Rehm Self-Control Therapy

Major depression is one of the most common mental disorders in the world, causing great suffering to those who suffer from it and those around them. Due to its high prevalence and the high level of life-threatening discomfort and disability that it is capable of causing, multiple approaches have attempted to give it an effective explanation and treatment. Many therapies have been developed to treat this condition.

One of the most effective forms of psychotherapy for treating depression is Rehm’s self-control therapy, Through which it is proposed to improve symptoms through work in various aspects related to self-control and self-management.

    The problem to be treated: major depression

    Major depression is considered to be the continued presence throughout the day, for at least two weeks, of a series of symptoms, including the presence of a sad mood characterized by a high negative affect and a low level of positive affect and / or a lack of interest and pleasure in stimuli and situations generally appetizing to the subject, as well as other elements such as weight disorders or sleep, vital passivity, progressive isolation, feelings of guilt or suicidal thoughts.

    It is common for them to feel helpless and helpless in the face of life events, to be in a state of hopelessness which reduces their participation in the environment and their activity in general.

    The symptoms of greater depression themselves assume a serious affectation in a person’s usual functioning, invalidating it or interfering with its action in one or more vital areas. It is also a source of mental suffering which makes the person who suffers feel discomfort over time. That is why their treatment is of particular importance, especially since the high percentage of the population has suffered or suffers from some type of depressive episode throughout their life.

      Rehm’s Self-Control Therapy

      As we have said, there have been multiple perspectives and authors who have looked at the issue of major depression to explain it and try to treat it successfully. One of the many treatments that have been developed for this is Rehm’s Self-Control Therapy.

      Rehm’s Self-Control Therapy Is A Psychological Treatment Derived From The Cognitive Behavioral Paradigm and focused specifically on the treatment of depression. It is a well-established efficacy therapy based on the concept of self-control and the importance that the author places on this aspect in behavioral self-management. And it is that in the model from which he starts, the origin of the depressive symptoms can be found in an imbalance between rewards and punishments.

      Depression according to Rehm’s model

      Rehm’s self-control therapy is based on the model that the author developed for the purpose of explaining depressive disorder. According to this model, depression is primarily caused by the lack of consistent reinforcement of behavior. In other words, the main problem is that depressed people they are unable to obtain positive elements or stimuli from the environment.

      However, the origin or gradual worsening of this lack of reinforcers may lie in the fact that the individual is unable to secure his behavior in order to obtain them, or is unable to manage himself. Thus, the person suffering from depression would have a number of internal characteristics that they would make it difficult to control oneself and to adapt one’s behavior to reality, So that facing the loss of strengthening can lead to depressive symptoms.

      So, the problem that leads to depression is that the individual is not able to properly manage his own behavior. Thus, the main objective of this therapy is to improve mood through the development and training of different aspects of self-control.

      Components of self-control

      Rehm’s self-control therapy is based on training and strengthening a number of basic self-control skills which in the depressed subject tend to be deficient.

      More precisely, Rehm considers that people control their behavior through three processes basic: self-monitoring or self-observation, self-assessment and self-reinforcement or self-punishment according to the self-assessment carried out.

      1.self-monitoring

      In depressed people this can be observed as in self-control processes we tend to draw attention to the immediate consequences behavior, in addition to generally paying more attention to negative information than positive information

      2. Self-assessment

      In terms of self-assessment, from the model on which Rehm’s self-control therapy is based, we generally see it biased towards the negative by creating exaggeratedly high goals and targets, which, as a rule, cannot be achieved. This, along with the fixation on the immediate and the negative, usually makes the person frustrated.

      3.self-reinforcement

      Finally, due to the inability to achieve the proposed goals, depressed people they tend to punish themselves or, if not, not to see their behavior reinforced vis-a-vis the achievement of the objectives.

      Profile of the person vulnerable to depression

      According to this model, depressed people tend to be perfectionists and overly demanding, creating very high expectations and goals that tend not to be achievable. Because of this, they usually fail to meet them, so failure to meet the goals causes them to self-criticize and punish themselves.

      The depressed would therefore have high self-punishment rates and low reinforcement, which in the long run leads to a decrease in the emission of conduits which in turn feeds the absence of reinforcement. They tend to focus on the negative elements, which it causes them to rate themselves negatively and that self-concept and self-esteem are reduced. It is on these aspects that Rehm’s self-control therapy will focus in order to improve self-control and compensate for deficits that induce vulnerability to major depressive disorder.

        Structure of self-control therapy

        Rehm’s self-control therapy is performed in twelve sessions, Divided into three phases in which the three skills that allow correct self-control and self-management are worked on.

        1. Self-observation phase

        This part of the therapy is fundamentally cognitive. Throughout the sessions during which the therapist is realized, he helps and trains the patient to become aware of the existence of positive and pleasant experiences, which the patient must record and try to associate with the state of anim .

        Through this phase, it is expected make the patient see positive aspects or pleasant situations and reduce the emphasis on the negatives.

        2. Self-assessment phase

        As mentioned above, in Rehm’s theory of self-control, individuals tend to set goals for themselves with very high, usually unachievable, standards that end up being cause feelings of helplessness and frustration.

        Therefore, in a second phase of therapy, the goal will focus on teaching the subject in order to set more specific, concrete and realistically achievable goals. The goal is for individuals to have a positive self-assessment of their own abilities in order to achieve their goals.

        3. Self-reinforcement phase

        The last phase of self-control therapy has to do with strengthening, which in subjects with depression tend to be underweight. The work focuses on train the patient to identify various reinforcers which are important to him, as well as to apply them in a contingent way according to the objectives which are marked are accomplished.

        Effectiveness of the technique

        even if it is not one of the most applied therapies Due to the predilection for other techniques also of a cognitive-behavioral type, Rehm’s self-control therapy is one of the treatments which have demonstrated a high level of effectiveness, having a well-established effectiveness.

        A further, several studies show that each of the components or phases that Rehm’s Self-Control Therapy is divided into is also effective on its own, with some of its elements being applied in different techniques. One example is Stark and Kendall’s Cognitive Behavioral Action Program for Childhood Depression, which relies on self-control therapy and is effective in the treatment of depression in childhood and adolescents.

        Bibliographical references:

        • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
        • Belloch, A .; Sandín and Ramos (2008). Manual of psychopathology. Madrid. McGraw-Hill (vol. 1 and 2). Revised edition.
        • Kahn, JS; Kehle, TJ; Jenson, WR and Clark, E. (1990). Comparison of cognitive-behavioral, relaxation and depression modeling interventions in high school students. School Psychology Review, 19, 196-211.
        • Rehm, L, P. (1977). Self-control model of depression. Behavioral therapy. 8, pages 787-804.
        • Sants, JL; Garcia, LI; Calderon, MA; Sanz, LJ; of rivers, P .; Left, S .; Román, P .; Hernangómez, L .; Navas, E .; Lladre, A and Álvarez-Cienfuegos, L. (2012). Clinical Psychology. CEDE PIR preparation manual, 02. CEDE. Madrid.

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