Psychological therapies for depression

Question 1

When was CBT first developed?

Answer 1

Beck 1967

Question 2

Whats the aim of CBT?

Answer 2

identify and alter maladaptive cognitions and therefore change dysfunctional behaviour

Question 3

What does CBT focus on?

Answer 3

current problems

Question 4

How long does CBT last for?

Answer 4

16-20 sessions

Question 5

Whats thought-catching?

Answer 5

Individuals are taught the link between their behaviour and their thoughts. As homework they may be asked to record emotion-arousing events, record their initial negative thoughts on it, and then a realistic thought which could challenge this, for example ‘where is the evidence for this?’ ‘why does it matter?’. By challenging the dysfunctional thoughts and replacing them with more constructive ones, clients are trying out new ways of behaving.

Question 6

Whats behavioural activation?

Answer 6

One characteristic of depression is that they no longer participate in activities they previously found pleasurable. In CBT the therapist and client identify potentially pleasurable activities and anticipate and deal with possible cognitive obstacles.

Question 7

Effectiveness of CBT: research support

Answer 7

a meta-analysis by Robinson et al (1990) found that CBT was superior to non-treatment control groups, however wasn’t significantly more effective than a placebo group.

Question 8

Effectiveness of CBT: depression and exercise

Answer 8

Babyak et al (2000) studied 156 adult volunteers diagnosed with major depressive disorder. They were randomly assigned to a four-month course of aerobic exercise, drug treatment, or a combination of the 2. All 3 groups experienced significant improvement. However 6 months later the exercise group had significantly lower relapse rates, particularly those who had continued to exercise on their own.

Question 9

Effectiveness of CBT: importance of homework

Answer 9

Brayant et al (1999) suggests that client’s engagement with homework predicts the outcome.

Question 10

Appropriateness of CBT: who its suitable for

Answer 10

March et al found that in a group of 327 adolescents aged 12-17 that CBT combined with drug therapy had a significantly better outcome than drug therapy along. CBT also significantly reduced suicidal thoughts.
CBT can also be conducted over the phone which helps reduce attrition rates and makes it more accessible.

Question 11

Appropriateness of CBT: who it isnt suitable for

Answer 11

unsuitable for people resistant to change, or when stress reflects real stressors in a person’s life which therapy cannot resolve?

Question 12

When was PIT first developed?

Answer 12

Robert Hobson 1985

Question 13

What does PIT talk about?

Answer 13

past and present events

Question 14

Whats the importance of the relationship?

Answer 14

Hobson believed symptoms of depression can arise from disturbances in interpersonal relationships and these can only be explored within another relationship.
the quality of the relationship is crucial

Question 15

Effectiveness of PIT: research support

Answer 15

Paley et al (2008) showed CBT to be at least equal to PIT. However, they didn’t consider life changes and therefore the outcomes might not be just due to the therapy. (62 ps over a 52 month period)

Question 16

Effectiveness of PIT: Collaborative psychotherapy project (CPP)

Answer 16

Barkham et al (1996) found that PIT and CBT were equally effective in reducing the severity of depression (measured with BDI). But after 12 months both groups experienced relapse.

Question 17

Effectiveness of PIT: attrition

Answer 17

Hunt and Andrews (2007) examined 5 meta-analysis and found that an average of 8% of ps drop out of studies because it isn’t helping. Therefore the results are only based on ps who feel it is helping; making them artificially high.

Question 18

Appropriateness of PIT: importance of relationships

Answer 18

Guthrie (1999) suggested pit is particularly important as it focuses on interpersonal relationships which other cognitive therapies ignore. As a result the quality of the relationships has shown to determine the outcome of the therapy.

Question 19

Appropriateness of PIT: brief interventions

Answer 19

NHS psychotherapy patients were randomly assigned to receive 12 weeks PIT or remain waiting list controls. 54 entered, 33 completed the study. Significant improvement was shown; even brief therapy with a trainee therapist can have significant effects.