Lesson 10 - Depression: Cognitive Behavioural Therapy (treating depression - Beck & Ellis) Flashcards
Ao1: cognitive behavioural therapy by Beck
• central idea of Beck’s is to challenge and restructure negative ways of thinking so that they become more positive and rational
• CBT can be used on individual patients and in small groups
• allows patient to have some control over their thinking
• focuses on present experiences
• therapist needs to be highly trained
• can help depressed patient to think in a more positive way, which can positively influence their behaviour.
• thought that positive thinking will have a positive impact on behaviour (both of these are linked together)
• negative thoughts associated with the depression are challenged.
• Beck would use the cognitive triad as the basis for his cognitive behavioural therapy (negative thoughts about self, world and future would be addressed).
• Patients encouraged to identify their negative thoughts “thought catching”
• patient would be encouraged to challenge their negative thoughts and test them out
• patient must test out their negative thinking & act as a scientist
• Patients encouraged to keep record of events in their life that can be used to challenge negative thinking to try to prove the existence of positive events
Ao3: strength & weaknesscognitive behavioural therapy by Beck
(Very effective to use when client has mild depression)
- CBT stops the mild depression from getting much worse
- thus, CBT is more applicable to clients who had mild depressive symptoms rather than severe symptoms
- if depression is very severe then drugs/medication might be more appropriate than CBT
Ao3: strength cognitive behavioural therapy by Beck
(Widely respected & supported by vast amounts of research as a therapy for depression)
- offered as a cost effective treatment for many disorders by the NHS in Britain, especially for depression
- treatment is quite economical compared to other treatments such as the psychodynamic approach
Ao3: strength cognitive behavioural therapy by Beck
(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)
- thus, 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)
Ao3: strength cognitive behavioural therapy by Beck
(Praised: tends to get to root cause of depressive problem)
- CBT can uncover the real underlying issues that caused the depression in the first place such as job loss or divorce etc
- 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
- thus, CBT actually works as a cure for depression
Ao3: weakness cognitive behavioural therapy by Beck
(Most popular treatment for depression is anti-depressant drugs)
- Drugs require less effort than CBT in general.
- Cujipers (2013) found that CBT can be very effective if is combined with drug therapy
- thus, maybe CBT used on its own to treat depression is not very effective, and drugs should be used alongside it
Ao1: rational emotive behavioural therapy by Ellis
• Irrational thoughts also cause negative self-statements and so the therapy involves making depressed clients think in a more rational and positive manner
• therapist aims to challenge depressed patients’ thinking and show them how irrational their thoughts are
• Depressed patients are told to practise positive and optimistic thinking, which can then have a positive impact on their behaviour.
• REBT involves challenging negative thoughts by reinterpreting the ABC model in a more positive and logical way
• Homework - Depressed clients are asked to complete homework assignments between therapy sessions which is vital for testing irrational beliefs out in the real world, and replacing them with more rational and positive beliefs.
• Behavioural Activation - CBT encourages depressed clients to become more active and engage in pleasurable activities. Many depressed clients often do not engage in activities that they used to enjoy, so the therapist would encourage active participation.
Ao1: REBT by Ellis
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 depressed client, “Does thinking in this way make sense?”
Thoughts can also be disputed by empirical disputing, whereby self defeating beliefs may not be consistent with reality e.g. “You believe that everyone hates you, but there is little proof of this.”
2) Effects of disputing and effective attitude to life:
Effective disputing can change self defeating beliefs into more rational beliefs. The depressed client can move away from negative and irrational thinking, e.g. “No one likes me” to more rational interpretations of events, e.g. “My friend has not replied to my text message because she is busy, not because she hates me.”
3) Feelings/emotions:
The depressed patient will begin to think in a more positive and rational way and they will begin to feel better. This can have a positive impact on their behaviour
Ao3: strength of REBT by Ellis
(Flannaghan supports use of REBT)
- effective way to treat depressive stroke victims
- thus, suggests that REBT is a suitable treatment for specific groups of people with depression and can help them become more positive over time in terms of their thoughts and behaviour
Ao3: strength of REBT by Ellis
(Research evidence to support use of CBT - David)
- compared 170 depressive patients who had 14 weeks of REBT and compared them to depressive patients who were treated with the drug fluoxetine
- 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
Ao3: weakness of REBT by Ellis
(Unclear if distorted negative thinking is cause or merely 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
Ao3: weakness of REBT by Ellis
(Dependent on depressed clients being articulate)
- being able to talk about their thought processes coherently
- thus, 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
Ao3: weakness of REBT by Ellis
(Success of treatment depends upon skill & expertise of therapist)
- more skilled the therapist, the better the therapeutic outcomes will be for the depressed client, and this is essential for the treatments effectiveness
- thus, psychologists need to be highly skilled and develop a good rapport with their client in order for REBT to be successful
