Initial Contact

• Introductions.
• Explain program.
• Review materials.
• Answer FAQs.
• Schedule calls.

Session 1

• Depression education.
• Elicit how depression affects their feelings, body, thinking and behavior.
• Motivation enhancement to strengthen engagement in therapy.

Practice Activity

• Describe best and worst parts of their days.

Session 2

• Review depression education.
• Review practice activity and identify what activities made patient/client feel better or worse.
• Learn what helps others feel better.
• Pleasant activity identification exercise.

Practice Activity

• Choose pleasant activities.

Session 3

• Review pleasant activity preferences.
• Plan pleasant activity experiment.

Practice Activity

• Pleasant activity experiment.

Session 4

• Review pleasant activity experiment.
• What worked? What was the effect on mood? What were the barriers?
• Problem-solve overcoming barriers.
• Plan new experiments.

Practice Activity

• Pleasant activity experiments.

Session 5

• Review pleasant activity experiments.
• What worked? What was the effect on mood? What were the barriers?
• Problem-solve overcoming barriers. Add to and expand positive parts of experiments.
• Revise and repeat experiments.

Practice Activity

• Pleasant activity experiments.

Session 6

• Review pleasant activity experiments.
• What worked? What was the effect on mood? What were the barriers?
• Problem-solve overcoming barriers. Identify most promising activities.
• Make written weekly pleasant activity schedule.
• Write out most common barriers and best plans to overcome barriers.

Practice Activity

• Follow schedule.

Session 7

• Check practice activity.
• Discuss depressive thinking (guilt, self-blame, etc.).
• Common negative thoughts. Thought identification examples and exercise.

Practice Activity

• Keep schedule. Try catching negative thoughts.

Session 8

• Check practice activity.
• Elicit negative thoughts and triggers.
• Discuss more ways to observe automatic negative thoughts and their effects.

Practice Activity

• Keep schedule. Negative thought monitoring exercise.

Session 9

• Check practice activity.
• Discuss effects of negative thoughts.
• Illustrate ways of distancing from automatic negative thoughts.
• Practice ways of distancing.

Practice Activity

• Keep schedule. Watch negative thoughts.
• Try distancing.

Session 10

• Review practice activity.
• Identify examples of automatic negative thinking.
• Guided practice of cognitive strategies: Thought stopping, distracting, reasoning, and exaggeration.

Practice Activity

• Try cognitive strategies at home. Practice using cue card(s).

Session 11

• Review practice activity.
• Create a self-care plan, pinpoint strategies that worked best.
• Set long-term goals.
• Develop relapse prevention strategy.

Session 12

• Review most helpful parts of program.
• Integrate self-care plan (including medication adherence, if appropriate) into written schedule and cue cards.
• Review and adjust relapse prevention plan.
• Congratulate participant for gains made.