Major depression is one of the most common mental disorders worldwide, causing great suffering to those who suffer from it and those around them. Due to its high prevalence and the high level of vital discomfort and incapacitation that it is capable of causing, there have been multiple approaches that have attempted to provide an effective explanation and treatment. In order to treat this condition, numerous therapies have been developed.
One of the most effective forms of psychotherapy in the treatment of depression is Rehm’s self-control therapy through which it is proposed to improve the symptoms through work on various aspects linked to self-control and self-management.
Major depression is considered to be the continued presence throughout the day, for at least two weeks, of a series of symptoms, among which the presence of a sad mood characterized by high negative affect and a low level of positive affect and/or lack of interest and pleasure in stimuli and situations that are generally appetitive for the subject, along with other elements such as weight or sleep alterations, vital passivity, progressive isolation, feelings of guilt or suicidal thoughts.
It is common for them to feel powerless and defenseless in the face of life events, being in a state of despair that reduces their participation in the environment and their activity at a general level.
The symptoms of major depression involve a severe impairment in the person’s usual functioning, invalidating or impairing their performance in one or several vital domains. It is also a source of psychological suffering that makes the person who suffers from it feel continued discomfort over time. This is why its treatment is of special importance, even more so taking into account the high percentage of the population that has suffered or is about to suffer some type of depressive episode throughout their lives.
Rehm’s self-control therapy
As we have said, there have been multiple perspectives and authors who have addressed the issue of major depression in order to explain it and try to treat it successfully. One of the many treatments that have been developed for this is Rehm’s self-control therapy.
Rehm’s self-control therapy is a psychological treatment from the cognitive behavioral paradigm. and focused specifically on the treatment of depression. It is a well-established effective therapy based on the concept of self-control and the importance that the author gives to this aspect in behavioral self-management. And in the model from which it is based, the origin of depressive symptoms can be found in an imbalance between rewards and punishments.
Depression according to Rehm’s model
Rehm’s self-control therapy is based on the model that the author developed with the purpose of explaining depressive disorder. According to this model, depression is mainly caused by the lack of consistent reinforcement of behavior. That is, the main problem is that depressed people They are incapable of obtaining positive elements or stimulation from the environment.
However, the origin or progressive worsening of this lack of reinforcers can be found in the fact that the individual is not able to ensure his behavior in such a way as to obtain them, or that he is not capable of self-management. Thus, the person with depression would have a series of internal characteristics that would make self-control and adaptation of one’s behavior to reality difficult so that the loss of reinforcement can lead to depressive symptoms.
Thus, the problem that leads to depression is that the individual is not able to adequately manage his or her own behavior. Thus, the main objective of this therapy is the improvement of mood through the development and training of the different aspects of self-control.
Components of self-control
Rehm’s self-control therapy is based on the training and strengthening of a series of basic self-control skills that tend to be deficient in the depressed subject.
Specifically, Rehm considers that people control their behavior through three processes basics: self-monitoring or self-observation, self-evaluation and self-reinforcement or self-punishment according to the self-evaluation carried out.
1. Self-monitoring
In depressed people, it can be observed how the self-monitoring processes there is a tendency to focus attention on the immediate consequences of behavior, in addition to generally paying more attention to negative information than positive information
Regarding self-evaluation, from the model from which Rehm’s self-control therapy is based, this is usually biased towards the negative by creating exaggeratedly high objectives and goals, which as a general rule cannot be met. This, together with the fixation on the immediate and the negative, generally causes the person to feel frustrated.
3. Self-reinforcement
Finally, due to the impossibility of carrying out the proposed objectives, depressed people they tend to punish themselves or, failing that, not seeing their behavior reinforced in achieving objectives.
Profile of the person vulnerable to depression
According to this model, depressed people tend to be perfectionists and excessively self-demanding, creating very high expectations and goals that tend not to be achievable. For this reason, they usually fail to achieve them, so failure to meet objectives causes them to criticize and punish themselves.
The depressed person would therefore have high rates of self-punishment and low rates of reinforcement, which in the long run causes a decrease in the emission of behaviors that in turn feeds back to the absence of reinforcement. They tend to focus on negative elements, which causes them to end up evaluating themselves negatively and that self-concept and self-esteem are reduced. It is on these aspects that Rehm’s self-control therapy will focus in order to improve self-control and compensate for the deficits that induce vulnerability to major depressive disorder.
Structure of self-control therapy
Rehm’s self-control therapy is carried out over twelve sessions divided into three phases in which the three skills that allow correct self-control and self-management are worked on.
1. Self-observation phase
This part of the therapy is fundamentally cognitive. Throughout the sessions in which it is carried out, the therapist helps and trains the patient in becoming aware of the existence of positive and pleasant experiences, which the patient must record and try to associate with the state of mind.
Through this phase it is intended make the patient see positive aspects or pleasant situations and to reduce the focus on negative aspects.
2. Self-assessment phase
As we have mentioned previously, in Rehm’s self-control theory, individuals tend to set goals with very high standards, generally unrealizable, which end up causing feelings of helplessness and frustration.
That is why in a second phase of therapy the objective will focus on teaching the subject to set more specific, concrete and realistically achievable goals. This is intended for individuals to have a positive self-assessment of their own capabilities in order to achieve their objectives.
3. Self-reinforcement phase
The last phase of self-control therapy has to do with reinforcement, which in subjects suffering from depression tends to be insufficient. The work focuses on train the patient to identify various reinforcers that are important to him, as well as in applying them contingently according to the objectives that are set and are met.
Effectiveness of the technique
Yes ok It is not one of the most applied therapies Due to the predilection for other cognitive-behavioral techniques, Rehm’s self-control therapy is one of the treatments that have demonstrated a high level of effectiveness, having a well-established efficacy.
Furthermore, various studies show that each of the components or phases into which Rehm’s self-control therapy is divided is equally effective on its own, with some of its elements being applied in different techniques. An example of this is Stark and Kendall’s Action cognitive-behavioral program for childhood depression, which is based on self-control therapy and is effective in the treatment of childhood and adolescent depression.
Kahn, J.S. Kehle, T.J.; Jenson, W.R., & Clark, E. (1990). Comparison of cognitive-behavioral, relaxation, and self-modeling interventions for depression among middle-school students. School Psychology Review, 19, 196-211.
Rehm, L, P. (1977). A-self-control model of depression. Behavior Therapy. 8, pp. 787-804.
Santos, J.L. García, LI ; Calderon, MA ; Sanz, LJ; de los Ríos, P.; Izquierdo, S.; Roman, P.; Hernangómez, L.; Navas, E.; Ladrón, A and Álvarez-Cienfuegos, L. (2012). Clinical Psychology. CEDE PIR Preparation Manual, 02. CEDE. Madrid.
I’m Emily Williams Jones, a psychologist specializing in mental health with a focus on cognitive-behavioral therapy (CBT) and mindfulness. With a Ph.D. in psychology, my career has spanned research, clinical practice and private counseling. I’m dedicated to helping individuals overcome anxiety, depression and trauma by offering a personalized, evidence-based approach that combines the latest research with compassionate care.
