Is Self-System Therapy Right for Your Client?

2017 ◽  
pp. 25-30
Author(s):  
Kari M. Eddington ◽  
Timothy J. Strauman ◽  
Angela Z. Vieth ◽  
Gregory G. Kolden
Keyword(s):  
Depressive Disorder ◽  
Comprehensive Evaluation ◽  
Self Regulation ◽  
Primary Diagnosis ◽  
Diagnostic Assessment ◽  
Standardized Measures ◽  
Appropriate Treatment ◽  
System Therapy ◽  
Self System

Self-system therapy (SST) is an appropriate treatment for clients with a primary diagnosis of major depressive disorder (MDD) or persistent depressive disorder, with symptom severity ranging from mild to severe using standardized measures. SST was developed for individuals with depression characterized by problematic self-regulation, but it can also be used for treating comorbidities such as anxiety. Clients should receive a thorough diagnostic evaluation and medical examination to rule out nonpsychological causes of mood disturbance. Diagnostic assessment also includes a determination of whether the client meets the criteria for MDD, identification of contraindicated comorbidities, and a comprehensive evaluation of the client’s current problems and strengths. Chapter 3 discusses the recommendations for determining whether a client can benefit from SST and includes guidelines for diagnostic assessment.

Overview of Self-System Therapy Strategies

2017 ◽  
pp. 31-46
Author(s):  
Kari M. Eddington ◽  
Timothy J. Strauman ◽  
Angela Z. Vieth ◽  
Gregory G. Kolden
Keyword(s):  
Behavioral Activation ◽  
Behavioral Therapy ◽  
Self Regulation ◽  
Clinical Intervention ◽  
Acceptance And Commitment ◽  
System Therapy ◽  
Motivational Process ◽  
Activation Therapy ◽  
Regulation Model ◽  
Self System

Chapter 4 introduces the core strategies in self-system therapy (SST) and discusses how SST is similar to and different from other short-term, structured therapies, such as cognitive-behavioral therapy, interpersonal psychotherapy, behavioral activation therapy, and acceptance and commitment therapy. SST focuses on self-regulation as a motivational process and targets how clients go about setting, pursuing, and monitoring important personal goals that are defined in part by discrepancies between self-beliefs and self-guides. SST is a structured clinical intervention based on a self-regulation model of depression and involves three phases of treatment: orientation, exploration, and adaptation. Flexibility within this structure allows therapists to tailor strategies, tactics, and assignments to fit the unique needs of each client.

Concluding Treatment and Preventing Relapse

2017 ◽  
pp. 81-96
Author(s):  
Kari M. Eddington ◽  
Timothy J. Strauman ◽  
Angela Z. Vieth ◽  
Gregory G. Kolden
Keyword(s):  
Depressive Symptoms ◽  
Treatment Program ◽  
Self Regulation ◽  
The Self ◽  
Therapy Program ◽  
System Therapy ◽  
End Of Treatment ◽  
Self System

Chapter 10 focuses on end-of-treatment issues, such as maintaining gains, continuing to monitor depressive symptoms, addressing fears about relapse, and identifying long-term goals for continued growth and self-improvement. As clients approach the end of the self-system therapy program, it is important to recognize the progress they have made and to make plans to keep their progress going. Self-regulation is a lifelong process. Worksheets are provided to help set realistic goals for continued work after therapy and to develop a plan for maintaining progress, including work on daily goals and challenging situations. Clients often experience anxiety and uncertainty about finishing therapy. One goal of this skills-based treatment program is to provide the tools for continuing to make progress independently.

