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Over the past two decades, Beck and his colleagues have evolved a theory of depression that stresses the primacy of cognitive elements. Their basic formulation is that how we feel depends on how we think so that the affect of depression results from the particular thought patterns found in individuals suffering from this disorder. Beck has previously specified the core dysfunctional depressogenic thoughts as the “cognitive triad” (Beck, 1967), which consists of (1) negative expectations of the environment; (2) a negative view of oneself; and (3) negative expectations of the future. He believes that most of the myriad aspects of depression may be seen as elaborations resulting from these basic beliefs.
This current work is an attempt to apply Beck's cognitive theory to the treatment of depression. The book is essentially devoid of a comprehensive theoretical exposition (the reader is referred to Beck's previous work) and what is offered is a meticulously detailed program for a cognitive-behavioral therapy that the authors state has been remarkably effective in the treatment of unipolar, nonpsychotic, depressed outpatients. A great deal of space is devoted to the most elementary aspects of conducting psychotherapy so that this reviewer, at least, got the impression that the book is aimed at students who are beginning their clinical experience. As such, the book may be seen as a training manual for students who wish to learn about this particular type of therapy.
The conceptual basis of the therapy itself is fairly straightforward. The first goal is to identify those thoughts which are said to cause the depressive disorder. After these surface thoughts have been elucidated, therapy is directed to deeper dysfunctional assumptions from which the thoughts are derived. An example of these conceptual layers (given on p. 250) is the following: Automatic thought: “I caused my husband to behave badly.” Secondary assumption: “It is my fault when bad things happen (because I wasn'