Counseling options are available to individuals struggling with depression, but can you gauge effectiveness? A recent study published in the journal Cognitive Behaviour Therapy looked into the impact that cognitive behavioral therapy (CBT) can have on occupational outcomes for individuals struggling with depression.
What Is Cognitive Behavioral Therapy?
Cognitive behavioral therapy is one of the most researched types of therapy and is often used as a short-term, effective treatment for a wide range of conditions like anxiety, depression, addiction, eating disorders, and phobias. Recently, CBT has seen a rise in popularity as a treatment with specific, tangible goals that can be measured relatively easily. More people are turning to this type of therapy as an affordable treatment path for a variety of maladaptive behaviors. Individuals that undergo CBT are typically seeking to identify and change destructive thought patterns through a wide range of strategies, such as mental distractions or journaling.
How CBT Works
The goal of this type of therapeutic treatment is to change the automatic negative thought response that contributes to the individual’s feelings of psychological distress. These thoughts are then replaced with more realistic, objective ones. “The single most important skill that we try to help people acquire in CBT is to identify their thoughts and take a step back and reevaluate them,” says lead study author Daniel Strunk, PhD. Because thoughts and emotions can have a strong influence on an individual’s behavior, CBT aims to teach a person that, while they can’t control everything that happens around them, they can control their interpretations and reactions. This helps the individual to develop useful coping skills.
Efficacy of CBT
As a CBT therapist, Jolie Weingeroff, co-founder and director of PVD Psychological Associates, has found this method to be effective for patients struggling with presenteeism, which is another way of describing an individual’s lack of focus at work or inability to accomplish tasks. Presenteeism can manifest as a result of injury, illness, or mental state. “Often, the very things we do to avoid negative emotions are the behaviors we would seek treatment to address, such as substance use or problems in relationships or as it relates to employment, procrastination, being late, difficulty concentrating, [and] problems with time management,” Weingeroff says.
The Research
The study looked at employment status, presenteeism, depressive symptoms, cognitive style, and CBT skills of 126 participants taking part in a 16-week course of CBT for depression. Participants fell into two groups: those seeking to improve their employment status and those consistently employed during treatment. Participants were assessed both before and after treatment. For patients seeking to improve their employment status, researchers found significant improvement from pre- to post-treatment, with 41% of patients achieving this goal and landing a new position. For patients who were consistently employed and looking to improve performance, presenteeism decreased significantly over the course of treatment. These findings suggest patients can improve occupational outcomes with the help of CBT, partly as a result of changes in negative cognitive styles. But for individuals who have depression and are struggling to find employment, the resolution is not just in necessarily alleviating the symptoms, but in building a strong mental foundation with the help of CBT. Strunk points to negative self-views as a key characteristic of depression that can also exacerbate the stress of looking for work. “When you’re in the job search process, a lot of people have to face rejection repeatedly and keep persisting in the face of that rejection,” he says. “So, If you take each of those rejections as an indication of your potential as an employee or your value to society, it makes it harder to persist.” In the same way, treating depression can treat the root cause of poor job performance. “Depression as a cause of presenteeism is not a widely accepted reason for non-productivity at work,” says Mary Gay, PhD, who specializes in helping professionals work through addiction and developmental trauma. “CBT increases concentration and efficiency in the workplace by helping move away from the negative frame of mind that consumes depression sufferers.” It’s important to note that depression is not always the only influence at play when it comes to presenteeism. Weingeroff presents the example of someone who struggles with people-pleasing or overcommitting themselves because they have trouble saying no. These behaviors will almost certainly lead to burnout and, as a result, poor performance at work. “Once we identify the thought patterns leading to and perpetuating presenteeism, we can work to address fears of failure, perfectionism, people-pleasing, imposter syndrome, among other things that essentially make it so that people cannot get out of their own way,” she says.
Working Through It
While this study was conducted prior to the COVID-19 pandemic, these findings are perhaps even more relevant today. Millions of jobs have been lost as a result of the pandemic, and countless others are navigating this time as either essential workers or working from home. For many people with a history of depression, this immense stress has only exacerbated symptoms. “The more you have people facing this uncontrollable stressor with a lot of uncertainty, the more they’re going to be pulled into overly negative views,” Strunk says. “And it’s hard not to succumb to that.” For this reason, it’s imperative to find healthy ways of coping if you’re struggling through this time. Cognitive restructuring is a major focus in CBT, but there are other coping skills that can have just as big an impact. Cultivating practices of mindfulness and self-care, developing time management and interpersonal skills, and performing exercises like progressive muscle relaxation and diaphragmatic breathing can all decrease anxiety and help you better protect yourself against external stressors. Whether you’re seeking employment or trying to keep up with the daily grind of working from home, CBT and its array of coping skills has proven effective in managing stress and depression. The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.
