Behavior Management: Relapse Management


As already mentioned, framing may be a crucial tool for changing negative thoughts or goals into positive ones. Kennerley & Westbrook (2017) are right to note that reframing may be used to turn the negative ‘dead man’s solution’ goals into more positive targets, but there is more to that. For instance, one may use reframing to help a person come to terms with negative thoughts about his or her qualities or feelings that are deemed socially undesirable.


To illustrate, if a person suffers from a negative self-perception because of the envy he or she feels for others, this feeling can be reframed as a motivation to learn and improve (Leahy, 2021). As one can see, reframing can turn negative thoughts into positive ones not merely by avoiding ‘dead man’s solution’ goals but also by changing the perception of certain emotions.

The contradiction between the need to manage one’s emotions as a central pillar of relapse management and the fact that depressed people lack in this very regard is indeed an issue of acute importance. It is also true that the bias in favor of changing the cognitive aspect of depression, as opposed to its emotional component, is present in CBT (Kennerley & Westbrook, 2017).


However, this emphasis is reasonable in the sense that the cognitive aspect of depression is easier to categorize and measure and, as such, easier to treat by establishing and addressing relapse predictors. For example, ruminative habits in depressed patients are known to be a good predictor of relapse possibility, and the attempts to address it specifically have demonstrated lower relapse rates (Bessette et al., 2020). With this in mind, the best that can be done to help depressed clients is probably addressing relapse predictors that are already known.


Bessette, K. L., Jacobs, R. H., Heleniak, C., Peters, A. T., Welsh, R. C., Watkins, E. R., Langenecker, S. A. (2020). Malleability of rumination: An exploratory model of CBT-based plasticity and long-term reduced risk for depressive relapse among youth from a pilot randomized clinical trial. PLoS One, 15(6), e0233539.

Kennerley, H., Kirk, J., & Westbrook, D. (2017). An introduction to cognitive behavior therapy – Skills and applications (3rd ed.). Sage Publications.

Leahy, R. L. (2021). Cognitive-behavioral therapy for envy. Cognitive Therapy and Research, 45, 418–427.