Lesson 10: The Cognitive Behavioural Therapy- Treating Depression

Question 1

Becks central idea

Answer 1

To challenge and restructure negative ways of thinking so that they become more positive and rational

Question 2

Cognitive behavioural therapy AO1

Answer 2

CBT can be used on individuals or in small groups with a highly trained therapist and has a focus on positive thinking. It is thought that positive thinking will have a positive impact on behaviour and the negative thoughts associated with depression are challenged.
- patients encouraged to identify their negative thoughts- “thought catching”
- patient encouraged to challenge negative thoughts e.g. “is it really the case that I’m bad at this? this cannot be true because…”
- patient tests out their negative thoughts logically and act as a scientist
- patients encouraged to keep a record of events that challenge their negative thinking e.g. test results or diary entries as proof of existence of positive events
- reinforcement is encouraged

Question 3

Positives of cognitive behavioural therapy (CBT)

Answer 3

• Has been praised because it tends to get to the root of the depressive problem. Can usually uncover the real underlying issues that caused depression in the first place such as job loss etc. This is a very good point because other treatments such as drugs and medication tend not to do that, but merely act as a “plaster” that mask the problem. Therefore, CBT actually works as a cure for depression.
• Can be used as a long term cure. Once patient has undergone CBT, it has lasting positive outcomes and they’re less likely to relapse compared to other treatments. Therefore, may be cost effective to the NHS as patients unlikely to return to hospital for further treatment.

Question 4

Negatives of cognitive behavioural therapy Beck

Answer 4

The most popular treatment is anti-depressant drugs. Drugs require less effort than CBT in general. However, Cujipers (2013) found that CBT can be very effective if it is combined with drug therapy. Therefore maybe CBT used on its own to treat depression is not very effective, and should be supplemented by drugs.

Question 5

Rational Emotive Behavioural Therapy by Ellis

Answer 5

REBT developed by Ellis (1975). Irrational thoughts also cause negative self-statements so the therapy involves making depressed clients think in a more rational and positive manner. Therapists aims to challenge patients using logical arguments, making them realise how irrational their thoughts are. REBT involves challenging negative thoughts by reinterpreting the ABC model in a more positive and logical way.

Therapist also uses empirical arguments to show patients that their self defeating beliefs are not consistent with reality.

Homework- depressed clients 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 positive and rational beliefs.

Behavioural action- CBT encourages patients to engage in pleasurable activities.

Question 6

Positives of Ellis: REBT approach

Answer 6

Flannaghan et al (1997) supports it as an effective treatment for depressive stroke victims, indicating it is suitable for specific groups of people with depression and can help them become more positive over time in terms of their thoughts and behaviour.

David (2008)- research evidence to support CBT as a therapy for depression- compared 170 depressive patients who had 14 weeks of CBT and compared them to depressive patients treated with the drug fluoxetine. Six months later it was found that patients treated with CBT were less likely to have relapsed.

Question 7

Negatives of Ellis: REBT approach

Answer 7

It is unclear if the distorted negative thinking is the cause of depression of merely a symptom; if it is only a symptom then REBT is not tackling the root cause of the depression and the depression may return. This means the depression has not been cured properly.

It is dependent on the depressed clients being able to articulate their thought processes coherently. Therefore it would not work for those with severe depression if they were unable to talk or communicate properly, or those uncomfortable talking about feelings with a psychologist. Other treatments could be more effective in this case.