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'Sad is how I am!' Treating Dysthymia in Children and Adults

Appendix C - Conducting A Research Study On Yourself
Reproducible Client Worksheet


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As you will see, the self-monitoring measures that I am about to recommend take time: four weeks’ time, to be exact. I encourage you to take all of that time and complete all of the steps. Follow through to the end!

The following self-monitoring strategy will enable you to uncover reasons for your long-standing blue mood. Unlike the predisposing factors you learned about in the last chapter, these reasons direct you to the solutions you have been hoping to find. What is more, the process itself provides certain benefits. First, it gives you an opportunity to take the healthy, objective, mindful part of yourself and bring it to bear on your dysthymic, depressed side. You have been doing the exact opposite for quite some time now, so the change in focus will be refreshing, even uplifting. Second, by concentrating on specific parts of your condition instead of looking at it as a huge, unmanageable whole, you will feel less powerless. Although making the blues go away in one fell swoop is still beyond your capabilities, correcting small pieces of the problem is something you can do, and you will see a ray of hope. Finally, you will be developing a new positive habit of paying attention to what is happening within and around you, and with it, the potential to recognize and do something about upsetting circumstances before they send you plummeting into the pits of depression.

With that in mind, get out your notebook and make copies of the Weekly Self-Monitoring Chart (Appendix A).

Week One: Five times a day, rate your mood and your energy level/physical condition. Use the following 1-10 rating scales:

Mood
10 = elation, feeling on top of the world
1 = the pits, utterly depressed, as down as you can get

Energy
10 = bursting with energy, feeling in peak condition
1 = completely exhausted, worn out or aching all over

If you give yourself the same rating five times a day every day, you are probably operating on the assumption that you feel about the same all of the time, you’re not really paying attention. That won’t help you.

Week Two: Continue your ratings and in the space provided list the emotions you are experiencing or experienced between ratings. Be specific. You already know you feel “blah” or blue. What else are you feeling—anger, frustration, resentment, sadness, confusion, jealousy, hopelessness, fear, anxiety annoyance, self-doubt, disappointment? Remember that you can have several feelings at the same time and that pleasant feelings count. List them too.

Week Three: Continue rating and listing feelings. Also jot down (in the appopriate columns) any encouraging experiences or stressful/upsetting things that occurred between ratings.

Week Four: Continue rating, listing feelings, and keeping track of your experiences. In addition, set aside time each day or evening to analyze one of the stressful or upsetting situations you noted on your chart. It can be something you encountered that day or something you jotted down during Week Three. Conduct your analysis by answering, in writing, the following questions that were developed by James P. McCullough of Virginia Commonwealth University as part of his Cognitive-Behavioral Analysis System of Psychotherapy (C-BASP) for treating DD:

1. What happened? Describe the event objectively, as if it were a movie you were watching. Provide details in sequence (what happened first, next, and so on).

2. What did it mean to you? For instance, to Judy, her experiences at the birthday party meant that she had “lost another chance to be happy.” Beverly concluded that “Nothing, not even a simple shopping trip and lunch, turns out the way I want it to.” And Dame thought her experience meant that, “No matter what I do, I’ll never impress Greg.” Try to identify what you told yourself, expected, or feared during the experience as well. Phrases such as “I can’t,” “I’ll never,” “If only I had,” or calling yourself a jerk, a fool, a dope, or some other derogatory name are clues for answering this question.

3. What were you feeling?

4. What was your role in the situation? In response to what was happening, what did you do, say, or signal non-verbally? What didn’t you do or say that you could have? For example, when Greg turned the spotlight on himself, Danielle “got quiet” and responded unenthusiastically (hoping that he would notice she was upset and give her some of the spotlight.). When she learned that Greg had made plans without consulting, her she “swallowed” her anger and did nothing. And when Greg finally expressed interest in what had happened to her that day, she played down her news, presenting it as if it was as unimportant as she already assumed Greg would view it.

5. How did the situation turn out for you? What was its actual out­come? And how did that compare to...?

6. What did you want to happen (the desired outcome)?
Once you have answered those questions, go back through your analysis and underline the possible problem areas—any thoughts, feelings, actions, or interactions that might have contributed to the stressful or upsetting nature of the event or prevented you from obtaining the out­come you desired.
At the end of the Fourth Week: Review your charts and other writings and identify the patterns that emerged by completing sentences beginning with: “I learned that I . . . ,” “I discovered that I . . . ,” “I noticed that I . . . ,” and so on.

Based on those patterns, identify some areas where changes or adjustments might help you to feel better. You don’t need irrefutable proof. A hunch is fine. And rather than phrasing things negatively (that is, “I have to stop jumping to stupid conclusions,” or “I’d better stop acting like such a doormat”), try putting your goals in the following framework: “If I could ____ [weigh the evidence before I draw conclusions or be more assertive] ____, I might feel better.” Then prioritize your goals, giving number one priority to the self-help measure you would be most willing to try, number two priority to the one you are next-most willing to try, and so on until all of your goals have a numerical ranking.


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