Psychopathology - Treating Depression

Question 1

AO1

Answer 1

• Patient is diagnosed with Depression, offered CBT as treatment
• An assessment of cognition and mental processing occurs as a foundation for all of the CBT sessions
• Goals of CBT sessions are planned early on and small goals are set encourage a sense of personal effectiveness and achievements. This often occurs after the initial assessment
• Therapists help clients identify negative thoughts that need to be challenged within their sessions
• Therapist challenges dysfunctional cognition by drawing to positive incidents that discredit these (however small)
• Reality Testing can be implemented by setting homework between sessions
• Behavioural activation can also be assigned to encourage positive behaviour and minimise isolation
• Homework is discussed and this helps show negative thoughts are irrational and unrealistic
• Goals are achieved and progress of challenging irrational thoughts increases
• ABCDE, Cognitive Therapy
• Behavioural Activation
• Homework
• Challenging Irrational Thoughts
• CBT – Cognitive Behaviour Therapy – a method for treating mental disorders based on both cognitive and behavioural techniques. From the cognitive viewpoint, the therapy aims to deal with thinking, such as challenging negative thoughts. The therapy also includes behavioural techniques such as behavioural activation.
• Irrational thoughts - also called dysfunctional thoughts. 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 disorders such as depression
• Depression – a mental disorder categorised by low mood and low energy levels
• Behavioural – ways in which people act
• Emotional – related to a persons feeling or mood
• Cognitive – refers to the process of ‘knowing’ including thinking, reasoning, remembering, believing

Question 2

AO3

Answer 2

• A strength for treating depression with CBT is the evidence for effectiveness.
• For example, John March et al compared CBT to antidepressant drugs and also a combination of both treatments when treating 327 depressed adolescents, after 36 weeks, 81% of the CBT group, 81% of the antidepressant group and 86% of the CBT plus antidepressants groups were significantly improved.
• This is a strength because it shows that CBT is just as effective when used on its own and more so when used alongside antidepressants.
• However, it can be argued that not all clients want to tackle their depression this way as some people just want their symptoms gone as quickly and easily as possible and prefer medication, Yrondi et al found that depressed people rated CBT as their least preferred psychological therapy.
• Despite this, due to its effectiveness, CBT is seen as a first choice of treatment in public health care systems such as the National Health Service
• Thus increasing the validity of CBT for treating depression
• A weakness of CBT for the treatment of depression is its high relapse rates
• For example, Shehzad Ali et al assessed depression in 439 clients every month for 12 months following a course of CBT, 42% of clients relapsed into depression within six months and 53% relapsed within a year
• This is a weakness because it shows that CBT does not have good long-term outcomes or long-lasting benefits which means that it is not as useful of a treatment over a long period of time for depression
• However, it can be argued that there is a lots of evidence to show that when used with appropriate clients, it is highly effective, at least in short term, in tackling symptoms of depression showing that it does have an effect on its clients.
• Despite this, CBT may need to be repeated periodically due to high relapse rates, which means it is less cost effective reducing its usefulness as a treatment for depression
• Thus reducing the validity of CBT for treating depression
• Another weakness for CBT as a treatment for tackling depression is the lack of effectiveness for severe cases for clients with learning disabilities.
• For example, researchers suggest that, in general, any form of psychotherapy (talking therapy) is not suitable for people with learning disabilities, and this includes CBT. Additionally, it also seems likely that the hard cognition work involved in CBT makes it unsuitable for treating depression in clients with learning disabilities
• This is a weakness because it shows that in some cases depression can be so severe that clients cannot motivate themselves to engage with the cognitive work of CBT or even pay attention to what is happening in a session meaning that CBT does not work for everyone with depression, showing its effects on all clients are limited
• However, it can be argued that CBT is just as effective as antidepressant drugs and behavioural therapies for severe depression and Taylor et al concluded that CBT is effective for people with learning disabilities when used appropriately, showing that CBT may be suitable for a wider range of people.
• Despite this, CBT may only be appropriate for a specific range of people with depression but not all, like people who have severe depression, decreasing its generalised applicability for patients.
• Thus decreasing the validity of CBT as a treatment for depression