Changeways Clinic - The Depression Program

Introduction
What does the Depression Program cover?
Which clients are appropriate?
The Client Workbook
The Trainer's Manual
The Training Workshop
Who should attend the workshop?
What's included in the workshop cost?
How to register

Introduction

The Changeways Depression Program (also known as the Core Program) is a psychoeducational group therapy protocol designed to introduce clients to basic psychological self-care concepts. It has been offered in Vancouver since 1992 and has gone through several major revisions since that time. Over 5000 clients at mental health facilities across Canada have taken the program. An open-trial evaluation with clients recently discharged from inpatient care for depression produced an 8% rate of rehospitalization within six months relative to a 30% rate for a comparison group (as well as a reduced length of stay among those hospitalized). The program was most recently revised in 1996 based on extensive feedback from clients and from other therapists offering the program. The two-day training workshop for therapists emphasizes strategies for conducting the group.

Click here to see a recent summary of outcomes from on-site implementations of the Changeways Depression Program.

What does the Depression Program cover?

The program provides clients with instruction in a variety of problem-solving and lifestyle management skills. It is designed to run for six to ten weeks (one session per week). The emphasis is on providing specific, research-based strategies for dealing with life problems. The contents include:

Identifying problems and transforming them into goals for change.
Breaking goals down into manageable steps.
Learning about stress.
The signs, symptoms, and causes of depression.
The effects of diet, exercise, sleep habits, caffeine, and drugs and alcohol.
The importance of building recreation into one's daily life.
Strategies for developing a more satisfying social life.
An introduction to assertiveness skills.
Identifying negative and self-defeating thought patterns.
Learning to think in a more balanced and realistic manner.
Preventing mood problems from becoming unmanageable.

Which clients are appropriate for the Core Program?

The program is applicable to a variety of client populations. It is provided most often to clients experiencing major depression, dysthymia, bipolar II disorder, generalized anxiety disorder, and adjustment disorder. It has also been offered to clients experiencing major life stressors or transitions (such as retirement, immigration/acculturation, and dealing with chronic illness). The protocol is sufficiently flexible that it can be tailored to specific client concerns and to the therapist's own style. One centre has used the protocol as the core of a group for caregivers of patients suffering from Alzheimer's disease. Another centre has offered several groups for impoverished single mothers.

The program is mainly applicable for adults, though selected older teens may also benefit. The Client Workbook requires a grade six reading level, though clients functioning below this level may benefit if they have help. The program is not designed for clients with a psychotic disorder, borderline personality disorder, current alcohol or drug abuse problems, head injury, or developmental delay.

The Client Workbook

The Core Program provides clients with an 86-page workbook that presents all of the concepts in a pleasant, easy-to-read format. It includes a number of suggestions and exercises that clients can work on at home. The manual is presented in a modular format for maximum flexibility. Therapists can choose to use the entire manual with a group or an individual client, or they can use only those sections of the manual that directly pertain to the client's presenting problem. Thanks to a grant from the Department of Canadian Heritage, this workbook has been translated into Chinese (the nonabbreviated character set common to Cantonese and Mandarin) with bilingual section headings. The translated version is available to workshop participants at no extra cost.

The Trainer's Manual

The Trainer's Manual is a 184-page resource for therapists. It includes a description of the populations likely to benefit from the program, suggested formats for six-, eight-, and ten-session groups, extensive notes on the teaching of each section of the Client Workbook, a reference and resource section, a set of brief session notes for therapists to use as reminders, and an appendix of forms and measures to assist with the group.

The Depression Program Training Workshop

The Depression Program training workshop is a two-day instructional seminar designed to give professional therapists much of the information that they need in order to conduct a group based on the model at their own facilities. The workshop presumes psychotherapeutic expertise on the part of those attending, plus a degree of familiarity with cognitive-behavioural models and with group therapy. The workshop should not be construed as basic therapy training nor as complete training in cognitive-behavioural technique or group work. The instructional style is lecture format with substantial opportunity for interaction, questions, and feedback. Here is the workshop schedule:

Day One

Registration
Introductions
Orientation to Changeways
Creating a psychoeducational group
Break
Leading the Core Program

Lunch

Beginning the group
Orienting clients to the cognitive-behavioural model
Break
Goal-setting to build confidence and motivation

Day Two

Stress and depression
The balanced lifestyle
Break
Social support
Assertiveness

Lunch

How thoughts influence emotion and behaviour
Break
Altering negative or distorted thinking
The road ahead: Preventing future difficulties
Ending your group

Who should attend the workshop?

The workshop is intended for professional therapists (including clinical counselors, psychologists, psychiatrists, psychiatric nurses, and other trained psychotherapists). It is likely to be particularly helpful for those therapists wishing to conduct empirically-based psychoeducational groups for the acutely distressed nonpsychotic adult population.

Are the materials included in the cost of the workshop?

Yes. Workshop participants receive the following:

The Client Workbook in English.
The Client Workbook in Chinese (upon request).
The 184-page Trainer's Manual in English.
A CD-ROM with master copies of the Client Workbook and related group materials.
Permission to reproduce the Client Workbook for use with your own clients.

How to register

Check the Calendar for information on upcoming workshop dates, locations, and prices.
Print a copy of the workshop flyer for the program you wish to attend. Alternatively, call us at 604 871 0490 and we will mail you a copy.
If there is an indication that the workshop is nearing capacity, or if the registration deadline is approaching, call us at 604 871 0490 or fax the registration form to us at 604 871 0495 and we will save you a spot.
If paying by credit card, enter your card information on the registration form and fax or mail it to us.
If paying by cheque, mail a copy of the form and your cheque (made out to "Changeways Clinic") to us at Changeways Clinic, Suite 509, 2525 Willow Street, Vancouver BC, V5Z 3N8.

If you have any questions about the program or about registration, call us at 604 871 0490 or email workshops@changeways.com.

If you know of additional staff members who might be interested in the program, call us and we can send out brochures via email or regular mail. Your help in contacting others will be most appreciated.

Space is limited for all workshops, so register early!

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