cognitive approach to treating depression

Question 1

what is CBT?

Answer 1

a method for treating mental disorders (e.g. depression) based on both cognitive and behavioural techniques
begins with assessment- patient and therapist work together to clarify problems
both identify goals for therapy and plan to achieve them
identify irrational thoughts to challenge
change negative thoughts and put more effective behaviours into place

Question 2

Beck’s cognitive therapy

Answer 2

identify negative triad thoughts and challenge them
therapists help patients test reality of their negative beliefs
e.g. ‘no one is nice to me’, set homework to record when people were nice to them which can be used as evidence to prove thoughts incorrect (‘patient as scientist’)

Question 3

Ellis’ rational emotive behaviour therapy (REBT)

Answer 3

central technique- identify and dispute irrational thoughts

e.g. ‘Things are so unfair’- therapist identifies utopianism, challenges this as an irrational belief with a vigorous argument- changes belief and breaks link between negative life events and depression

disputing methods:
empirical argument- disputing whether there is actual evidence for negative belief
logical argument- disputing whether negative thought flows logically from facts

Question 4

behavioural activation

Answer 4

therapist may also encourage a depressed patient to be more active and engage in enjoyable activities
provides more evidence for the irrational nature of beliefs

Question 5

strength- evidence for effectiveness

Answer 5

March et. al- compared effects of CBT with antidepressants and a combo of the two in 327 depressed patients
36 weeks- 81% of CBT group, 81% of antidepressants group and 86% of combo group significantly improved
strength- suggests CBT is just as effective as medication and is helpful alongside it, good case for making it first choice of treatment in NHS

Question 6

limitation- may not work in more severe cases

Answer 6

severely depressed patients cannot motivate themselves to engage with hard cognitive work of CBT
lack of attention/ low motivation
can treat them with antidepressants and start cut when more alert and motivated
limitation- CBT not entirely useful for all cases, cannot be used as sole treatment for more severe cases

Question 7

issue- ignores influence of past

Answer 7

CBT focuses on the present and future
some patients aware of link between childhood experiences and current depression and want to talk about this
assimilation therapy may be better- explores past to begin them moves to cog techniques when ready
issue- can cause frustration in some patients, CBT not a perfect fit for all, so has less universal value as a therapy

Question 8

problem- overemphasis on cognition

Answer 8

CBT emphasises what is happening in patient’s mind
may minimise importance of circumstances they are living in
e.g. poverty or abuse- needs to change circumstances, CBT may prevent them from doing so
CBT techniques used inappropriately can demotivate people to change situation- may think they just need to think about things differently
problem- ethical issue for therapists, ignores fact that not all problems in the mind, limited value