The six cycles maintenance model: Growing a "vicious flower" for depression

Behavioural and Cognitive Psychotherapy
Stirling Moorey

Abstract

Cognitive behavioural models of anxiety disorders often include visual representations of feedback loops that maintain the disorder. Cognitive therapy for depression is the prototype for therapy for many other disorders, and there is now good evidence for factors that maintain depression, yet there is still no accepted diagrammatic form of the maintenance model. To develop a simple, clinically acceptable and empirically based version of the "vicious flower" for depression. Current theoretical developments in depression (Differential activation and Beck's concept of modes) and empirical findings on maintenance factors were reviewed. A model was developed based on clinical utility and current knowledge of the processes and maintenance factors in depression. This model was tested for its usefulness with a small sample of IAPT trainees. The model contained 6 cycles comprising 2 cognitive cycles (automatic negative thinking and rumination/self-attacking), 2 behavioural cycles (withdrawal/avoidance and unhelpful behaviour), a mood/emotion cycle, and a motivation/physical symptoms cycle. Students found it a very useful tool for understanding maintenance factors. This diagrammatic maintenance model of depression, like similar "vicious ...Continue Reading

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Citations

Feb 24, 2015·Behavioural and Cognitive Psychotherapy·Catherine A CampbellLucia Valmaggia
Sep 4, 2010·Clinical Psychology Review·Robert DudleyChristine A Padesky
Feb 13, 2020·Social Psychiatry and Psychiatric Epidemiology·Christian HakulinenMarko Elovainio
Dec 23, 2021·Clinical Child Psychology and Psychiatry·Charlie TyackJustyna Voisnyte

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