cognitive approach to treating depression Flashcards
what is the most commonly used psychological treatment for depression (& other mental health issues)
cognitive behaviour therapy (CBT)
cognitive element of CBT
- begins with assessment where client & cognitive behaviour therapist work to clarify clients problem
- jointly identify goals for therapy & create a plan to achieve them
- one of central tasks is identifying negative/irrational thoughts that will benefit from being challenged
behavioural element of CBT
involves working to change negative/irrational thoughts & put more effective behaviours into place
3 types of cognitive behaviour therapies to treat depression
- beck’s cognitive therapy
- ellis’s rational emotive behaviour therapy
- behavioural activism
describe beck’s cognitive therapy
- application of becks’ cognitive theory of depression (negative triad)
- identify automatic thoughts about world, self & future = negative triad
- once identified, these thoughts are challenged (central component)
- aims to help clients test reality of negative beliefs
- may be set homework (eg. record when they enjoyed an event, record when people were nice to them) = ‘client as scientist’ = used in future sessions
describe ellis’s rational emotive behaviour therapy
- extends ABC model to ABCDE model
- D = dispute
- E = effect
- REBT main technique is to identify & dispute irrational thoughts
- intended effect is to change irrational belief (eg. through vigorous argument)
- break link between negative life events & depression
- other ways to dispute (other than vigorous argument), eg: empirical argument (evidence to support belief), logical argument (if negative thought logically follows facts)
describe behavioural activation
- as people become depressed, they increasingly avoid difficult situations/isolate = maintains/worsens symptoms
- goal: work with those depressed to gradually decrease avoidance/isolation & increase engagement in atctivites which have been shown to improve mood (eg. exercising)
- therapist aims to reinforce activity
AO3 +) large body of evidence supporting CBT’s effectiveness for treating depression
E: eg. march et al. (2007)
- compared CBT to antidepressant drugs & combination of both when treating 327 depressed adolescents
- after 36 weeks, 81% of CBT group, 81% of antidepressants group & 86% of CBT/antidepressants groyp were significantly improved
- shows CBT was equally effective when used on own & more when used with antidepressants
- CBT usually brief therapy (6-12 sessions normally), so cost-efffectvie
T: means CBT is often seen as first choice of treatment in public health care system (eg. NHS)
AO3 -) CBT’s lack of effectiveness for severe cases & clients with learning disabilities
E:
- sometimes depression is so severe clients cannot motivate themselves to engage with cognitive work of CBT
- may be unable to pay attention to session
- complex rational thinking in CBT is unsuitable for treating depression in those with learning disabilities
- sturmey (2005) suggests that, in general, any form of psychotherapy isn’t suitable for people with learning disabilities, including CBT
T: suggests CBT may only be appropriate to particular range of people with depression
AO3 +) evidence to challenge CBT’s lack of suitability for extreme depression & clients with learning disabilities
E:
- lewis & lewis (2016): conducted review & concluded CBT was equally effective as antidepressant drugs & behavioural therapies for severe depression
- taylor et al. (2008): conduced review & concluded, if used appropriately, CBT is effective for clients with learning disabilities
T: means CBT may be suitable for wider range of people than previously thought
AO3 -) when used for treatment of depression, CBT has high relapse rates
E:
- CBT effective in tackling depressive symptoms but concerns over how long benefits last
- relatively few early studies into CBT for depressive looked at long-term effectiveness
- more recent studies suggest long-term outcomes not as positive as assumed
- ali et al. (2017) assessed depression in 439 clients every month for 12 months following CBT course: 42% relapsed within 6 months & 53% relapsed within 1 year
T: means CBT may need to be repeated periodically
