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Problem solving & behavioural activation

“ Only dead fish swim with the stream. ” - Anonymous

Here are a series of forms, questionnaires and handouts that I use regularly in my work.  The problem solving diagram is a recurring theme - both at the start of therapy and as a sheet to return to when reviewing and considering additional therapeutic options.  Other sheets are classic variants on the tools used by many cognitive behavioural therapists - with occasional alternatives and additions, that I've come up with over the years, thrown in as well.

Depression assessment

Beware the barrenness of a busy life.

- Anon

Depression assessment scales come in two basic forms - interviewer/clinician rated and sufferer/patient rated.  As stated in the background information on the IDS/QIDS questionnaires (see below) "There are several accepted clinician rated and patient self report measures of depressive symptoms. The most commonly used clinician rated scales are the 17, 21, 24, 28, and 31 item versions of the Hamilton Rating Scale for Depression (HRSD) (Hamilton 1960, 1967), and the 10-item Montgomery-Asberg Scale (Montgomery and Asberg 1979). The most frequently used self-reports include the 13, and 21 item version of the Beck Depression Inventory (BDI) (Beck et al. 1961), the BDI-II (Beck et al. 1996), the Zung Depression Rating Scale (Zung 1965), the Carroll Rating Scale (CRS) (Carroll et al. 1981), and the Patient Health Questionnaire - 9 (PHQ-9) (Kroenke et al.

Depression information

The brains of human beings seem built to process stories better than other forms of input ...  

- Thomas B Newman, professor of epidemiology and biostatistics

Here are a few handouts that I've put together over the years to provide background information about depression.  The development/maintenance diagram is probably the handout here that I use most - both to explain issues about depression and also for many other psychological disorders as well. 

Introduction & monitoring

The genius of Tulku Urgyen was that he could point out the nature of mind with precision and matter-of-factness of teaching a person how to thread a needle and could get an ordinary meditator like me to recognize that consciousness is intrinsically free of self ... I came to Tulku Urgyen yearning for the experience of self-transcendence, and in a few minutes he showed me I had no self to transcend ... Tulku Urgyen simply handed me the ability to cut through the illusion of the self directly, even in ordinary states of consciousness.  This instruction was, without question, the most important thing I have ever been explicitly taught by another human being.  It has given me a way to escape the usual tides of psychological suffering - fear, anger, shame - in an instant.

- Sam Harris

Here are a series of forms that I use almost every session with clients, or for screening and orientation at the start of therapy:

Diagnosis of psychological disorders

Our lives are not our own. From womb to tomb, we are bound to others, past and present, and by each crime and every kindness, we birth our future.

- David Mitchell

Making a formal psychological diagnosis can be a mixed blessing. It has several potential advantages. If many of my symptoms can be accurately grouped under a specific psychological diagnosis, it may well help to understand what is happening, to clarify the likely time course of my symptoms, and to choose treatments that have the best chance of being effective. It's worth noting that often people suffer from more than one psychological disorder at the same time - this is called comorbidity and it is common.

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