Cognitive Approach To Treating Depression Flashcards
What is cognitive-behavioural therapy (CBT)?
A combination of cognitive therapy ( a way of changing maladaptive thoughts ) and behavioural therapy (changing behaviour in response to these thoughts.
Outline the two types of cognitive-behavioural therapy.
- Beck’s cognitive therapy - challenge negative schemas about the world, themselves and the future.
- Ellis’ rational emotive behaviour therapy (REBT) - Turn irrational thoughts into rational ones.
What are irrational thoughts?
Rational thinking is flexible and realistic, based on logic whereas irrational thinking is rigid, unrealistic and lacks internal consistency.
How does REBT extend Ellis’ ABC model?
Extends ABC model to ABCDE model:
D – disputing irrational thoughts
E – effects of disputing/revising beliefs.
Outline the three ways to dispute irrational thoughts.
- Logical disputing - make client aware of how self-defeating beliefs don’t follow logically from the information available.
- Empirical disputing - Make client aware of how beliefs are not consistent with reality.
- Pragmatic disputing - emphasis on the lack of usefulness of self-defeating beliefs.
How can disputing make a person with depression feel better?
Helps them turn irrational thoughts into rational ones and stops them from catastrophising.
2 Strengths (1 counter) for cognitive approach to treating depression
Research support for behavioural activation:
There is research support for the idea that the behavioural aspect of CBT is effective in alleviating depression.
Babyak et al. (2000)- studied 156 adult volunteers diagnosed with major depressive disorder. They were randomly assigned to a course of aerobic exercise, drug treatment or a combination of the two. 6 months after the end of the study, those in the exercise group had significantly lower relapse rates than those in the medication group.
Research support for effectiveness:
March et al. (2007) investigated the effects of CBT in adolescents with depression. It was found after 36 weeks that 81% CBT group showed improvement (Same as those who used antidepressants) . COUNTER - CBT may not be effective for everyone. CBT appears to be less suitable for people who have high levels of irrational beliefs and cannot motivate themselves to engage with the hard cognitive work of CBT. Some people prefer to just share their worries with a therapist without getting involved in the cognitive effort associated with recovery. Sturmey et al. (2005) found any forms pf psychotherapy not effective for those with learning difficulties. May not be able to engage in the complex rational thinking required for CBT.
State and outline two methods used in CBT.
- Keeping a diary – monitoring events where negative thoughts occur and target them.
- Homework assignments – carry out tasks to test their irrational beliefs/negative schemas against reality “patient as a scientist”. Engaging in previously enjoyed activities to raise mood (behavioural element)
What is “patient as a scientist?
The patient is encouraged to investigate the reality of their negative schemas/irrational thoughts in a way a scientist would evaluate evidence.
2 Limitations of CBT
Relapse rates:
Although CBT is quite effective in tackling the symptoms of depression, there are concerns over how long the benefits last. Shehzad et al. (2017) assessed depression in 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.
Success may be due to therapist parent relationship:
Rosenzweig (1936)- the differences between different methods of psychotherapy might actually be quite small. The aspect that could be resulting in effective treatment is not the cognitive and behavioural basis of the psychotherapies but the therapist-patient relationship.
