Overview of the Program

Chapter 1 provides clients with an overview of self-system therapy (SST), which is a structured, short-term, evidence-based treatment approach that targets motivational deficits in depression. Depression robs people of the ability to enjoy the pleasures of life. Because there can be a fine line between a normal sad mood and a diagnosis such as major depressive disorder, a qualified professional is needed to determine whether the symptoms cross that line and whether the client is likely to benefit from SST. The chapter defines the roles of the client and the therapist and explains how the workbook is used in the therapeutic process.

Concluding Treatment and Preventing Relapse

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.

Adaptation Phase Goal 2

Chapter 8, which addresses module the 2 goal of the adaptation phase of self-system therapy, takes a step-by-step approach to evaluating the extent to which certain personal goals are realistic and to identifying obstacles to progress in goal pursuit. The importance of balancing promotion- and prevention-type goals is emphasized. Two strategies can improve clients’ pursuit of goals: assessing how goals are set and pursued and looking at the tendency to focus on promotion or prevention goals. Adjustments can be made in how clients define goals and in the methods they use to pursue them. Clients can also work to balance their promotion and prevention goals to increase opportunities for positive emotional experiences. Worksheets are included to encourage effective goal pursuit and make sure that expectations are reasonable and achievable.

Exploration Phase Goal 1

In addressing the first goal of the exploration phase of self-system therapy (SST), Chapter 5 focuses on helping clients identify self-beliefs and self-guides. Self-beliefs are characteristics that describe people as they actually are. Ideal self-guides are characteristics that clients would like to have, and ought self-guides are characteristics clients think they should have. Discrepancies can exist between the actual self and the client’s own expectations and standards and those that come from other people. Chronic self-discrepancies can lead to or exacerbate depression. Self-belief analysis is used to examine the content, function, origins, and adaptiveness of clients’ beliefs about themselves in relation to others. A worksheet that is designed to be completed with the help of the therapist or counselor is included.

Adaptation Phase Goal 1

Chapter 7 addresses the module 1 goal of the adaptation phase of self-system therapy. It describes strategies aimed at reducing self-discrepancies, including modifying standards and enhancing the importance of positive qualities or characteristics. Depression typically involves self-discrepancies, and most people with depression can benefit from reducing or eliminating self-discrepancies and bringing self-guides and self-beliefs more in line with each other. One approach is to lower standards (i.e., ought or ideal self-guides) by identifying and modifying unrealistic expectations. Another method is to find a new way to approach the preferred goal rather than lowering the standard. Evaluation of self-discrepancies sometimes shows that the expectations are invalid and that the focus should shift from perceived deficits to strengths.

Orientation Phase Goal 3

People with depression often focus too little on promotion goals (i.e., making good things happen). Pursuing promotion goals is important because they provide opportunities for experiencing positive emotions. The third goal in the orientation phase of self-system therapy is to encourage clients to focus on promotion goals. The therapist completes an assessment of what the client does or does not do during a typical week to determine activities that can reinstate a sense of reward, accomplishment, or progress. Chapter 4 focuses on increasing involvement with activities that can make good things happen. Worksheets are designed to help identify activities that can produce experiences of pleasure and pride and make specific plans to follow through with those activities.

Orientation Phase Goal 2

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

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.

Adaptation Phase Goal 3

Chapter 9, which addresses the module 3 goal of the adaptation phase of self-system therapy, focuses on managing perfectionism. Many people with depression have standards that are unrealistically high, and they become very self-critical and fear rejection when extreme standards cannot be met. Perfectionists often are willing to cut others some slack but may be reluctant to lower their own standards. The therapist works with clients to take a realistic view of perfectionistic goals and standards and explore more moderate alternatives. Because perfectionism can be compartmentalized, the first step is to identify the areas in clients’ lives that are affected. Worksheets are provided to encourage careful consideration of the costs and benefits of holding on to personal standards that may be too high.

Exploration Phase Goal 2

Chapter 6 addresses goal 2 of the exploration phase of self-system therapy, which focuses on how clients pursue their goals. Clients assess their self-regulatory style by exploring their self-guides (clients’ own standards and expectations that other people have of them), promotion and prevention goals, and self-beliefs. With a better understanding of the role of self-discrepancies in depression, clients are asked to take a look at the daily influences on their experiences. Clients are helped by therapists to synthesize what they have learned in previous sessions and implement corrective strategies in daily life. The client begins by filling out worksheets that keep track of events in daily life. The worksheets ask the client to think about and write down how these daily events are related to personal goals and standards.