Cognitive Approach to Treating Depression Flashcards
what is the cognitive approach to treating depression?
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cognitive behaviour therapy (CBT)
what is CBT?
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a combination of cognitive therapy (changing maladaptive thoughts and beliefs) and behavioural therapy (changing behaviour in response to these thoughts and beliefs)
a non-invasive treatment for depression that involves talking through the client’s thoughts
aims to turn irrational thoughts into rational ones because irrational thoughts cause psychological problems
irrational thinking is rigid, unrealistic and lacks internal consistency whereas rational thinking is flexible, realistic and based on fact/logic
x4 features of CBT.... • challenging irrational thoughts • homework • behavioural activation • unconditional positive regard
define irrational thoughts
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rational thinking is flexible, realistic and based on fact/logic
irrational thinking is rigid, unrealistic and lacks internal consistency
what does CBT involve?
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challenging irrational thoughts
homework
behavioural activation
unconditional positive regard
CBT: challenging irrational thoughts
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Ellis extended his ABC model to ABCDEF as a method of treating depression by…
- D = disputing irrational thoughts and beliefs (in 3 main ways)
- E = effects of disputing these thoughts and effective attitude to life
- F = new feelings are produced
focuses on challenging irrational thoughts and replacing them with effective, rational beliefs
3 main ways of disputing irrational thoughts…
• logical disputing — irrational beliefs do not follow logically from the information available so the therapist must ask the client whether thinking in this way makes sense
- empirical disputing — irrational beliefs are not consistent with reality so the therapist asks where the proof for such beliefs is and if this proof is accurate
- pragmatic disputing — irrational beliefs are not useful, so the therapist asks how this belief is likely to help
cognitive restructuring = challenging the client’s irrational thoughts by evaluating evidence for their beliefs, changing automatic negative thoughts and accentuating positive evidence to reframe their thoughts — helps them become more self accepting and rational
cognitive triad = distorted thoughts are not reflective of evidence in real life, thoughts fit into three categories; the self, the world and the future
CBT: homework
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clients are often asked to complete homework assignments between therapy sessions
might include looking for a new job, asking someone out on a date when they’ve previously been afraid to do so due to fear of rejection, etc
vital in testing irrational beliefs against reality, putting new rational beliefs into practice and challenging existing beliefs — attempts to show the client that their beliefs do not correspond to reality
CBT: behavioural activation
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a characteristic of many depressed people is that they no longer participate in activities they previously enjoyed
so CBT focuses on encouraging clients to become more active and engage in pleasurable activities
the therapist and client identify potentially pleasurable activities and deal with any cognitive obstacles (e.g. the client believing they can’t achieve those activities)
being active leads to rewards that can act as an ‘antidote’ to depression
Babyak (2000) found that clients who engage in exercise have significantly lower relapse rates than those on medication
CBT: unconditional positive regard
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involves convincing the client of their value as a human being
if the client feels worthless, they will be less willing to consider changing their beliefs and behaviours — so UPR is essential in treating depression
the therapist will provide respect and appreciation regardless of what the client does or says, thus facilitating a change in their beliefs and attitudes
x3 evaluation points for CBT
research support
not suitable for everyone
client responsibility
evaluation
RESEARCH SUPPORT
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research has supported CBT as a useful way of treating depression
Ellis (1957) claimed a 90% success rate, stating that it takes an average of 27 sessions to complete the treatment
he also suggested that if it doesn’t work, it’s because the client did not put their revised beliefs into action rather than because the therapy is ineffective OR it may be the therapist that prevents CBT working rather than the therapy itself
a review has shown that 75 studies have found that CBT was superior to no treatment
evaluation
NOT SUITABLE FOR EVERYONE
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CBT relies on clients being willing to talk about their beliefs and challenge the way they think
this means it is not suitable for everyone, especially for people who have high levels of irrational beliefs that are both rigid and resistant to change
it also appears to be an unsuitable treatment for situations where depression may have resulted from situational factors, such as life events or family problems, because CBT focuses on the individual’s thoughts rather than on the events themselves
may also be unsuitable for people who are unwilling to talk about their thoughts and feelings — men?
evaluation
CLIENT RESPONSIBILITY
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CBT makes the client responsible and appears to ‘blame’ them for their depression rather than considering situational factors
it suggests the client is responsible for their disorder due to the way they think — it is the client’s thoughts that have caused their mental disorder rather than the events in their life
this overlooks situational factors that may have contributed to depression, such as a death in the family, a divorce or abuse
according to the approach, the disorder is simply in the client’s mind which may be putting too much pressure on the client to change their own thoughts and if therapy doesn’t work, they may blame themselves which may worsen their depression
