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Sad is how I am! Treating Dysthymia in Children and Adults

Section 10
Soothing & Amusing: Using a Time Management CBT Technique to Regain Competence

Question 10 | Test | Table of Contents

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As you know, many dysthymic clients sincerely believe that they do not have the time to feel better. The following Cognitive Beahvior Therapytechnique will help your clients achieve their goals by using their time effectively. These are steps Andrea described in the previous section to solve problems. Solving her problems will make her feel more competent, in control, productive, and proud of herself.

This CBT technique also makes time for activities that soothe or amuse them, adding some much needed comfort or pleasure to their life. The first step, as you know, to time management was to find out how Andrea was really spending her time.

♦ Time Management CBT Technique
Colleen had Andrea keep account of her time for one week, stopping at intervals during the day such as early morning, mid-morning, noon, mid-afternoon, evening, and bedtime to chronicle how she had used her time since the previous notation. One of the columns is headed Type. The letter O (for obligation) to denote activities they have to do, the letter C (for choice) for things they freely chose to do, and the letter A (for automatic) for anything they did without knowing or paying attention to what they were doing or why.Colleen had Andrea rate these as either positive experiences that made her smile, laugh or just feel good; neutral experiences or ones that had no emotional impact on her; or negative experiences that upset her in any way.

If your clients are reluctant to commit themselves to such detailed recordkeeping, they can take the following shortcut. It will not provide as much useful data, but it will give a general picture of how they are using their time.

Have your dysthymic adult or child client think of four days during the past month: one day that is a typical weekday, a second day that is a typical weekend day (or day off from work or school), a third day that seemed particularly hectic, and a fourth day when they felt more depressed than usual. Have your client reconstruct, in as much detail as possible, exactly what they did on that day and how much time they spent on each endeavor. Next, in the session put it on a flip chart or in a notebook for the client to keep.

With this method, Andrea's typical weekday sounded like this:

Get up, get dressed, and so forth:
Breakfast in front of the TV:
Travel to work:
Work:
Travel from work:
Stop to buy fast food and magazine:
Eat and read magazine:
Make phone calls:
Watch TV and snack:
Sleep:
1 hour (O-Obligation)
30 min. (A-Automatic)
20 min. (O-Obligation)
8 hours (O-Obligation)
20 min (O-Obligation)
20 min. (C-freely chose)
1 hour (C-freely chose)
30 min. (C-freely chose)
3 hours (A-Automatic)
9 hours (C-freely chose, O-Obligation, A-Automatic)

Andrea spent eight hours at a job she hated, nine hours sleeping, and three and a half hours watching TV, which she admits she does not particularly enjoy. Then, include forty minutes of commuting on congested freeways that frighten Andrea, and you get a daily routine that might depress even the cheeriest optimist. Looking closely at your client's Personal Activities Chart, together, you will probably find similar connections as well as other behavioral sources of their depression. Of course, your client may also begin to see some activities they can minimize in order to have time for things that will help them feel better.

QUESTION 10
What is a benefit derived from a client's time man
agement study? To select and enter your answer go to Test.

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