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September Quandary: Will a No-Suicide Contract Help My Client Stay Safe?

Four Clinicians Weigh In

Chris Lyford

By Chris Lyford - A new clinician is working with a client who’s expressed some suicidality at times. She's worried about him and thinks it might be a good idea to have him sign a no-suicide contract, but she's heard mixed things about them and isn't sure what to do. Here, four therapists offer their advice.

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April Quandary: My Teenage Client’s Parents Say He’s Depressed, But He Disagrees!

Five Clinicians Give Their Take

Chris Lyford

By Chris Lyford - Fourteen-year-old client Tyler’s parents brought him to therapy because they say he rarely engages with classmates or teachers, isn’t interested in extracurriculars, and heads straight to his room after school to play video games. They worry he’s depressed, but he’s mostly responsive in therapy and insists he’s happy. Here's how five therapists say they'd proceed.

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The Four Types of Depression and How to Overcome Them

Using the "Microtherapy" Approach

Margaret Wehrenberg

By Margaret Wehrenberg - Rather than seeing depression as some kind of monolith, I've found it useful to see depressive symptoms as falling into four basic clusters. By immediately addressing the attitudes and distinctive vulnerabilities that lie at the core of each cluster, treatment can begin to bring about a shift in brain function that makes longer term work easier.

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The "Marbling" Approach to Treating Depression

Three Simple Methods for Joining Depressed Clients While Still Inviting Possibility

Bill O'Hanlon

By Bill O'Hanlon - Repeating patterns can "groove" the brain; that is, your brain gets better and faster at doing whatever you do over and over again. This includes "doing" depression, feeling depressed feelings, and talking about depression. To counter this effect, I like to use a method I call "marbling," going back and forth between investigations of depressed and non-depressed experiences and times.

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In Your Client's Shoes

To Get a Depressed Client Unstuck, First Understand Their Thought Process

Michael Yapko

By Michael Yapko - Often when I work with depressed clients, I learn about the discriminations they didn’t make that have made matters worse. That typically leads to my asking a series of questions that begin with the word how. I’m not looking to interpret the meaning of people’s depression: I’m trying to understand the way my client is thinking that limits their perspective.

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We Need to Talk About Depression Recurrence

Talking About Staying Well After Therapy May Be Lifesaving

Marian Sandmaier

By Marian Sandmaier - Virtually all clinicians make clear to departing clients that they’re welcome to return to therapy at any point. But for clients with recurrent depression, that may not be enough. I propose that before termination, therapists talk with clients candidly about the possibility of another episode of suffering down the line.

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Helping Clients Accept Loss and Find a "Good" Bye

Practical Interventions Using Elisabeth Kubler-Ross's Grief-Stage Model

David Kessler

By David Kessler - Although many people experience common responses to loss, the stages—Denial, Anger, Bargaining, Depression, Acceptance—were never meant to tuck messy emotions into neat packages. Still, the stages can provide a practical framework to help us identify what clients may need in their journey toward healing. Here, we explore two of these stages: denial and acceptance.

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Breaking the Cycle of Depression

Bill O'Hanlon on the "Marbling" Technique for Working with Depressed Clients

Bill O'Hanlon

Depressed clients repeat the same thoughts, activities, feelings, and experiences again and again, as if entranced. Good depression treatment is largely about awakening them from this bad trance.

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When Depressed Clients Blame Themselves

Elisha Goldstein on Treating Depression with Self-Compassion

Rich Simon

While the source of physical wounds can usually be easily identified, the cause of emotional wounds are often hidden and hard to recognize, leading many depressed clients to assume they’re responsible for their own pain and therefore their suffering isn’t legitimate.

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What Type of Depression is It?

Margaret Wehrenberg on Working with Low-Energy Depressed Clients

Rich Simon

The techniques you might employ to help a quiet avoider client dealing with depression won't work with a panicky depressive client, so identifying the type of depression you're working with is imperative.

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