Borderline personality disorder and depressive disorder

2019 ◽  
Vol 27 (6) ◽  
pp. 573-577 ◽  
Author(s):  
Sathya Rao ◽  
Jillian Broadbear
Keyword(s):  
Depressive Symptoms ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Depressive Disorder ◽  
Antidepressant Medication ◽  
Primary Diagnosis ◽  
Borderline Personality ◽  
Electroconvulsive Treatment ◽  
Appropriate Treatment ◽  
Iatrogenic Harm

Objective: Borderline personality disorder (BPD) is frequently accompanied by low mood, the features of which may satisfy the diagnostic criteria for major depressive disorder (MDD). Treatment of depressive symptoms in the absence of BPD-appropriate treatment is less effective and may cause iatrogenic harm. This paper briefly reviews the co-occurrence of BPD and depressive disorder and suggests ways of differentiating these disorders and optimising treatment within the Australian Mental Health context. Conclusions: Depressive symptoms are present in the majority of people with BPD. To address the difficulty differentiating clinically distinct MDD from depressive symptoms that are integral to BPD psychopathology, it is suggested that depressive symptoms arising from a primary diagnosis of BPD (i) may exhibit transience and be stress reactive, (ii) lack a robust clinical response to antidepressant medication and/or electroconvulsive treatment and (iii) are responsive to BPD-appropriate psychotherapy.

Adaptation Phase (Sessions 9–15)

2017 ◽  
pp. 96-126
Author(s):  
Kari M. Eddington ◽  
Timothy J. Strauman ◽  
Angela Z. Vieth ◽  
Gregory G. Kolden
Keyword(s):  
Self Regulation ◽  
Final Phase ◽  
Therapy Goals ◽  
System Therapy ◽  
Self Discrepancy ◽  
Adaptation Phase ◽  
Self System

Chapter 7 provides a session-by-session guide to the adaptation phase of self-system therapy, which focuses on reducing chronic, distressing self-discrepancies and modifying unsuccessful patterns of self-regulation. The approaches and tactics used by therapists can be broadly categorized as altering one or more of the maladaptive aspects of self-regulation or as compensating for aspects of self-regulation that are not optimal targets for change. To address various clients’ therapy goals, the therapist can use three freestanding modules, each of which has a broad goal for the final phase of treatment, and they can be completed in any order. The Module 1 goal is to reduce self-discrepancy and increase self-congruency; the Module 2 goal is to modify the client’s regulatory style; and the Module 3 goal is to manage perfectionistic tendencies. The therapist uses the adaptation phase of therapy to help the client reduce self-discrepancies, modify regulatory style, and manage perfectionistic tendencies.

Exploration Phase (Sessions 5–8)

2017 ◽  
pp. 68-96
Author(s):  
Kari M. Eddington ◽  
Timothy J. Strauman ◽  
Angela Z. Vieth ◽  
Gregory G. Kolden
Keyword(s):  
Self Regulation ◽  
Problem Formulation ◽  
Situation Analysis ◽  
System Therapy ◽  
Self Knowledge ◽  
Exploration Phase ◽  
Self System

Chapter 6 provides a session-by-session guide to the exploration phase of self-system therapy (SST). This phase involves assessing important aspects of the client’s self-regulation, including self-knowledge and regulatory style. The therapist applies two tactics specific to SST. Self-belief analysis is used to examine the content, function, origins, and adaptiveness of the client’s beliefs about herself or himself in relation to others, with an emphasis on goals and standards. Psychological situation analysis is applied to evaluation of the client’s goals and standards in everyday situations to determine his or her typical patterns of self-regulation. The therapist and client then construct a revised problem formulation and a set of specific targets for reducing self-discrepancies and improving the effectiveness of self-regulation.

Self-System Therapy for Depression

2017 ◽  
Author(s):  
Kari M. Eddington ◽  
Timothy J. Strauman ◽  
Angela Z. Vieth ◽  
Gregory G. Kolden
Keyword(s):  
Self Regulation ◽  
Empirical Work ◽  
Goal Pursuit ◽  
Theoretical Background ◽  
Research Literature ◽  
Short Term ◽  
Evidence Based Treatment ◽  
The Core ◽  
System Therapy ◽  
Self System

