Non biological treatment for Unipolar depression - Cognitive Behavioural Therapy Flashcards
what does the ‘cognitive’ element of CBT ?
the therapy corrects faulty cognitions by addressing the negative triad with a range of therapeutic techniques
what does the behaviourist element of CBT ?
the therapy uses learning theory techniques to help the client develop skills to function effectively (e.g. coping with everyday life)
what is the initial step of CBT ?
assessment - therapist and client assess aspects of the clients’s functioning (severity, past treatments, personal coping resources, etc.)
what is used during the assessment (tools and techniques) ?
1) questionnaires and interviews measure depression and co-morbid disorders (e.g. anxiety and substance abuse)
2) client and therapist identify specific issues, list goals and construct a plan
what is a key task in the assessment stage of CBT ?
a key task is to identify the client’s negative thoughts and re-evaluate them to avoid relapse
why is the role of education so important in CBT ?
the client has a active role in the therapy plan, and so needs to clearly understand their symptoms (i.e. learn about the role of their faulty thinking)
how is the client educated ?
1) therapist is a valuable source of information and also provides other resources (e.g. printed or online materials)
2) the therapist suggests and explains techniques to help the client, who can then express their views from a position of knowledge
what is the role of homework ?
whilst the therapy sessions identify and challenge faulty cognitions, the client has to also carry out the plan in real life - the homework tests the reality of negative beliefs
what is an example of homework ?
the client writes down the details of an event they enjoyed or an occasion when someone was nice to them, the next time the client later says ‘everyone hates me’, the therapist can use written evidence to show the client’s negative beliefs are wrong
what was clinical psychologist, Keith Dobson (2008)’s, account of a typical session ?
1) client’s current functioning is assessed (e.g. using Beck’s Depression inventory), changes from the previous session can then be discussed
2) discussion on latest homework (what client learned or why it was not completed)
3) client chooses most important topics to discuss
4) therapist might use the three questions technique to challenge the client’s automatic negative thoughts (ANTs)
what is the three question technique ?
- therapist asks three questions such as: what’s the evidence?, what are the alternatives?, so what?
- this helps the client address cognitive distortions, such as jumping to conclusions
- this technique can explore the possibility that ANTs may not be the only interpretations of an event
what is the supporting evidence for the strength of CBT ?
Elkin et al. (1989) randomly allocated 239 ppts diagnosed with depression to one of four treatment groups
what were the findings of Elkin et al (1989) ?
CBT was as effective in reducing symptoms as interpersonal therapy, anti-depressants or a placebo pill which continued to be effective after 18 months (shea et al. 1992)
what does Elkin et al. (1989) suggest ?
it suggests that CBT is a successful treatment for mild to moderate depression in the short-and longer-term
what is a competing argument to the supporting evidence of CBT ?
both Elkin and Shea showed that CBT is not very successful for severely depressed people - anti-depressants and interpersonal therapy were both much more effective for treating severe depression - after 18 months, 36% of clients relapsed (higher rate than the interpersonal group)
