L10 - Cognitive Treatments for Depression Flashcards
what is the CENTRAL AIM of COGNITIVE BEHAVIOURAL THERAPY?
BECK DEVELOPED A FORM OF COGNITIVE THERAPY for DEPRESSION called COGNITIVE BEHAVIOURAL THERAPY.
The CENTRAL AIM of COGNITIVE BEHAVIOURAL THERAPY is to CHANGE IRRATIONAL THOUGHTS and so ALLEVIATE THE DEPRESSION
How does BECK’s COGNITIVE BEHAVIOURAL THERAPY (CBT) WORK? - PT 1
The first step is to IDENTIFY IRRATIONAL THOUGHTS, this is known as THOUGHT CATCHING. The patient is then ENCOURAGED to GENERATE A HYPOTHESIS to TEST THE VALIDITY OF THEIR IRRATIONAL THOUGHTS, this is known as PATIENT AS SCIENTIST
SEVERAL STRATEGIES are used in CBT to TEST THE PATIENT’S HYPOTHESIS. The patient may be ASKED TO GATHER DATA ABOUT BEHAVIOUR and INCIDENTS and then COMPARE THE EVIDENCE WITH THEIR HYPOTHESIS to CHECK WHETHER THEY MATCH
How does BECK’s COGNITIVE BEHAVIOURAL THERAPY (CBT) WORK? - PT 2
The Patient may also be ASKED TO COMPLETE HOMEWORK ASSIGNMENTS IN BETWEEN THERAPY SESSIONS to TEST IRRATIONAL THOUGHTS OUT IN THE REAL WORLD and then EVALUATE THE EVIDENCE
Patients may also be ASKED TO KEEP A DIARY to RECORD EVENTS and IDENTIFY SITUATIONS in which NEGATIVE THINKING OCCURS so these can be TARGETED
When patients RECORD POSITIVE THOUGHTS they are PRAISED BY THE THERAPIST, which provides POSITIVE REINFORCEMENT
The aim of this therapy is COGNITIVE RESTRUCTURING; learning to IDENTIFY, DISPUTE, and therefore CHANGE IRRATIONAL THOUGHTS
what did ELLIS do? - what is the aim of REBT?
ELLIS DEVELOPED A CBT THERAPY for DEPRESSION called RATIONAL EMOTIVE BEHAVIOURAL THERAPY (REBT)
This therapy AIMS AT CHALLENGING AUTOMATIC NEGATIVE THOUGHTS and REPLACING THEM WITH RATIONAL BELIEFS
how does REBT (ELLIS) work?
The THERAPIST USES LOGICAL ARGUMENTS to SHOW PATIENTS that their SELF DEFEATING BELIEFS DO NOT LOGICALLY FOLLOW from the INFORMATION AVAILABLE (e.g just because your friend didn’t say hello to you it does not mean they hate you, they might’ve just not seen you)
The therapist ALSO USES EMPIRICAL ARGUMENTS to SHOW PATIENTS THAT THEIR SELF DEFEATING BELIEFS are NOT CONSISTENT WITH REALITY (e.g it does not make sense to believe everyone hates you when they keep inviting you out to dinner)
Patients UNDERTAKING REBT are ENCOURAGED to ENGAGE IN BEHAVIOURAL ACTIVATION; becoming MORE ACTIVE and taking part in PLEASURABLE ACTIVITIES.
Many depressed patients OFTEN DO NOT ENGAGE IN ACTIVITIES that they USED TO ENJOY
+ MARCH ET AL (EVALUATION OF COGNITIVE BEHAVIOURAL THERAPY)
+ MARCH ET AL found that CBT was AS EFFECTIVE AS ANTIDEPRESSANTS in TREATING DEPRESSION
The researchers EXAMINED 327 ADOLESCENTS WITH DEPRESSION.
They looked at the EFFECTIVENESS OF CBT, ANTI DEPRESSANTS, and a COMBINATION OF THE TWO
After 36 WEEKS, 81% OF THE ANTI DEPRESSANT GROUP and 81% OF THE CBT GROUP SIGNIFICANTLY IMPROVED. However, 86% OF THE COMBINATION GROUP HAD SIGNIFICANTLY IMPROVED. This suggests that a COMBINATION OF CBT and ANTI DEPRESSANTS is the MOST EFFECTIVE TREATMENT
+ DAVID (EVALUATION OF COGNITIVE BEHAVIOURAL THERAPY)
+ DAVID found that CBT is a BETTER TREATMENT FOR DEPRESSION in the LONG TERM than ANTI DEPRESSANTS
He COMPARED 170 PATIENTS WITH DEPRESSION who HAD 14 WEEKS OF CBT with patients who were TREATED WITH THE DRUG FLUOXETINE.
SIX MONTHS LATER it was found that patients who had RECEIVED CBT were LESS LIKELY TO HAVE RELAPSED
- COMMITMENT and MOTIVATION (EVALUATION OF COGNITIVE BEHAVIOURAL THERAPY)
- One ISSUE ASSOCIATED WITH CBT is that it REQUIRES COMMITMENT and MOTIVATION.
Patients with SEVERE DEPRESSION MAY NOT ENGAGE WITH CBT, or even ATTEND SESSIONS, and therefore this TREATMENT WILL BE INEFFECTIVE in TREATING THESE PATIENTS
Alternative treatments, for example, ANTIDEPRESSANTS, DO NOT REQUIRE THE SAME LEVEL OF MOTIVATION and MAY BE MORE EFFECTIVE in THESE CASES. This poses a PROBLEM FOR CBT, as CBT CANNOT BE USED AS THE SOLE TREATMENT for SEVERELY DEPRESSED PATIENTS
- IGNORES OTHER FACTORS (EVALUATION OF COGNITIVE BEHAVIOURAL THERAPY)
- CBT ATTEMPTS to address the CAUSE OF DEPRESSION as it assumes that the ROOT CAUSE of depression is IRRATIONAL THOUGHT PROCESSES
However, psychologists have CRITICISED CBT, as it SUGGESTS that a persons IRRATIONAL THOUGHT THINKING is the PRIMARY CAUSE OF THEIR DEPRESSION and therefore IGNORES OTHER FACTORS or CIRCUMSTANCES that MIGHT CONTRIBUTE to a persons depression
E.g a patient who is SUFFERING FROM DOMESTIC VIOLENCE DOES NOT NEED TO CHANGE IRRATIONAL THOUGHTS, but in fact needs to CHANGE THEIR CIRCUMSTANCES. Therefore CBT WOULD BE INEFFECTIVE IN TREATING THESE PATIENTS until their CIRCUMSTANCES HAVE CHANGED
