The book is designed to provide both trainee and qualified clinicians with the latest understanding on the biopsychosocial processes that underpin depression and the psychological interventions that are available to address these processes. Consequently, the book comprises 15 chapters split across theory and practice. The first six chapters discuss some of the psychological theories and evidence that can help the clinician to understand the nature and function of depression, and the second section focuses on the process of applying this theory to practice.
Consistent with the author's research and clinical interests, the theoretical view taken of depression is influenced by developmental psychology, evolutionary models of depression, and the neuroscience of emotion. For example, Gilbert conceptualizes depression as an evolved and understandable response to disturbances in social connection and social safeness; he then describes how these disturbances influence the neural organization of people's brains and, in turn, their thoughts, behaviour and feelings. Although the focus of the theory is on depression, Gilbert is essentially presenting a general framework for how the brain may work, which has the potential to provide many useful insights into the nature and function of other psychological difficulties, although Gilbert does not explore these possibilities to any great length in the text. The impressive integration of a wide variety of theory and research is presented throughout in an engaging and understandable way. The theory is often conceptualized in terms of clinical examples, which not only facilitate its assimilation but also allow the reader to develop a sense of how these ideas may practically look and sound in their delivery to a client.
In the second half of the book, the clinical implications of the theory for depression are presented within a cognitive behavioural therapy (CBT) framework, placing an emphasis on the importance of developing a soothing and compassionate relational style with self and others in the treatment of depression. The clear emphasis on the social in Gilbert's approach is cleverly emphasized by starting the clinical section with a chapter on the therapeutic relationship, before beginning to discuss a range of cognitive-behavioural techniques for depression. This is refreshing as CBT has traditionally been an easy target for being too individualistic, and some CBT texts maintain this to some extent by emphasizing the importance of the therapeutic relationship without ever really offering a cogent theoretical rationale. Gilbert does not do this; he instead draws on the theory that he has outlined in the first section of the text. Because of the well described theory and useful reiteration of it in the therapy section, the clinician is guided to develop a useful understanding of “what to do” and “why to do it” in their work with people experiencing depression. Gilbert illustrates the treatment of depression by drawing on clinical examples and dialogue, in addition to providing a number of useful compassion-focused therapeutic resources in the appendices. He is skilful in demonstrating how to formulate both within a traditional CBT framework and also within an evolutionary/neuroscience perspective. Specific chapters are presented on developing a compassionate-self, addressing issues of self-criticism, approval seeking, rebellion, shame, envy and endings.
This is a very good book that exemplifies the scientist-practitioner model. Gilbert's focus on people's needs for social connection and fulfilment of personal goals provides a fresh and modern lens through which to view CBT, providing an ecological validity that will hopefully soften the view of some of its detractors.
Comments
No Comments have been published for this article.