Cognitive Approach to Treating Depression

Question 1

Intro

Answer 1

• Aims to identify and alter negative irrational beliefs and expectations (cognitive element) to alter dysfunctional behaviours that may be contributing to the depression (behavioural element)
• CBT assumes that successfully challenging the patient’s irrational thoughts is crucial for recovery
• There are 2 parts of treatment: one targeting cognition and the other targeting behaviour

Question 2

What is CBT?

(the cognitive part)

what is done + how its done + what it leads to

Answer 2

CBT was developed by Beck and is based on his theory of depression. The idea is to identify the automatic thoughts and about the world, the self, and future
1. Thought catching: therapist helps client identify faulty and negative beliefs they are suffering from
2. Done through conservations with client or homework assignments where they’re asked to record their daily thoughts and events
3. Cognitive restructuring: replacing negative thoughts with constructive ones. This leads to the individual having more positive thoughts thus alleviating depressive symptoms

Question 3

What is the behavioural part?

Answer 3

Behavioural activation:
- Many depressives no longer participate in activities they previously enjoyed
- During CBT the client and therapist identify potentially pleasurable activities and how to overcome any obstacles that could prevent doing them
- Clients are given graded homework assignments which allow them to experiment with the chosen activity and then engage in progressively more rewarding activities

Question 4

What is REBT?

Answer 4

Ellis adds on stages D and E to her ABC model (explanation of depression)
The technique of REBT is to identify and dispute irrational thoughts. There are 3 types of disputing:
1. Empirical: irrational beliefs are not consistent with reality - there is no evidence for them in real life
2. Logical: irrational beliefs don’t make sense from available info - conclusions are illogical
3. Cognitive Restructuring: irrational beliefs have no real use to the client and negatively effect them - should be dispensed

Effect of Disputing: successful disputing changes self-defeating irrational beliefs to more rational beliefs so the client can interpret events more rationally. This makes the client feel better and become more self-accepting

Question 5

How does David et al support?

Answer 5

• A strength of cognitive treatments is that they’ve been proven effective
• Ellis claimed to have a 90% success rate for REBT
• David et al compared REBT, CBT, and drug therapy and found REBT was most effective
• This suggests that cognitive treatments are effective and REBT is most effective in the long-term and should perhaps been seen as the first choice treatment for depression

Question 6

How does Kuyken weaken the approach?

Answer 6

• A problem with CBT is that its effectiveness relies on the competency of the therapist
• Kyuken found that 15% of variance in outcome is due to therapist competence
• They found that therapists who were assessed as most competent had better patient outcomes regardless of the complexity of the case
• This is a weakness because as the quality of cognitive treatment may depend on the therapist’s ability it may not work as well for everyone
• This reduces the effectiveness of the treatment

Question 7

How is variety a strength?

Answer 7

• A strength of CBT is that its appropriate for a variety of situations and modes of delivery
• CBT can be delivered in many ways e.g. online, through apps, face-to-face
• Also, it’s been used to help people of all ages and varying degrees of depression
• This is a strength because it shows that CBT is not restricted to a certain group of people as it can be adjusted to different lifestyles and types of depression
• Also, CBT doesn’t have negative side effects like insomnia or weight loss found in SSRIs and other drugs
• Thus CBT is an easily accessible treatment which can help a wide range of people with depression