Rumination-Focused Cognitive-Behavioral Therapy for Depression

Edward R. Watkins, PhD, CPsychol, is Professor of Experimental and Applied Clinical Psychology at the University of Exeter, United Kingdom, and Director of the Mood Disorders Centre and the Study of Maladaptive to Adaptive Repetitive Thought (SMART) Lab. Dr. Watkins has practiced as a cognitive-behavioral therapist for 20 years, specializing in depression. His research focuses on the experimental understanding of psychopathology in depression--with a particular focus on repetitive negative thought and rumination--and the development and evaluation of new psychological interventions for mood disorders, including randomized controlled trials of treatments targeting rumination in depression. Dr. Watkins is a recipient of the British Psychological Society's May Davidson Award for outstanding contributions to the development of clinical psychology within the first 10 years of his career.

"RFCBT is a natural and useful extension of CBT that is applicable to many, if not most, chronically or recurrently depressed individuals. Watkins has translated lessons from the laboratory and clinical work into a well-formulated, clearly described intervention. In addition to drawing on CBT and behavioral activation, RFCBT incorporates many unique and original strategies. It helps patients to develop effective alternatives to habitual and dysfunctional ruminative patterns, and to become more 'concrete' and actively oriented toward problem solving instead of abstract, reflective, and passive."--Constance Hammen, PhD, Distinguished Research Professor, Departments of Psychology and Psychiatry and Biobehavioral Sciences, University of California, Los Angeles"Rumination is the hallmark feature of depression, implicated in its maintenance and recurrence. The treatment so eloquently presented in this book fills a significant gap for clinical practice. Written by the leading researcher in the field and based on an extensive corpus of basic and applied research, this book offers a comprehensive and thoroughly validated approach. The techniques offered will serve as an important resource for clinicians for many years to come."--Thorsten Barnhofer, PhD, Heisenberg Fellow, Free University of Berlin"Watkins has identified a critical but often overlooked factor in the treatment of mood disorders. Rumination is a central feature of depression, and is arguably the primary mediator of the maintenance of the disorder. A book that focuses on targeting rumination in treatment is sorely needed, and Watkins has delivered a masterful volume that is insightful, thorough, and accessible. This is an essential guide for anyone who treats depressed patients."--Rick E. Ingram, PhD, Professor and Director of Clinical Training, Department of Psychology, University of Kansas"Written by an internationally recognized expert, this book provides a highly accessible and engaging review of the phenomenology, etiology, assessment, and treatment of rumination. Practical, evidence-based treatment strategies are supplemented with rich clinical transcripts that illustrate the moment-by-moment intricacies of intervention. The techniques in this manual empower patients to go beyond the content of their thoughts to address the process and form of rumination. Clinicians at every level of expertise will benefit from this excellent volume."--David J. A. Dozois, PhD, Professor and Director, Clinical Psychology Graduate Program, Department of Psychology, University of Western Ontario, Canada -

• I. Rumination Processes in Psychopathology and Treatment1. Why a Treatment Targeting Rumination?2. Understanding Rumination3. Key Components and Principles of RFCBTII. Rumination-Focused Cognitive-Behavioral Therapy4. Initial Assessment5. Therapy Rationale and Goal Setting6. Functional Analysis of Rumination7. Choosing Treatment Interventions8. Practice at Developing Interventions: Addressing Difficulties and Hurdles9. Shifting Processing Style: Becoming Concrete and Specific10. Shifting Processing Style: Absorption11. Shifting Processing Style: CompassionIII. Application and Extension of RFCBT12. A Case of RFCBT from Beginning to End13. Adaptations of RFCBTAppendix. HandoutsReferencesIndex