Psychopathology - cognitive approach to treating depression

Question 1

What are irrational thoughts?

Answer 1

In Ellis’s model and therapy, these are defined as thoughts that are likely to interfere with a person’s happiness

Such dysfunctional thoughts lead to mental health disorders such as depression

Question 2

What are the two types of behaviour therapy in treating depression?

Answer 2

Cognitive behaviour therapy (CBT) - Beck
Rational emotive behaviour therapy (REBT) - Ellis

Question 3

Describe and explain CBT
(6 points)

Answer 3

It begins with an assessment in which the client and the cognitive behaviour therapist work together to clarify the client’s problems
Jointly identify goals for the therapy and put together plan to achieve them
(Cognitive Element)

Then involves working to change negative and irrational thoughts and finally put more effective behaviours into place
(Behaviour Element)

Beck:
- the aim to identify negative thoughts about yourself, the world and the future (negative triad)
- these thoughts must be challenged by the client taking an active role in their treatment
- client’s may be set homework e.g to record when they enjoyed an event (client as the scientist)
- future sessions if clients say that no one is nice to them, therapist can produce this evidence to prove their beliefs are incorrect

Question 4

Explain REBT

Answer 4

REBT extends the ABC model to an ABCDE model
- D for dispute (challenge) irrational beliefs
- E for effect

Question 5

Explain behavioural activation in terms of REBT

Answer 5

As individuals become depressed, they tend to increasingly avoid difficult situations and become isolated, maintains or worsens symptoms

The goal of behavioural activation = work with depressed individuals to gradually decrease avoidance and isolation, increase their engagement in activities that have been shown to improve mood e.g exercising

Question 6

What is a strength of the cognitive approach in treating depression?

Answer 6

Evidence of effectiveness

Question 7

Explain why a strength of using the cognitive approach for treating depression is evidence of effectiveness (A03)

Answer 7

Point - One strength of CBT is that there is evidence of effectiveness

Evidence - One study (March) compared the effects of CBT with antidepressant drugs and a combination of the two in 327 depressed adolescents

Explanation - The results showed that after 36 weeks 81% if CBT, 81% antidepressant group and 86% of CBT + antidepressant group were significantly improved

Link - Therefore a strength as there is a good case for making CBR the first choice of treatment in public healthcare systems such as the NHS

Question 8

What are the limitations in using the cognitive approach for treating depression

Answer 8

Suitability for diverse clients

CBT has a high relapse rate

Question 9

Explain why a limitation of using the cognitive approach for treating depression is suitability for diverse clients (A03)

Answer 9

Point - One limitation is suitability for diverse clients

Explanation - Severe cases, depressed clients may not be able to motivate themselves to engage with the cognitive work of CBT. May not even be able to pay attention in a session

Evidence - Sturmey suggests that any form of psychotherapy is not suitable for people with learning difficulties

Link - Therefore a limitation as CBT may only be appropriate for a specific range of clients

Question 10

Explain why a limitation of using the cognitive approach for treating depression is that CBT has a high relapse rate (A03)

Answer 10

Point - One limitation of CBT is its high relapse rates

Explanation - Few early studies looked at long term effectiveness and recent studies suggests that relapse is common

Evidence - For example Ali assessed depression for 12 months following a course of CBT. 42% relapsed within 6 months of ending treatment and 53% within a year

Link - Therefore a limitation because CBT may need to be repeated periodically