L10 The Cognitive Behavioural Therapy - Treating Depression ( Beck And Ellis) Flashcards
What is the central idea of cognitive behaviour therapy ?
- challenge and restructure negative ways of thinking so that they can become more positive and rational in order to alleviate depression
What is the first step in CBT ?
- 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.
What other strategies are use in CBT ?
Several strategies are used in CBT to test 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. 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 could be asked to keep a diary to record events and identify situations
in which negative thinking occurs so these can be targeted.
When patients report positive thoughts they are praised by the therapist,
which provides positive reinforcement.
What is REBT ?
- Ellis developed a CBT therapy for depression called rational emotive behavioural therapy
- aims at challenging automatic negative thoughts and replacing them with rational beliefs
What arguments do the therapist use in REBT ?
- 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 does not say hello to you does not mean they hate you, it could be
that they just didn’t see you). - The therapist also uses empirical arguments to show patients that their selfdefeating beliefs are not consistent with reality (e.g. it does not make sense to
believe everyone hates you when they keep inviting you out for dinner).
What are behavioural activities
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
Evaluation of CBT (very effective for mild depression)
1) A strength of CBT is that it is very effective to use when a client has mild depression, as CBT stops the mild depression from getting much worse. Therefore CBT is more applicable to clients who had mild depressive symptoms rather than severe symptoms. If the depression is very severe then drugs/medication might be more appropriate than CBT
Evaluation of CBT ( drugs)
2) The most popular treatment for depression is anti-depressant drugs. Drugs require less effort than CBT in general. However, Cujipers (2013) found that CBT can be very effective if 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.
Evaluation for CT (supported by research)
3) An advantage of CBT is that it is widely respected and supported by vast amounts of research as a therapy for depression. It is offered as a cost effective treatment for many disorders by the NHS in Britain, especially for depression. The treatment is quite economical compared to other treatments such as the psychodynamic approach
Evaluation for CBT (get to the root cause)
4) CBT has been praised because it tends to get to the root cause of the depressive problem. Usually CBT can uncover the real underlying issues that caused the depression in the first place such as job loss or divorce etc. This is a very good point because other treatments for depression such as medication and drugs tend not to get to the root cause of the problem of depression, but merely act as a, “plaster” that cover up and mask the symptoms of depression. Therefore CBT actually works as a cure for depression
Evaluation for CBT (long term cure)
5) An advantage of CBT is that it can be used as a long term cure for depression. Once a patient has undergone CBT, it has lasting positive outcomes and there is a high chance that the patient has actually been cured and they are less likely to suffer a relapse compared to other treatments (such as medication or placebos). Therefore CBT might be cost effective for the NHS. When a depressed patient has successfully completed CBT treatment they are very unlikely to return to hospital needing further treatment in the future (relapse rates are low)
What is DEF in REBT ?
- Disputing irrational thoughts and behaviours
- Effects on disputing and effective attitudes to life
- Feelings/emotions
Evaluation of REBT (research evidence)
2) There is research evidence to support the use of CBT as a therapy for depression. David (2008) compared 170 depressive patients who had 14 weeks of REBT and compared them to depressive patients who were treated with 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 for depression compared to the drug therapy
Evaluation for REBT ( cause or symptom)
3) A disadvantage of REBT is that it is unclear if the distorted negative thinking is the cause of depression or merely a symptom; if it is only a symptom of depression then REBT is not tackling the root cause of the depression, and the depression might return in the future. This means that the depression has not been cured properly
Evaluation of REBT ( dependent on clients abilities)
4) A problem with REBT is that it is dependent on the depressed clients being articulate and being able to talk about their thought processes coherently. Therefore REBT would not work for people 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 have to be considered such as drug therapy
