The Core Program: Conducting Group Therapy for Depression
The Changeways 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 2006 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.
This program is also available as an online on-demand training course. For information, click here. Group discounts are available for organizations wishing to enrol 5 students or more. Contact us at firstname.lastname@example.org for information on this option.
What does the Core Program Protocol cover?
The protocol 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) in most outpatient settings. Many inpatient programs have adapted the program for ward use, however, and here sessions are generally shorter but more frequent. As well, some outpatient settings have adapted the group to an open-ended (rotating) format.
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 protocol 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 Manual is written at the 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 Manual
The Core Program provides clients with a 92-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.
The Clinician’s Guide
The Clinician’s Guide is a 220-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 Core Program Training Workshop
The Core 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:
Orientation to Changeways
Creating a psychoeducational group
Leading the Core Program
Beginning the group
Orienting clients to the cognitive-behavioural model
Goal-setting to build confidence and motivation
Stress and depression
The balanced lifestyle
How thoughts influence emotion and behaviour
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 and online course?
Yes. Workshop participants receive the following:
- The Client Manual.
- The Clinician’s Guide.
- PDF copies of the Client Workbook and related group materials.
- Presentation slide printout.
- Permission to reproduce the Client Workbook for use with their own clients.
Feedback on this program
“Thanks so much! Excellent work. I hope to co-facilitate this program in future.”
“The materials are very user-friendly.”
“An excellent presenter and a well-organized course. Thank you!”
“It was very interesting. I enjoyed the humour and stories used to describe the points being made.”
“Very well-organized. The presenter obviously ‘wrote the book’ and read the audience well.”
“So very excellent. Thank you for your common sense and knowledge in applying all the strategies. The material is simple to read and well organized.”
“Our facility is hoping to run a group based on this model continuously.”
“Thanks so much - a really enjoyable two days.”
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