Download Behavioral-Cognitive Tools Beck Depression Inventory

Behavioral-Cognitive Tools 1
Behavioral-Cognitive Tools Beck Depression Inventory
Name
BSHS 312
September 12, 2010
Behavioral-Cognitive Tools 2
Behavioral-Cognitive Tools Beck Depression Inventory
Cognitive interventions are a set of techniques and therapies practiced in counseling.
Cognitive intervention is based largely on the social learning theory. Albert Ellis and Aaron
Beck are largely the ones given credit to cognitive intervention. Cognitive interventions
emphasize the role of learning and adaptation to the environment both in shaping and
maintaining normal life functions. In essence, these approaches focus on behavior as important
in its own right and often seek to change instances of disordered behavior via the application of
clearly articulated basic principles of learning. Aaron Beck developed a series of questions to
measure the intensity, severity, and depth of depression in patients with psychiatric diagnoses.
This set of questions has helped many therapists determine the need for further medical
treatment. This tool is widely used in cognitive behavioral therapy.
Dr Aaron T. Beck
Aaron T. Beck started training as psychoanalysis alongside Albert Ellis.
Beck researched depression under the psychoanalytical with the understanding that depression
stemmed from anger turned against oneself. Although Beck began his work in the area of
depression, latterly he had begun to work with Borderline Personality Disorder and
Schizophrenia (Ridgway, 2005). Beck said that negative automatic thoughts, generated by
dysfunctional beliefs, were the cause of depressive symptoms, and not vice versa. The main
argument that Beck had was that depression started by the view one’s self image, instead of one
having a negative view of them because of depression (Allen, 2003). Beck believed that
systematic errors in logical thinking caused depression. These thoughts were understood to be
‘automatic’, derived from generalizations of past experience (Ridgway, 2005).
Behavioral-Cognitive Tools 3
Historical Development of the Beck Depression Inventory
The first BDI was published in 1961 and consisted of questions that were geared at how
the patient was feeling in the last week. Each answer carried a respective numeric score and the
total indicated the severity of depression. During the 1970’s Beck developed and copyrighted a
revision (BDI-IA) to his initial model. The new inventory model was to improve the ease of
reading the results of the inventory and the questions were more correlated with each other in an
effort to assess the patients’ depression severity. The BDI-IA model did however retain flaws; it
only addressed six of nine depression related criteria recognized by the DSM-III (Diagnostic and
Statistical Manual of Mental Disorders).
The BDI-II was the third revision to the inventory and was completed in 1996. This
version addressed the concerns and criticism of the BDI-IA. It was also the product of
publications such as the American Psychiatric Association and the Diagnostic and Statistical
Manual of Mental Disorders, criteria for diagnosing major depressive disorders. Indicators were
added in conjunction to the mood assessors to include sleep loss, appetite loss, suicidal thoughts,
and interest in sex. The development of the BDI was significant in the psychiatry and psychology
fields. It represented a new way of identifying depression amongst therapist and health care
professionals.
Originally, the BDI was meant to provide a quantitative assessment of depression
intensity. As of 1998, it had been used in over 2000 studies and had been translated into Arabic,
Japanese, Persian, Xhosa, and Chinese. Today it is not only used to identify depression but to
also evaluate the progress of the individual over a period and measures the effectiveness of
treatment methods.
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Ideal Situations for the Utilization of the Beck Depression Inventory
The Beck Depression Inventory is composed of 21 questions that address specific
symptoms or elements of depression. It is designed to be used in a clinical setting. However, it
has been self-administered. It is not advisable for individuals who suffer from depression to self
assess or self treat as they may not understand how severe their depression is or how to properly
manage symptoms. An individual should seek professional advice. Once properly diagnosed,
they should be administered the BDI.
The BDI is advised for patient's age 13 - 80 years old. Some mental health treatment
agencies administer the BDI at the onset of treatment and once again at treatment termination.
Other agencies administer the BDI each time a patient presents for an appointment. It is a matter
of policy. There are other inventories to specifically address the unique depression
characteristics of the elderly and the youth. Once the mental health provider scores the
inventory, then a treatment plan can be developed. In cases where the BDI is administered
frequently and the therapist and patient can assess if the treatment plan is effective.
Treatment variations may be appropriate and medications may be called for or altered to
enhance treatment outcomes. Taking an on-going assessment also allows a patient the sense of
success when they acknowledge and see results of improvement. The BDI can therefore be used
to enhance and reinforce independence and satisfaction in a patient. A therapist would need to
feel as though a patient were indeed improving prior to using this method as it may also have the
opposite effect on a patient who was not improving. The BDI is a very effective tool when
properly used.
Why the Beck Depression Inventory?
Behavioral-Cognitive Tools 5
The Beck's Depression Inventory (BDI) has been used by mental health providers for
many years to successfully assess depression in their patients. It has been evaluated for validity
and is one of the most successful measurements available to clinical providers. The BDI can be
administered to patients diagnosed with many forms of depression ranging from Minor
Depression to Major Depression. It is an extremely versatile tool and quite easy to administer
and score.
Simple directions explained to a patient is basically all the pre-test preparation needed.
The patient then answers 21 questions specifically addressing various symptoms present in
depression. The clinician then scores the inventory and the patient is evaluated. If the patient is
a "follow up" patient or one that has been seen previously, the BDI then serves as a tool to assess
the effectiveness of treatment. Certainly, other tools are effective but the simplicity of the BDI
can't be overlooked. The BDI provides immediate feedback for the patient and the provider and
increases communication, treatment options and assessment of treatment effectiveness (or
ineffectiveness).
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Conclusion
Dr. Beck and Dr. Ellis began their careers working alongside each other developing
different cognitive interventions, which are practiced in counseling sessions today. Beck is well
known for his work regarding depression. Beck had the understanding that depression stemmed
from anger turned against oneself. With all that Beck learned in regards to depression, he created
the Beck Depression Inventory – better known as the BDI. The BDI was published in 1961 and
was significant in the psychiatry and psychology fields, as it represented a new way of
identifying depression amongst therapist and health care professionals. Today the BDI is not
only used to identify depression, but also to evaluate the progress of the individual over a period
of time. It also measures the effectiveness of treatment methods. The BDI is one of the most
successful measurements available to clinical providers as it can be used to assess patients with
differing severities of depression.
Behavioral-Cognitive Tools 7
Reference
Advameg, Inc. (2010). Beck Depression Inventory. Retrieved September 9, 2010, from
Encyclopedia of Mental Disorders: http://www.minddisorders.com/A-Br/BeckDepression-Inventory.html
Allen, J P. (2003) An Overview of Beck's Cognitive Theory of Depression in
Contemporary Literature Rochester Institute of Technology. Retrieved on September 9,
2010 from:
http://www.personalityresearch.org/papers/allen.html
Psychiatry.HealthSE.com (2004-2005) Current Diagnosis & Treatment. Retrieved Spetember
10, 2010 from:
http://psychiatry.healthse.com/P75/
Ridgway, I. R (2005-2007) 2321 Theory & Practice 2: Lecture 7 Cognitive Therapy (CT):
Aaron T. Beck (b. 1921). Retrieved on September 9, 2010 from:
lect7conitivebeck.pdf
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