Cognitive therapy for the treatment of depression includes a variety of emotional, cognitive, and behavioral techniques aimed at reducing depressive symptoms. In this article we will talk about the assignment of graduate assignments, A technique particularly indicated in the early stages of psychological treatment.
The assignment of graduates is focused on decreasing the patient’s apathy and promoting his behavioral activation, so that his mood gradually improves. Let’s find out in detail how to achieve this using this technique.
Cognitive therapy for depression includes different components or techniques grouped into 3 main areas: behavioral, cognitive and emotional techniques. Within behavioral techniques, we find the attribution of graduated tasks.
Behavioral techniques are used to promote changes in behavior and alleviate motivational and emotional symptoms, especially in severely depressed patients. They also help to detect and modify maladaptive cognitions used as small experiments.
In them they stand out:
- Techniques of mastery and / or satisfaction.
- Cognitive or practical test.
- Role games.
- Adaptation techniques.
- Programming of activities.
- Allocation of graduate assignments.
Let’s see what the latter consists of, the assignment of assignments to graduates.
Assignment of graded tasks: characteristics
Graduate assignment is a behavioral technique widely used in Aaron Beck’s cognitive therapy for the treatment of depressive disorders.
Assignment of graduate missions it is mainly used in the early stages of therapy, And / or when the patient is very depressed, in order to get him out of this state of absolute apathy and harassment. The goal of the therapist will be to restore the patient’s previous level of functioning before the depression.
The application of the graduated tasks will allow to integrate more cognitive techniques in more advanced phases of the treatment, when the patient’s mood is better.
The technique consists of assigning the patient to tasks with different degrees of difficulty, which pose a challenge but with a high probability of success. The tasks will be noted, that is to say their level of difficulty will increase less and more, and they will become more and more complex for the patient.
The therapist should record the patient’s expectations for difficulty and effectiveness regarding the different tasks or activities, as well as the degree of realism in relation to those expectations.
It will also be important, as the therapy progresses, to contrast the patient’s evaluations of their performance.
Theoretical Foundations of Graduate Assignment
The theoretical basis of this method is based on the clinical observation that the patient in a severe depressive state considers that he is no longer able to develop the functions “expected of him” as a student, worker, mother or father, etc. Likewise, sometimes your other important people start to think about it too.
In addition, the patient may no longer have the hope of obtaining satisfaction from the activities that he previously enjoyed. Hence the attribution of graduate missions it is also considered a behavioral experiment, Where the patient checks that he can perform all these tasks and can even enjoy them again.
Likewise, the therapist, by helping the patient to modify certain behaviors, will be able to show him that his negative and too general conclusions were wrong.
When to use the technique?
As already mentioned, graded task assignment is usually used at the start of psychotherapy, in the early stages of treatment. More precisely, we can differentiate three phases of cognitive therapy:
- Phase 1: Behavioral activation techniques.
- Phase 2: Interrogate automatic thoughts.
- Phase 3: challenge basic assumptions and beliefs.
In phase 1 is the assignment of graduated tasks. At this stage, a series of activities or graduated tasks have been planned with the patient that it will develop.
First of all, you need to record your daily activities and your mood.
Then the therapist will plan with him activities aimed at increasing his activity level, their satisfaction and sense of accomplishment (The aim is to make the patient feel “useful” even when faced with simple tasks).
Finally, the activities they will break down into smaller steps if necessary.
Additional benefit of the technique
This first phase of therapy, in addition, as well as the assignment of graded tasks, is an additional benefit for the patient, as it will help prevent or control the tendency to rumination.
In this way, in the increase the level of activity, attention and energy they will focus on aspects other than their own thinking (they will be directed to the outside world, not so much inward).
Thus, when the patient focuses his interest and attention on specific activities, the therapist will encourage him to thwart his flight to ruminative or depressive thoughts and allow him to engage in more constructive activities.
On the other hand and as we have already seen, there are other techniques similar to the assignment of graduated tasks. More precisely, the programming of activities is very similar. Let’s take a look at the differences between them, as these are concepts that are sometimes used interchangeably (although they are slightly different techniques).
Differences between scheduling activities and assigning graded tasks
Scheduling activities is more demanding and structured than assigning graduated tasks, and assigning graduated tasks, in turn, focuses on activities of daily living of the patient.
In addition, the activity calendar should include a patient calendar where he writes down the planned tasks with the therapist.
- Feixas, G; Miró, T. (1993). Approaches to psychotherapy. An introduction to psychological treatments. Barcelona: Ed. Paidós
- Pagès, FJ et al. (2001). Handbook of Modification Techniques and Behavioral Therapy. Madrid: Pyramid