full day workshop

COGNITIVE BEHAVIOUR THERAPY TO TREAT DEPRESSIVE AND ANXIOUS RUMINATION
Edward Watkins, School of Psychology, University of Exeter,  UK

AC Hotel Room: Sants

Rumination has been identified as a core process in the maintenance and onset of depression (Nolen-Hoeksema, 1991; 2000) and as a possible mechanism contributing to co-morbidity (Harvey et al., 2004). Furthermore, rumination seems to be a difficult-to-treat symptom, which is associated with poorer outcomes for psychological therapy. This workshop will illustrate how the CBT approach can be modified to reduce rumination in chronic, recurrent and residual depression, using new approaches derived from clinical experience and experimental research. A programme of research by Dr Watkins has suggested that the thinking style adopted during rumination can determine whether it has helpful or unhelpful consequences on social problem solving (Watkins & Moulds, 2005) and emotional processing (Watkins, 2004). This experimental work has inspired a novel approach to treating depression, called Rumination-focused CBT, which focuses on changing the process of thinking, rather than simply changing the content of thinking, in order to be more effective in succesfully reducing rumination and treating depression. There is now empirical backing for the efficacy of this approach for difficult-to-treat patients in terms of a positive open case series and an ongoing randomised controlled trial funded by NARSAD. The workshop will review the theoretical background and core techniques of the therapy, including functional analysis of thinking style, behavioural activation, use of imagery, experiential exercises and behavioural experiments to coach patients to shift to more adaptive styles of thinking. This workshop has been successfully received at a number of BABCP and EABCT events.

Dr Watkins is Reader in Clinical Psychology at the School of Psychology, University of Exeter and co-director of the Mood Disorders Centre, University of Exeter. Previously Dr Watkins was research fellow for cognitive clinical psychology of depression, a joint post between the Institute of Psychiatry, London and the MRC-Cognition and Brain Sciences Unit, Cambridge. Dr Watkins has received specialist training in CBT and was previously a supervisor on the MSc course for CBT at the Institute of Psychiatry, and a therapist on the recently completed randomised controlled trial of CBT for bipolar affective disorder (Lam et al., 2003). Dr Watkins currently holds a Wellcome Project Grant to investigate cognitive processes in depressive rumination and a NARSAD Young Investigator award to develop new treatments for rumination (with Professor Jan Scott). In 2004, Dr Watkins was awarded British Psychological Society’s May Davidson Award for 'outstanding contribution to the development of clinical psychology within the first 10 years of qualification'.

Key References:
Harvey, A., Watkins, E., Mansell, W., & Shafran, R. (2004). Cognitive behavioural processes across psychological disorders: A transdiagnostic approach to research and treatment. Oxford University Press. Nolen-Hoeksema, S. (2000).
The role of rumination in depressive disorders and mixed anxiety depressive symptoms. Journal of Abnormal Psychology, 109, 504-511 Nolen-Hoeksema, S. (1991).
Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology, 100, 569-582. Watkins, E.R. (2004).
Adaptive and Maladaptive Ruminative self-focus during Emotional Processing. Behaviour Research and Therapy, 42, 1037-1052. Watkins, E.R., & Moulds, M. (2005).
 Distinct modes of ruminative self-focus: Impact of abstract versus concrete rumination on problem solving in depression. Emotion, 5, 319-328.