Psychopathology - 04 The Cognitive Approach To Explaining and Treating Depression Flashcards
What does the cognitive approach focus on in depression?
-the role of cognitive processes
-distorted and irrational thinking
What 3 things make up Beck’s cognitive theory to explaining depression?
1-cognitive bias
2-negative self-schemas
3-the negative triad
What does Beck mean by cognitive bias?
-found that depressed people more likely focus on negatives
-prone to distorting/misinterpreting information (cognitive bias)
What are 2 examples of cognitive bias?
-over-generalisation- make sweeping conclusions based on single incident
-catastrophising- exaggerate a minor setback and believe it is a disaster
What does Beck mean by negative self-schemas?
-schema is package of knowledge developed during childhood
-a person with a negative self-schema is likely to interpret information about themselves in a negative way which could lead to cognitive biases
What does Beck mean by the negative triad?
-cognitive biases and negative self-schemas maintain the negative triad and irrational views of ourselves, our future and the world around us
-for people with depression this occurs automatically
How was Ellis’ model for explaining depression different from Becks’?
Started by explaining what is required for good mental health
What is good mental health defined as?
Rational thinking, ways of thinking that allows someone to be happy and free from pain
What does Ellis’ ABC model say about the explanations of depression?
-it explains how irrational thinking/thoughts can lead to the development of depression
What does the ABC model stand for?
Activating event
Beliefs
Consequences
Weakness of the cognitive approach to explaining depression (blames the client)
-suggests that the client is responsible for their disorder as it is a result of their negative and irrational thinking
-can be a good as motivates client to change thinking as they are in control
-BUT clients may overlook factors in life which have contributed like family problems
Strength of the cognitive approach to explaining depression (CBT)
-forms the basis of treatment (CBT)
-Beck’s negative triad can be identified and challenged in CBT
-Ellis’ theory can be used in CBT by challenging irrational/negative beliefs
-So theories have real world use and can help improve quality of life and society
Weakness of the cognitive approach to explaining depression (too simplistic)
-Depression complex disorder
-some patients are angry Beck cannot easily explain extreme emotion
-some experience hallucinations
-may prevent people from getting help as theories cannot be generalised to everyone with depression
weakness of the cognitive approach to explaining depression (ignores biology)
-low levels of neurotransmitter serotonin and genetic factors linked to cause of depression
-drug therapy successful in treating it suggesting neurotransmitters do play part
-holistic or interactionist approach should be used to combine factors of both
weakness of the cognitive approach to explaining depression (different types of depression)
-some cases of depression follow an activating event like Ellis says (reactive depression)
-some depression arises without an obvious cause
-so it is limited as it doesn’t provide explanation for all kind of depression
What did Beck develop for treating depression?
Cognitive behavioural therapy
What is CBT based on?
Beck’s negative triad
What is the aim of CBT?
-help client identify their negative/irrational thoughts and replace them with more positive and rational ways of thinking
What does CBT consist of?
about 20 sessions over about 16 weeks with homework between sessions
How many stages of CBT are there?
4
What is stage 1 of CBT?
-behavioural activation
-identify pleasurable activities and to overcome obstacles in carrying them out
What is stage 2 of CBT?
-recognise the negative thoughts, record them in diary and bring them to weekly sessions
-therapist helps them to test reality of their thoughts and challenge negative thinking
What is stage 3 of CBT?
-therapist helps client to recognise underlying illogical thinking processes that produce negative thinking
What is stage 4 of CBT?
-therapist helps client change maladaptive attitudes, often by asking them to test them out in the real world (homework tasks)
What does Ellis’s rational emotive behavioural therapy (REBT) do to the ABC model?
extends it to make it an BCDE model
What two things did Ellis identify as ways of disputing irrational thoughts?
Empirical argument
Logical argument
What does the D and the E stand for in the ABCDE model?
D-dispute challenges
E-effect is new rational beliefs
What does the empirical argument involve?
disputing whether there is actual evidence to support the negative belief
“where is the evidence that your beliefs are true?”
What does the logical argument involve?
disputing whether negative thoughts logically follow from the facts
“does the way you think about that situation make any sense?”
What does homework involve in REBT?
the patient identifies their own irrational beliefs and then disputes them
Effectiveness of CBT
-March et al found CBT was equally as effective as antidepressants
-After 36 weeks 81% of both CBT and antidepressant group had improved
-BUT 86% of CBT and antidepressant group had improved suggesting combination is most effective
Suitability of CBT
-individual differences, some people positive, others refuse to engage
-Also fails to acknowledge may be due to biological factors, so CBT will not work for some people due to the role of biology
Conflicting evidence of CBT
-has high relapse rate so there are concerns as to how long the benefits of CBT last
-March et al also found 19% not helped by CBT
Alternative treatments of CBT
-antidepressant drugs
-despite being equally as effective as CBT it is easier, quicker, cheaper and more discrete
Practical issues of CBT
TIME- 16 weeks so very distressed or suicidal patient get more help in short term from drug therapy
COST- free on NHS but is waiting list, private cost £40-100 per session
Ethical issues of CBT
-Can be therapist centred, can give therapist power and client can become too dependant on the therapist
-Can be seen as blaming client as it focuses on their irrational thoughts
