Self-control therapy for depression

Domain II · Behavioural & cognitive · Lynn Rehm · 1977

What it is

Self-control (self-management) therapy is a structured, didactic cognitive-behavioural course for depression derived from Frederick Kanfer's three-stage self-regulation model. Rehm's model holds that depressed people show six deficits across the three stages: they attend selectively to negative…

Format

• Format. Usually a closed group of about 6–10 adults with two co-therapists; individual delivery is also documented. Each session has four parts: a didactic presentation of one self-control principle, discussion of how it applies to members' lives, in-session paper-and-pencil exercises, and a…
• Original programme: 6 weekly sessions of about 1.5 hours, in three two-session blocks (self-monitoring 1–2, self-evaluation/goal setting 3–4, self-reinforcement 5–6).

Who practises it, and how they are trained or regulated

• Self-control (self-management) therapy is a structured, didactic cognitive-behavioural course for depression derived from Frederick Kanfer's three-stage self-regulation model. Rehm's model holds that depressed people show six deficits across the three stages: they attend selectively to negative events, attend to immediate rather than delayed consequences, set stringent self-evaluative standards, make inaccurate…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Switching targets mid-course without reason.
• Review that runs over the session. Time-box it.
• Self-criticism that is chronic and intense may need more than this module (see section 5).
• Clients who see the gains as the group's, not theirs. Use attribution skills to credit their own work.
• "Yes, but" responses that discount achievements ("anyone could do that"). Point back to the agreed standard.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.