Cognitive Behavioral Group Therapy for Depression

Cognitive behavioral therapy (CBT) is a tried and proven way to deal with depression and its cognates such as anxiety or low self-esteem. The basic structure of cognitive therapy has to do with the relations of thought to action or feelings. Thoughts must be brought into balance with reality rather than be distorted perceptions of reality. Group therapy, given its inherent support structure, is a particularly useful way of addressing these issues.

Preparations and Structure

• Prepare one or two trained people to begin the sessions. The groups should be relatively small, roughly between four and eight people. The therapy sessions should be divided according to topic. Dr. Ricardo Munoz, who wrote a manual for group CBT, recommends the sessions be divided three ways: how thoughts make us feel, how actions make us feel and how interactions with people make us feel. Keep the sessions focused on the topic.

Method

• Keep the topics close to the cognitive method at all times, and direct the flow of conversation back to the purpose if it veers off. The topics of each session should be focused on the clarification of thought and its effect on action. The concept is to confront irrational thought patterns with rational ones. For example, a person can state, “I'm a total failure because I've lost a job.” This is an irrational conclusion at the root of many depressive or anxious states. This should be replaced by a rational statement, such as “Many people get fired; it is a fact of life. I am not a failure for it any more than others are. This could be a great opportunity.” This is the method behind cognitive behavioral group therapy sessions. This should be the focus whether the stress is on action, thought or interaction.

Managing Stress

• Managing stress, peer pressure or daily problems of life is another central core topic for these group sessions. The main cognitive structure concerns thoughts and beliefs, but this thought process must be able to survive stressful situations and not break down into pathological behavior. Therefore, in addition to the above topics, the ability to use cognitive techniques in stressful or painful situations also should be stressed. These can be separate sessions, or this topic can be used to buttress existing sessions.

The Group as Therapy

• Focus also on the purpose of the group in this therapy. In general, the benefit of the group is that it can serve as a sympathetic forum for members to air their feelings and frustrations, it can provide personal and social support for its members and it can show its members they are not alone in these struggles. Therefore, as the topics mentioned are being worked out, make certain that the group retains its supportive purpose and ensure that problems are aired in a highly empathetic environment.