Concreteness Training As a Supplement to Existing Depression Treatments

Symptoms of moderate to mild depression are often treated with psychological therapies such as cognitive behavioral therapy, mindfulness approaches, or relaxation techniques (RT). The prevalence of depression and the fact that many individuals do not respond to one type of treatment alone creates a need for other techniques that can be used in conjunction with more traditional therapies. In recent years, novel approaches such as internet-based therapy and guided self-help programs have been designed to complement existing treatments. These therapies offer many benefits to clients and communities because they are easily accessible, private, and reduce overall health-care costs. Another unique form of treatment is cognitive bias modification (CBM). This method stresses concreteness training (CNT), which is the repeated practice of cognitive skills to create habitual behaviors. It has been shown to alleviate symptoms of depression and anxiety in individuals by creating a habit of switching cognitive focus from negative thoughts to more positive ones.

Because it is relatively new, CBM has not been researched extensively as of yet. Therefore, Edward R. Watkins of the Clinical Psychology and Mood Disorders Centre at the University of Exeter in the UK recently led a study that assessed 121 individuals with depression who underwent either CNT with treatment as usual (TAU), TAU alone, or TAU plus RT. Watkins found that the participants that received CNT had lower rates of both overgeneralization and rumination at the conclusion of the treatment, and these results were maintained over a 6-month period. He also discovered that although the RT and CNT had the same immediate posttreatment outcomes, participants in the CNT group had better problem-solving skills than the participants in the TAU or TAU plus RT groups.

The participants claimed that practicing the techniques, which is a key component of CBM, helped them develop the habitual cognitive skills needed to reduce their overgeneralization and rumination, thus reducing their symptoms of depression. Because it is affordable and requires reduced clinical involvement, Watkins believes that this approach is a viable supplemental treatment for individuals with depression. “Moreover, CBM training lends itself to automatization and delivery through information technology (computerized training, internet delivery, Smartphone apps), making it highly accessible,” said Watkins. In sum, CNT could be one more beneficial treatment option from which individuals with depression could choose.

Watkins, E. R., Taylor, R. S., Byng, R., Baeyens, C., Read, R. (2012). Guided self-help concreteness training as an intervention for major depression in primary care: A phase II randomized controlled trial. Psychological Medicine, 42.7, 1359-1371.

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  • Jayma


    June 7th, 2012 at 4:18 AM

    Call me a traditionalist, but I still feel that if someone is depressed, they have enough time alone. Why not still give them the benefit of meeting with someone who can talk them down from the ledge that depression has them on and give them real life interactive skills for overcoming this mental illness? I realize that foe many this may not be the most affordable option, but I still can’t help but feel that it is the most appropriate one for depression sufferers.

  • ray


    June 7th, 2012 at 11:30 AM

    Creating new pathways for thinking and believing is difficult, a challenge to say the leats, but I am encouraged that there are both therapists and patients who are pursuin this approach, hopefully, with a lot of success.

  • Carter


    June 10th, 2012 at 2:00 PM

    I find it hopeful that there are new and varying treatments on the horizon for those with all dimensions of mental illness.
    I remember a time on the not so distant past that to admit to mental illness would be akin to digging your own grave. You didn’t talk about it or discuss it in public.
    But now, I find it so uplifting that there are positive forums and outlets such as this website where you can express your thoughts and learn about all matters related to mental illness and its treatment without the fear of being labeled and ostracized.

  • K


    November 9th, 2012 at 1:56 PM

    Replying to commenter #1, I don’t know how intimate your knowledge of depression is, and I see your point about a ledge–that sounds like a very depressed person. At least one article by Watkins specifies that CNT would work best for mild to moderate depression. My view is that of someone who has been more than mildly depressed in the past, and based on what I learned my problems were, this sounds like it would have been just the thing when I was in that boat. Someone who’s been depressed is at higher risk of depression ever after, and CNT also sounds like a good preventive measure. I would definitely use the concepts myself in an informal way on days when I feel down so things don’t accelerate.

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