psychological treatment

Question 1

cognitive behavioral therapy CBT

Answer 1

• depression could be caused by maladaptive thoughts that lead to irrational behavior
• it could be treated with a therapy that replaces maladaptive thoughts and adjust behavior to environment
• cognitive restructuring: maladaptive thoughts —> reality congruent thoughts (self monitoring, thought records, questioning assumptions)
• behavioral activation: irrational behavior —> relational and enviornemnt adjusted behavior (behavioral experiments, gradual exposure, pleasant activity scheduling)

Question 2

March et al (2007) randomized control

Answer 2

• to examine short and long term effectiveness of antidepressants, psychotherapy or both
• participants were 439 depressed teenagers which were assigned a group: control, CBT only, fluoxetine only, or a combination. depression levels were measured after 12,18, and 36 weeks
• participants in all three treatment options improved significantly more than participants in the control condition. after 12 weeks CBT was less effective, but after 36 weeks was as effective as fluoxetine. the combination of treatments had the highest improvement
• both therapy and antidepressants (alone or in combination) are effective to treat depression

Question 3

DeRubies te al (2005) experiment

Answer 3

• to examine the effectiveness of antidepressants and CBT
• 240 patients with moderate to severe depression were assigned a condition, 16 weeks of medication, 16 weeks of CBT or 8 weeks of placebo. all patients rated their depression levels
• at 8 weeks medication had a response rate of 50%, CBT of 43%, and they both outperformed the placebo 25%. at 16 weeks response rates were 58% for both medication and CBT, remission rates were 46% for medication and 40% for CBT. results varied across clinical centers
• CBT can be as effective as medication for the treatment of depression, but the exact effectiveness depends on the therapists skill and experience

Question 4

Hollon te al (2005) randomized control

Answer 4

• to determine if cognitive therapy has more enduring effect than antidepressants
• 104 depressed participants were placed in three groups: patients who responded well to CBT were withdrawn for 1 year, patients that responded well to medication and continued, and patients that responded well to medication and received placebo
• patients withdrawn from cognitive treatments were less likely to relapse than patients withdrawn from medication (31% compared to 76%) during the first year, and even less likely to relapse than the group that continued to take medication (47%)
• CBT had an enduring effect that extend beyond the end of the treatment. drugs are good at reducing symptoms but do not that get the cause of the disorder

Question 5

mindfulness based CBT (MCBT)

Answer 5

• depression could be caused by rumination of negative thoughts, feelings, and beliefs about the past and future
• it could be treated by fostering awareness of ones mental and emotional state, and staying present
• experiential focus: present. momentary, without judgement
• narrative focus: linking past, present, and future experiences, establishing associations, positive/negative judgement
• unlike CBt instead of aiming to change maladaptive thoughts, it guides patients to observe them and be present

Question 6

Mason and Hargreaves (2001) interviews

Answer 6

• to investigate the therapeutic benefit of MCBT from the patients subjective perspective
• 7 participants who had undergone MCBT treatment were asked open ended questions, their answered were categorized
• MCBT helped individuals come to terms with heir depression through an attitude of acceptance, and becoming better at being present
• MCBT helped participants come to terms with their depression ny internalizing skills they could use in their everyday life and by changing their attitudes towards depression