Depression : Cognitive Approach to Treating Depression - CBT Flashcards
What does CBT stand for ?
Cognitive behavioural therapy
What is the idea behind CBT?
Aims to challenge and restructure maladaptive ways of thinking so that they become more adaptive and rational.
This can help them to think more positively, which can have a positive effect on their behaviour.
How does CBT work?
Beck would use the cognitive triad as the basis for his CBT ( negative thoughts about self, world and future would be addressed ) .
The patient would be encouraged to challenge their negative thoughts and test them out.
They would also be encouraged to keep a record of events in their life that can be used to challenge their negative thinking e.g. diary entries, test results, birthday cards etc to try to existence of positive events.
They would attend weekly sessions either independently on their own or wire a group in order to overcome their negative thinking.
What are the positives of CBT by beck?
It is very effective for mild depression, as it stops it from getting worse. Therefore it is more applicable to mild depressive symptoms rather than severe symptoms.
It is widely respected and supported by vast amounts of research. It is offered as a cost effective treatment for many disorders by the NHS, especially for depression. The treatment is quite economical compared to other treatments such as the psychodynamic approach.
It tends to get to the root cause. It can usually uncover the real underlying issues that causes the depression in the first place. Other treatments such as medication and drugs tend not to get to the root cause but only mask the symptoms. Therefore CBT works as a cure.
It can be used as a long term cure. It has lasting positive outcomes and there is a high chance that they have actually been cured and they are less likely to suffer a relapse compared to other treatments. Therefore is it cost effective as they are unlikely to return to hospital needing further treatment in the future.
What are the negatives of CBT by Beck?
It is very effective for mild depression, as it stops it from getting worse. Therefore it is more applicable to mild depressive symptoms rather than severe symptoms. If the depression is severe, then medication may be more appropriate.
Cujipers found that CBT can be very effective is combined with drug therapy. Therefore maybe CBT used on its own to treat depression is not very effective and drugs should be used alongside it.
What is the theory behind rational emotive therapy ?
Irrational thoughts also cause negative self statements and so the therapy involves making depressed clients think in a more rational and positive manner by challenging their thinking.
They are told to practise positive and optimistic thinking, which can have a positive impact on their behaviour.
How does REBT work?
It involves challenging negative thoughts by reinterpreting the ABC model in more positive and logical way e.g. the exam was hard, they aren stupid.
They are asked to complete homework between sessions which is vital for testing irrational beliefs out in the real world, and replacing them with more rational and positive beliefs.
CBT encourages depressed clients to become more active and engage in pleasurable activities. Many depressed clients often do not engage in activities they used to enjoy, so the therapist would encourage active participation.
What are the steps in disputing irrational thoughts?
1 : Disputing irrational thoughts and behaviour
- Logical disputing occurs when self defeating beliefs do not follow logically from the information available, the therapist can ask the client ‘ does thinking this way make sense?
- Empirical disputing is where self defeating beliefs are not consistent with reality.
2 : Effects of disputing and effective attitude to life
- effective disputing can change self defeating beliefs to more rational beliefs. The client can move away from negative and irrational thinking e.g. No one like me, to more rational interpretations of events e.g. My friend has not replied to my texts because she is busy, not because she hates me.
3 : Feelings / Emotions
- the patient will think in a more positive and rational way and they will then begin to feel better. This can have a positive impact on their behaviour.
What are the positives of REBT?
Flannaghan supports the use of REBT as an effective way to treat depressive stroke victims. This therefore suggests that REBT is a suitable treatment for specific groups of people and can help them become more positive over time in terms of their thought and behaviour.
There is research evidence to support it. David compared 170 depressed patients who had 14 weeks of REBT and compared them to patients who used the drug fluoxetine. The outcomes were compared 6 months after the treatment ended and it was found that REBT was a better long term treatment compared to drug therapy.
What are the negatives of REBT?
A disadvantage of REBT is that it is unclear if the distorted negative thinking is the cages of depression or just a symptom; if it is only a symptom of depression then REBT is not tackling the root cause, and the depression might return in the future. This means they haven’t been cured properly.
It is dependent on the clients being articulate and being able to talk about their though processes coherently. Therefore REBT would not work with severe depression if they were unable to talk or communicate properly, or those who feel uncomfortable talking about their feelings with a psychologist. In this case other treatments would be considered such as drug therapy.
The success of the treatment depends upon the skill and expertise of the therapist. The more skilled the therapist, the better the therapeutic outcomes will be for depressed client, and this is essential for the treatments effectiveness. Therefore psychologists need to be highly skilled and develop a good rapport with their client in order for REBT to be successful .
