Outline and evaluate the cognitive approach to treating depression Flashcards
outline
The Cognitive approach assumes that depression is caused by negative and irrational cognitions.
Therefore, it suggests that it can be treated by challenging the patient to replace their thoughts with positive and rational cognitions.
Ellis introduced REBT, a form of CBT (Cognitive Behavioural Therapy) used to treat patients with depression. REBT sessions are structured and time-limited: 10 to 15 weekly sessions of about 45 minutes, early sessions involve the patient describing their negative self-schemas, negative automatic thoughts and negative cognitive biases.
The therapist then tries to persuade the patient that their irrational thinking is causing their depression using an ‘ABCDEF’ chart.
The therapist aims to challenge their irrational beliefs, replacing them with effective, rational beliefs.
Behavioural techniques are used to help the patient put their rational beliefs into practice. This is reinforced by asking the patient to conduct regular homework.
Ellis recognised that for therapy to be successful the therapist had to show the patient unconditional positive regard, whereby they show continuous respect and appreciation for the client, regardless of what they say or do, to help the patient develop positive beliefs about themselves.
strength
One strength of cognitive treatments for depression is that there is supporting research evidence for CBT.
Cuijpers et al., (2013) performed a meta-analysis of 75 studies, which incorporated over five countries.
They found that CBT was superior the control group (no treatment).
This suggests that CBT is an effective treatment for depression, and due to using a meta-analysis, it can be concluded that the effectiveness of CBT is found cross-culturally.
limit 1
A limitation of cognitive therapies for depression is that some patients want to explore their past.
One of the basic principles of CBT is that the focus of the therapy is on the patient’s present and future, rather than their past.
For example, CBT requires patients to dispute their current irrational beliefs. Other psychotherapies which are equally as effective make links between childhood experiences and current depression.
This suggests CBT over emphasises the patients’ present circumstances and ignores the role of past experiences.
limit 2
A limitation of cognitive therapies is that the success of CBT may be due to the therapist-patient relationship.
Rosenzweig (1936) suggested that the quality of the relationship between the client and therapist determines success, rather than any technique.
This suggests that although CBT attempts to address/treat the cause of depression (irrational beliefs), disputing these beliefs may not be the therapies active ingredient, weakening its credibility.
limit 3
A limitation of the cognitive treatments of depression is that some research suggests all treatments are equally as effective.
March et al., (2007) compared the effect of CBT, antidepressants and a combination of the two in 327 depressed patients.
At a follow-up, they found that for both CBT and antidepressants 81% of patients had shown significant improvement and for the combination group there was an 86% improvement.
This suggests that although CBT is an effective therapy for depression, it is not more effective than other treatments and a combination of treatments might be best.
