Cognitive Approach And Treatment Of Depression Flashcards
What is depression
A mood disorder that affects the emotional state of a person suffering from it
Cognitive characteristics of depression
-poor concentration
-attention to the negative
-absolutist thinking
What is the cause of depression according to cognitive explanations
- faulty /irrational thinking
Examples of faulty thinking
-Misinterpretation of events, cognitive distortions, irrational beliefs
These cause depression
What model does the cognitive approach use to explain faulty thinking
The computer model- faulty information processing
What are the two main explanations of depression
-Ellis’ ABC model (1962)
-Beck’s negative triad (1967)
What is Ellis’ ABC model
-An activating event leads to the development of an irrational belief. The consequence of this irrational belief is the development of depression and unhealthy emotions
According to Ellis’ model what is the cause of depression
Irrational beliefs / thinking
What is the source of irrational beliefs according to Ellis
Musturbatory thinking
What is musturbatory thinking
The belief that you must always succeed in order to achieve perfection. People who hold these belief are more likely to become depressed.
E.G ‘I must do well or I’m worthless’
Example of the ABC model
-Activating event- Failing a mock exam
-Irrational belief- ‘I’m going to fail all of my GCSEs’
-Consequence- depression
Or
-Break up with a partner
-Irrational belief that you are ‘unlovable and will always be alone’
-Consequence is depression
What is Becks negative triad explanation
-Negative schemas maintain a negative triad of beliefs, concerning the self, the world and the future
-This makes it difficult to see past the negative aspects of life, maintain the depression
Example of Beck’s negative triad
-The self- ‘I’m worthless’
-The world- ‘no one likes me’
-The future-‘ I’ll always be a failure’
What leads to the development of negative schemas
-Childhood experiences, such as continual parental criticism or rejection by others can leads to negative self schemas developing
-These negative self schemas lead to depression
When are negative self schemas activated
-They are activated in similar situations to those present when the schemas were learnt
Evaluation of cognitive explanations of depression
-Support for the role of irrational thinking in the development of depression
-Success in its application to therapy (CBT)
-Alternative explanations
Describe Hammen and Krantz study and how it supports the role of irrational thinking
-Hammen and Krantz found that depressed participants made more errors in logic when asked to interpret written material than non depressed participants
Describe Bates study and how it supports the role of irrational thinking
-Bates found that depressed participants who were given negative automatic thought statements became more and more depressed.
What is a criticism /counterpoint of the role of irrational thinking
-However, it can also be argued that irrational thinking is a consequence of depression.
What evidence supports the cognitive explanations success in its application to therapy
-CBT has consistently been fond to be the most effective and useful treatment for depression, with further research (e.g march et al) finding it to be even more effective when paired with drug treatments.
-This demonstrates that depression can be alleviated by replacing the negative thoughts with more positive ones, suggesting that they had a role in its development in the first place
Name an alternative explanation of depression that this approach fails to consider
-The cognitive approach fails to taken into account the biological approach, which explains depression in terms of genetic and neural factors.
How does the biological approach explain depression
-In terms of biological and neural factors
-For example, a candidate gene called the SERT gene, which is associated with low levels of serotonin, is ten times more likely to be found in a depressed patient. Serotonin is a neurotransmitter responsible for mood.
-Furthermore, research shows that drug therapies, which aid serotonin levels are successful in treating depression, supported by the fact that cognitive behavioural therapy has been proven more effective when paired with drug therapies.
-this suggests that other factors play a role in casing depression and so a Diathesis stress model could be a better approach to take in explaining depression. Depression may have both a cognitive and biological element
What idea is CBT based on
-The idea that what you think and what you do affects how you feel.
What is the most common psychological treatment
CBT
What is the aim of CBT
-To challenge the cognitive element -irrational beliefs and the behavioural element- how it makes them behave (e.g isolation)
What is the Process of CBT
-The patient and therapist work together to identify the patients psychological problems
-They then use this information to set goals and plan how the patient will achieve them with the aim of challenging the irrational thoughts that are causing the depression
What is Ellis’ rational emotive behavioural therapy
-Ellis extends the ABC model to the ABCDEF model with the main stages:
-Disputing-
-Effects of disputing
-New feeling
What happens in the disputing stage of Ellis’ REBT
-The therapist will use different types of disputing to remove the patients irrational thoughts
E.G may use logical disputing to question the reality of their belief and empirical disputing to question the evidence that they have of these beliefs
What types of disputing are used in REBT
-Logical
-Empirical
-Pragmatic
What is logical disputing
getting the client to think about whether their though patterns ‘make sense’.
What is empirical disputing
asking the client if there is evidence to support their beliefs
What is pragmatic disputing
getting the client to think whether their thought patterns are useful to them or not.
What is the effect of the disputing (REBT)
-Negative beliefs are replaced with new more positive beliefs that provoke more positive feelings
What is the result of REBT
-No longer feel depressed
What are other elements of CBT
-Homework -‘client as scientist’
-Behavioural activation
What is the purpose of behavioural activation
-To encourage the patient to engage in activities that boost mood ,such as going for a walk or going out with friends in order to gradually reduce the avoidance behaviour.
What is the ‘client as scientist method’
A client may also be set homework to challenge negative thoughts E.G record a time you felt happy.
This can be used to challenge beliefs in the future
Evaluation of CBT
-Evidence demonstrating its effectiveness
-Not suitable for a more diverse range of clients
-High relapse rates
What evidence can be used to support the effectiveness of CBT (March)
-March compared the effectiveness of CBT with that of antidepressant drugs and both treatments combined with 327 depressed adolescents. After 36 weeks, she found that 81% of the antidepressants group and 81% of the CBT group had significantly improved.
Counterpoint of March’s study for supporting effectiveness of CBT
-March’s study also found that the group who were treated with both antidepressants and CBT showed to be even more effective with 86% showing significant improvement after 36 weeks, suggesting that the treatment of depression should consist of a combination of drug treatments and CBT in order to maximise the effectiveness of the treatment.
The biological approach should also be considered.
Why is CBT not suitable for everyone
-In some severe cases of depression, individuals can lack motivation and so may struggle to engage themselves with the cognitive work of CBT or may even struggle to attend the session and so therefore the treatment will be ineffective.
What treatment of depression may be more suitable for the severely depressed
antidepressants may be more effective in treating depression as they do not require as much motivation.
Evidence that individuals often relapse in the long term ( after CBT)
-Ali assessed depressed patients for 12 months following a course of CBT and found that 42% relapsed within the first 6 months of ending the treatment and 53% within a year.
-This suggests that CBT cannot be relied on as a long term treatment and so alternative treatments should be used instead
What did Keller find about recovery rates of drug therapy and CBT
-Keller found that when used alone, 55% of those who were treated with drugs alone and 52% of those treated with CBT alone recovered, however, when used together, 85% of patients recovered.
This provides further evidence that CBT and drugs should be used together when treating depression.
