psychopathology - cognitive approach to treating depression Flashcards
How does CBT work?
CBT works by the therapist and patient identifying the negative, irrational thoughts the patient may have. Strategies are then used to challenge these thoughts, with the therapist disputing the validity of the beliefs. Negative thoughts are therefore rejected and more positive strategies used instead.
Outline Beck’s cognitive therapy
If a therapist is using Beck’s cognitive therapy, they will help the patient to identify negative thoughts in relation to themselves, their world and their future, using Beck’s negative triad.
The patient and therapist will then work together to challenge these irrational thoughts, by discussing evidence for and against them.
The patient will be encouraged to test the validity of their negative thoughts and may be set homework, to challenge and test their negative thoughts.
Outline Ellis’ rational emotive behaviour therapy (REBT)
The idea of the therapy is to make the patient understand that their thoughts are irrational, and substitute these thoughts for more effective cognitions. This is done by extending the ABC model:
A – Activating Event (Fiona fails her driving test)
B – Belief (Fiona thinks this is a disaster and that she is a failure at life as she did not pass)
C – Consequence (Fiona starts to become depressed as she feels that she is worthless and incompetent)
D – Dispute (Fiona’s beliefs would be challenged- see below)
E – Effect (Fiona should think in a more positive way)
Strategies to challenge these beliefs include logical disputing- does it make sense to think in this way? Empirical disputing- what evidence is there that this belief is true?Patients may also be encouraged to take part in more enjoyable day-to-day activities to help them feel more positive.
Evaluate CBT as a treatment for depression - motivation
One issue with CBT is that it requires motivation. Patients with severe depression may not engage with CBT, or even attend the sessions and therefore this treatment will be ineffective in treating these patients. Alternate treatments, for example antidepressants, do not require the same level of motivation and maybe more effective in these cases. This poses a problem for CBT, as CBT cannot be used as the sole treatment for severely depressed patients.
Evaluate CBT as a treatment for depression - in the mind
Critics of CBT argue that saying the client is responsible for their depression is ‘victim blaming’, and suggesting depression is all in the mind and would go away is the client thought differently leads to the clients feeling shame and wider society thinking mental health conditions are less serious than other conditions. This is a weakness of CBT as it may have detrimental effects on how depression is thought of by sufferers and in wider society, decreasing its usefulness.
Evaluate CBT as a treatment for depression - March
One strength of cognitive behaviour therapy comes from research evidence which demonstrates its effectiveness in treating depression.
Research by March et al. (2007) found that CBT was as effective as antidepressants, in treating depression. The researchers examined 327 adolescents with a diagnosis of depression and looked at the effectiveness of CBT, antidepressants and a combination of CBT plus antidepressants. After 36 weeks, 81% of the antidepressant group and 81% of the CBT group had significantly improved, demonstrating the effectiveness of CBT in treating depression. However, 86% of the CBT plus antidepressant group had significantly improved, suggesting that a combination of both treatments may be more effective.
