 Mind Reading : “He thinks I’m foolish.

”
 Discounting positives : “The other questions were so easy. Any dummy could have gotten them right.”

The client is asked to describe evidence that both supports and disputes the automatic thought. The
logic underlying the inferences is then reviewed with the client. Another technique involves evaluating
what would most likely happen if the client’s automatic thoughts were true. Implications of the
consequences are then discussed
Clients should not become discouraged it one technique seems not to be working. No single
technique works with all clients. He or she should be reassured that any of a number of techniques may
be used, and both therapist and client may explore these possibilities.
Cognitive therapy has offered encouraging results ill the treatment of depression. In fact, the results
of several studies with depressed clients show that in some cases cognitive therapy may be equally or
even more effective than antidepressant medication (Rupke, Blecke, Renrow, 2006).

Electroconvulsive Therapy
ECT is the induction of a grand mal (generalized) seizure through the application of electrical current to
the brain. ECT is effective with clients who are acutely suicidal and in the treatment of severe
depression, particularly In those clients who are also experiencing psychotic symptoms and those with
psychomotor retardation and neurovegetative changes, such as disturbances in sleep, appetite, and
energy. It is often considered for treatment only after a trial of therapy with antidepressant medication
has proved ineffective.

Mechanism of Action
The exact mechanism by which ECT effects a therapeutic response is unknown. Several theories exist,
but the one to which the most credibility has been given is the biochemical theory. A number of
researchers have demonstrated that electrical stimulation results in significant increases in the
circulating levels of several neurotransmitters (Wahlund & Von Rosen, 2003). These neurotransmitters
include serotonin, norepinephrine, and dopamine, the same biogenic amines that are affected by
antidepressant drugs. Additional evidence suggests that ECT may also result in increases in glutamate
and gamma aminobutyric acid (Grover, Mattoo, & Gupta. 2005).

The result studies

dc effects of are h rh(. ,nosf con,,”s and confusion ntics of
f t mo.nnty • hcse changes represent jrr<f.
r'° argue Proponents insist they
*-25
temporal
VOID"' ' d|sftipw new memories «|ial Because »£• incorporated into long-term have not w* ecT c;in
cause anterograde memory s,°^’ JllinCsia that is most dense and retrijgrar ^ treatment. The antcro-
around the 1 uSu:illy clears quickly, but grade co,n^e amnesj3 can extend back to lhc 'T.'btfore
treatment It is unclear ,1 the
depressive symptoms. <P 550)
ii.e controversy continues regarding the choke of unilateral versus bilateral ECT. Studies have shown Lt
unilateral placement ul the electrodes decreases lhc amount ol memory disturbance. I lowever, unilat-
eral ECT often requires a greater number of treat¬ments to match the efficacy ol bilateral ECT in the
relief of depression (Geddes. 2003 '
Risks Associated With EC I Mortality
Studies indicate that the mortality rate from ECT is about 2 per 100.000 treatments (Marangell, Silver,&
Yudofsky, 2003; Sadock & Sadock, 2007). Although the occurrence is rare, the major cause of death with
ECT is from cardiovascular complications te.g., acute myocardial infarction or cerebrovascular accident),
usually in Individuals with previously compromised cardiac status. Assessment and man¬agement ol
cardiovascular disease prior to treatment is vital in the reduction of morbidity and mortality rates
associated with ECT.
Permanent Memory Loss
'lost individuals report no problems with their
inutlw^F# *r ,rom ll,e lime immediately surround* reported treatn,en,s- However, some clients have
months befo^S amncsia back
extensive^ Lal,nent. In rare instances, more
ory c.aps ,,lnes,a has occurred, resulting in mem-
8 P dj"n8 years (|.,ska & Mein. 20081