cognitive approach to treating depression

Question 1

cognitive behaviour therapy definition

Answer 1

a method for treating mental disorders based in both cognitive and behavioural techniques. form the cognitive viewpoint the therapy aims to deal with thinking, such as challenging negative thoughts. the therapy also includes behavioural techniques such as behavioural techniques as behavioural action

Question 2

irrational thoughts definitions

Answer 2

also called dysfunctional thoughts. in Ellis’s model and therapy, these are defined as thoughts that are likely to interfere with a person’s happiness . such as dysfunctional thoughts lead to mental disorders such as depression

Question 3

what is CBT

Answer 3

most commonly used psychological treatment for depression and a range of other mental health issues. it is an example of the cognitive approach to treatment, though it also includes behavioural elements

Question 4

what 2 elements are there to CBT

Answer 4

-behavioural element
-cognitive element

Question 5

what is the cognitive element to CBT

Answer 5

CBT begins with an assessment in which the client and the cognitive behaviour therapist work together to clarify the clients problems. they jointly identify goals for the therapy and put together a plan to achieve them. one of the central tasks is to identify where there might be negative or irrational thoughts that will benefit from challenge

Question 6

what is the behaviour element to CBT

Answer 6

CBT than involves working to change negative and irrational thoughts and finally put more effective behaviours into place

Question 7

which 2 people did cognitive therapy

Answer 7

-Beck
-Ellis

Question 8

what is the idea behind Beck’s cognitive therapy

Answer 8

idea behind is is to identify automatic thoughts about the world, the self and the future (negative therapy). once these are identified these thoughts must be challenged which is the central component to therapy

Question 9

how does cognitive therapy challenge thoughts and how

Answer 9

-challenge thoughts directly
-help clients test negative beliefs. they might therefore be set homework, such as to record when they enjoyed an event or when people were nice to them. this is sometimes referred to as the ‘client as scientist’, investigating the reality of their negative beliefs in the way a scientist would. in future sessions if clients say than no one is nice to them or there is no point in going to events, the therapist can then produce this evidence and use it prove the client’s statements are incorrect

Question 10

what is Ellis’s cognitive therapy

Answer 10

rational emotive behaviour emotional behvaiour therapy which extends the ABC model

Question 11

what does REBT stand for in ellis’s therapy

Answer 11

R-rational
E-emotive
B-behvaiour
t-therapy

Question 12

what can Ellis’s therapy extend the ABC model to

Answer 12

ABCDE model which D stands for dispute and E stands for effect which the central technique is to identify and dispute (challange) irrational thoughts

Question 13

example of Ellis’s rational emotive behvaiour therapy

Answer 13

client might talk about how unlucky they have been or how unfair things seem. an REBT therapist would identify these as examples of utopianism and challenge this as an irrational beliefs. this would involve vigorous argument. this interned effect of to change the irrational belief and so brake the link between negative life events and depression

Question 14

vigorous argument as Ellis’s rational emotive behaviour therapy

Answer 14

vigorous argument is the hallmark of REBT. Ellis identifies different methods of disputing. for example, empirical argument involves disputing whether there is actual evidence to support the negative belief. logical argument involves disputing wherever the negative thought logically follows from the fact

Question 15

behaviourism activation - what happens when individual become depressed

Answer 15

they tend to avoid difficult situations and become isolated, which maintain or worsens symptoms

Question 16

what is goal of behavioural activation

Answer 16

to work with depressed individuals to gradually decrease their avoidance and isolation, and increase their engagement in activities that they have been shown to improve mood such as exercising or going out to dinner. the therapist aims to reinforce such activity

Question 17

strength of CBT- evidence for effectiveness

Answer 17

-large body of evidence supporting its effectiveness for treating depression
-many studies show that CBT works. March et al 2007 compared CBT to antidepressants and can also to a combination of both treatments when treating 327 depressed adolescences. after 36 weeks 81% of the CBT group, 81% of the antidepressants group and 86% of the CBT group plus antidepressants group were significantly improved. so CBT was just as effective when used on its own and more so when used alongside antidepressants. CBT is unusually a fairly brief therapy requiring six to 12 sessions so it is also cost-effective –> means that CBT is widely seen as the first choice of treatment in public health care systems such as the NHS

Question 18

limitation of CBT - suitability for diverse clients

Answer 18

-lack of effectiveness for severe cases and for client with learning disabilities
-in some cases depression can be so severe that clients cannot motivate themselves to engage with the cognitive work of CBT. they may not even be able to pay attention to what is happening in a session. it also seems likely that the complex rational thinking involved in CBT makes it unsuitable for treating depression in clients with learning disabilities. Sturmey 2005 suggests that, in general, any form of psychotherapy (talking therapy) is not suitable for people with learning disabilities, this includes CBT –> suggests that CBT may only be appropriate for a specific range of people with depression

Question 19

strength of CBT - counterpoint to suitability for diverse clients

Answer 19

-although the conventional wisdom has been has been that CBT is unsuitable for very depressed people and for clients with learning disabilities, there is now some recent evidence that challenges this. a review by Lewis and Lewis 2016 concluded that CBT was as effective as antidepressant drugs and behavioural therapies for severe depression. another review by Taylor et al 2008 concluded that, when used appropriately, CBT is effective for people with learning disabilities –> means that CBT may be suitable for a wider range of people than was once thought

Question 20

limitation of CBT - relapse rates

Answer 20

-treatment of depression is its high relapse rates
-although CBT is quite effective in tackling the symptoms of depressions, there are some concerns over how long the benefits last. relatively few early studies of CBT for depression looked at long-term effectiveness. some more recent studies suggest that long-term outcomes are not as good as had been assumed. for example in one study Ali et al 2017 assessed depression in 439 clients every month for 12 months following a course of CBT. 42% of the clients relapsed into depression within 6 months of ending treatment and 53% relapsed within a year –> means CBT may need to be repeated periodically

Question 21

evaluation of CBT - client preference

Answer 21

-CBT for depression focuses on identifying and changing unhelpful patterns of thinking and behaviour. there is a large body of evidence to show that, when used with appropriate clients, this is highly effective, at least in short terms, in tackling symptoms of depression
-however, not all clients want to tackle their depression this way. some people just want their symptoms gone as quickly and easily as possible and prefer medication. others, for example survivors of trauma, wish to explore the origins of their symptoms. in a study of client preference, Yrondi et al 2015 found that depressed people rated CBT as their least preferred psychological therapy