Cognitive Approach To Explaining Depression - A03 Flashcards
A strength of CBT as a treatment for depression is that there is a large body of evidence to support its effectiveness, especially in combination with antidepressant treatment.
E – March et al (2007) examined 327 adolescents who were diagnosed with depression and looked at CBT’s effectiveness, antidepressants and CBT plus antidepressants combined. After 36 weeks, 81% of the CBT group and 81% of the antidepressant group had improved significantly. It demonstrated effectiveness of CBT in treating depression. However, 86% of the CBT plus antidepressants group had also improved significantly.
E – This shows that CBT is an effective treatment because 81% of patients’ symptoms improved demonstrating its efficacy. But the research suggests that a combination of both treatments may be most effective.
L – This suggests that cognitive treatment of depression is effective, but it’s not comprehensive. Physiology also needs to be taken into account, which can be addressed using drug therapy.
A limitation of CBT is that it may not be suitable for all patients, such as those with learning disabilities.
E – Sturney (2005) proposed that patients who have learning disabilities might not be able to access the complex rational thinking of any form of ‘talking therapy’. Furthermore, patient with severe depression might not be able to motivate themselves to engage with the cognitive work of CBT.
E – This suggests that CBT might not be appropriate for all patients who are suffering from depression.
C – However, there’s recent evidence that conflicts with this: Lewis & Lewis (2016) discovered that efficacy of CBT for severe depression was as equal to antidepressants. Taylor et al. (2008) found that CBT could be used with patients with learning difficulties, with appropriate adjustments.
L – This supports that the use of CBT could be more broadly applicable than what has been considered previously. But it’s application may need to be modified in particular populations.
A limitation of CBT for the treatment of depression is its high relapse rates.
E – Ali et al. (2017) assessed 439 clients with depression every month for 123 months following a course of CBT. 42% of the patients relapsed into depression within 6 months, within a year 53% relapsed with depression.
E – This suggests that fewer earlier studies had looked at the long-term effectiveness, which may not be as high as was assumed. A reason for this is that CBT requires motivation, so patients with severe depression might not attend the sessions or engage with CBT. Drug therapy doesn’t require the same level of motivation, so it might be more effective for people who suffer from severe depression.
L - This evidence supports the concern that a limitation of CBT is that it lacks efficacy, which might lead to limiting its application to patients of moderate severity, whereby motivation can be maintained for a longer duration.
A limitation of CBT for the treatment of depression is that its efficacy may not depend on the specific techniques of Beck or Ellis, but on the relationship between the patient and therapist.
E – Resenzweig et al. (1936) argued that this relationship is very significant in order to determine the success of psychological therapy.
E – This suggests that having a person to talk to might be a crucial component in having a positive outcome rather than the specific techniques adopted by the psychologist. Luborsky et al. (2002) supported this as it showed very little difference between different methods of psychotherapy, suggesting that the underlying principles don’t differentiate their efficacy.
L – This supports the concern that the efficacy of CBT might be non-specific and unrelated to its cognitive principals. But they rely on the opportunity for the patients to build a trusted relationship in which they’re able to voice and confide their concerns.