Self-system therapy (SST) for depression is a structured, short-term, evidence-based treatment approach that targets motivational deficits in depression. The treatment is grounded in an extensive research literature on self-regulation, and it translates that empirical work into therapeutic strategies aimed at enhancing effective goal pursuit in clients with depression. Studies have demonstrated that SST is superior to cognitive therapy for depressed clients with specific self-regulatory deficits and have shown that SST works in part by restoring adaptive self-regulation. Presented in a simplified format, the Therapist Guide provides clinicians with the critical theoretical background that forms the foundation of SST and includes worksheets to aid in treatment planning. The core SST interventions are presented within a 16-week course of therapy. Detailed descriptions of these interventions are provided along with an optional module for managing perfectionism, which is prevalent among clients with depression. The accompanying Client Workbook explains the core SST concepts using concrete examples and includes worksheets that can be used to enhance learning and at-home application of the skills.

Orientation Phase Goal 2

2017 ◽  
pp. 15-20
Author(s):  
Kari M. Eddington ◽  
Timothy J. Strauman ◽  
Angela Z. Vieth ◽  
Gregory G. Kolden
Keyword(s):  
Self Regulation ◽  
Personal Relationships ◽  
Emotional Experiences ◽  
System Therapy ◽  
Self System

Chapter 3 explains how relationships with other people can affect the ways in which people think about goals. The second goal of the orientation phase of self-system therapy is to determine the source of the client’s particular style of self-regulation. Style in this context refers to the client’s tendency to focus on promotion goals (i.e., trying to make good things happen) or prevention goals (i.e. trying to keep bad things from happening). Each type of goal is connected to certain emotional experiences and is influenced by personal relationships. Worksheets are included to help clients explore how their relationships have affected their expectations and standards.

Orientation Phase Goal 1

2017 ◽  
pp. 9-14
Author(s):  
Kari M. Eddington ◽  
Timothy J. Strauman ◽  
Angela Z. Vieth ◽  
Gregory G. Kolden
Keyword(s):  
Working Alliance ◽  
Self Regulation ◽  
System Therapy ◽  
Collaborative Working ◽  
Self System

During the orientation phase of self-system therapy (SST), the therapist familiarizes the client with the structure and focus of SST and establishes a strong, collaborative working alliance that supports the client’s efforts to identify and address underlying sources of problems in self-regulation. The first goal after beginning the program is to learn about self-regulation and how it is related to problems with depression. Self-regulation is the process of setting and pursuing goals that help people become who they want to be. Chapter 2 introduces the concepts of self-regulation and promotion and prevention goals, and it examines how these concepts are connected to emotions. Clients are encouraged to think about why they place importance on certain goals.

Self-System Therapy for Depression

2017 ◽  
Author(s):  
Kari M. Eddington ◽  
Timothy J. Strauman ◽  
Angela Z. Vieth ◽  
Gregory G. Kolden
Keyword(s):  
Self Regulation ◽  
Empirical Work ◽  
Goal Pursuit ◽  
Theoretical Background ◽  
Research Literature ◽  
Short Term ◽  
Evidence Based Treatment ◽  
The Core ◽  
System Therapy ◽  
Self System

Self-system therapy (SST) for depression is a structured, short-term, evidence-based treatment approach that targets motivational deficits in depression. The treatment is grounded in an extensive research literature on self-regulation, and it translates that empirical work into therapeutic strategies aimed at enhancing effective goal pursuit in clients with depression. Studies have shown that SST is superior to cognitive therapy for depressed clients with specific self-regulatory deficits and that SST works in part by restoring adaptive self-regulation. Presented in a simplified format, the Therapist Guide provides clinicians with the critical theoretical background that forms the foundation of SST. It includes worksheets to aid therapists in treatment planning. Detailed descriptions of the core SST interventions, which are conducted during a 16-week course of therapy, are provided along with an optional module for managing perfectionism, which is prevalent among clients with depression. The accompanying Client Workbook explains the core SST concepts using concrete examples; it includes worksheets that can be used by the client to enhance learning and at-home application of the skills.

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