Cognitive approach: Treating depression

Question 1

CBT

Cognitive approach: Treating depression

Answer 1

CBT is most commonly used psychological treatment for depp & range of other mental health issues
Example of cog approach to treatment, but also includes behavioural elements

Cog element - CBT begins w. assessment where client & therapist work together to clarify client’s problems
They jointly identifiy goals for the therapy & put together a plan to achieve them
One central task is to identify where there might be neg or irrational thoughts that will benefit from challenge

Behaviour element - CBT then involves working to change neg & irrational thoughts & finally put more effective behaviours into place

Question 2

Beck’s cognitive therapy

Cognitive approach: Treating depression

Answer 2

Idea behind cog therapy is to identifiy automatic thoughts about the world, self & future
Once identified these thoughts must be challenged
Cog therapy also aims to help clients test reality of their neg beliefs
They might be set homework such as record when they enjoyed an event
In future sessions if clients say there is no point going to events, therapist can produce evidence & use it to prove client’s statements are incorrect

Question 3

Ellis’s rational emotive behaviour therapy (REBT)

Cognitive approach: Treating depression

Answer 3

REBT extends ABC model to ABCDE model
D = dispute
E = effect
Central technique of REBT is to identify & dispute irrational thoughts
E.g. a client might talk about how unfair things seem
An REBT therapist would indentify this as example of utopianism & challenge this as irrational belief
This would involve a vigorous arguement
Intended effect is to change irrational belief & so break link between negative life events & depp
Ellis indentified diff methods for disputing, i.e. empirical arguement involves disputing whether there is actual evidence to support negative belief

Question 4

Behavioural activation

Cognitive approach: Treating depression

Answer 4

As individuals become depped, they increasingly avoid difficult situations & become isolated which maintains or worsens symptoms
Goal of behavioural activation is to work w/ depped individuals to gradually decrease their avoidance & isolation & increase their engagement in activities that have been shown to improve mood (i.e. exercising)
Therapist aims to reinforce such activity

Question 5

Evaluation: Evidence for effectiveness

Cognitive approach: Treating depression

Answer 5

Strength: Large body of evidence supporting effectiveness of CBT for treating depp
March et al compared CBT to antidepp drugs & combo when treating 327 depped adolescents
After 36 weeks, 81% of CBT group, 81% of antidepp group & 86% of combo group were sigly improved
CBT was just as effective when used on its own & more so when used alongside antidepps
CBT is usually fairly breif requiring 6-12 sessions so it’s also cost-effective
Therefore, CBT is widely seen as first choice of treatment in public health care systems (i.e. NHS)

Question 6

Evaluation: Suitability for diverse clients

Cognitive approach: Treating depression

Answer 6

Limit of CBT: lack of effectiveness for severe cases & clients w/ learning disabilities
Some cases depp can be so severe that clients cannot motivate themselves to engage w/ cog work of CBT
It also seems likely that complex rational thinking involved in CBT makes it unsuitable for clients w/ learning disabilities
Sturmey suggests that any form of psychotherapy is not suitable for people w/ learning disabilities
Therefore, CBR may only be appropriate for specific range of people w/ depp

Question 7

Evaluation: Suitability for diverse clients (Counterpoint)

Cognitive approach: Treating depression

Answer 7

However, there is evidence to challenge this
Lewis & Lewis concluded CBT was effective as antidepp drugs & behavioural therapies for severe depp
Another review by Taylor concluded that, when used appropriately, CBT is effective for people w/ learning disabilities
Therefore, CBT may be suitable for wider range of people than once thought

Question 8

Evaluation: Relapse rates

Cognitive approach: Treating depression

Answer 8

Limit of CBT: high relapse rates
Although CBT is effective in tackling symptoms of depp, there are concerns w/ how long benefits last
Relatively few early studies of CBT for depp looked at long-term effectiveness
Recent studeis suggest long-term outcomes are not as good as assumed
Ali et al assessed depp in 439 clients every month for 12 months following course of CBT
42% of clients relapsed w/in 6 months of ending treatment
53% relapsed w/in a year
Therefore, CBT may need to be repeated periodically