Cognitive Restructuring during Depressive Symptoms: A Scoping Review

Abstract

Cognitive restructuring (CR) aims to get people to challenge and modify their cognitive distortions, generating alternative, more adaptive thoughts. Behavioral, emotional, and physiological responses are modified by analyzing and changing dysfunctional thoughts. The person must have the cognitive capacity to participate in the analysis of their thoughts. CR for people with depression has positive effects, although there is little research on how it should be structured and applied. CR is a thought modification technique presented in the Nursing Interventions Classification (NIC), but is not organized in a sequential approach, and there is no procedure for applying it in practice. This scoping review aims to identify the structure, contents and assessment instruments used in CR for people with depressive symptoms and to analyze the health outcomes of applying the CR technique in this population. Out of 515 articles, seven studies were included in the review, up to 2021 and without any time limitation. The studies were not guided by a consistent and sound framework of the CR technique and each study used its own framework, although they used similar techniques. We grouped CR into six steps. No specific studies were found regarding intervention by nurses. CR is effective in reducing depressive symptoms, so it is an important therapeutic tool that should be used on people with depression. With this scoping review, mental health nurses will have a more comprehensive idea of the techniques that can be used in the application of CR to patients with depressive symptoms.

Keywords

• cognitive restructuring
• depression
• depressive symptoms
• nursing
• psychotherapy
• cognitive behavioral therapy