A fundamental premise of the well researched and evidence-based Cognitive Behaviour Therapy (CBT), is that behaviours (the ‘B’) or actions have a direct impact on our emotions. Think about the difference in your mood when you leave the house to do an activity or have social interaction, compared to spending an inactive day alone at home.
Depressed young people can feel that they have little or no control over their symptoms and their lives. They engage in activities but get little pleasure from them. They may also find it difficult to recognise, initiate and maintain pleasant events and activities, which are related to more positive thoughts and moods. They may have fallen into the trap of giving up easily, not being bothered and feeling that it’s useless to try.
Bearing this is mind, CBT works on “activity scheduling” – this is about taking a detailed look at the things/activities a young person does on a typical weekday and weekend. They can then rate how much pleasure or sense of achievement each activity gives them on a scale from 0-10. This is a very simple exercise, but gives young people a good understanding of how different activities can affect mood. They might notice that besides the routine of getting ready, spending 7 hours at school, doing homework and extra curricular activities, there isn’t much time for doing things that they actively enjoy or take pleasure from. An interesting dynamic is also considering how much pleasure time spent on social media gives the young person – they might notice that they are spending 2-3 hours on Instagram, but it’s having a detrimental impact on their mood.
Once we have a good understanding about the day to day routines, CBT helps to look at where and how we can make changes to this, thereby helping the young person to do more pleasurable activities. By being purposeful in scheduling more positive activities, we can help the young person to gain a sense of pleasure and mastery. CBT also encourages self-reward and praise when you manage to achieve something, and this is where parents can be particularly helpful in supporting the young person to implement this.
The rationale behind this approach is to enable the young person to reinforce positive behaviour and feel more in control, so that this impacts on mood. It’s a simple but effective method.
Dr Kanan Pandya-Smith