ By practicing optimism and addressing unhelpful thoughts people can reduce their overall stress, sleep better, gain more energy and feel less hopeless and helpless (depressed).