Pyschopathology L10

Question 1

What is the aim of cognitive behavioural therapy (CBT)

Answer 1

To change/modify negative/irrational thoughts and therefore alleviate the depression

Question 2

Describe Beck’s cognitive behavioural therapy

Answer 2

• The first step is to identify irrational thoughts/negative triad, which is known as thought-catching
• The patient is then encouraged to generate a hypothesis to test the validity of their irrational thoughts, which is known as patient as scientist
• Several strategies are used to test the patient’s hypothesis
• They may be asked to gather data about behaviour & incidents and then compare the evidence with their hypothesis to see if they match
• They may also be asked to complete homework assignments in between therapy sessions to test irrational thoughts out in the real world and then evaluate the evidence
• They could be asked to keep a diary to record events & identify situations in which negative thinking occurs so that they can be targeted
• When patients report positive thoughts, they are praised by the therapist, which provides positive reinforcement
• The aim of this therapy is cognitive restructuring (learning to identify, dispute & change irrational thoughts

Question 3

Describe Ellis’ rational emotive behavioural therapy

Answer 3

• Ellis (1994) developed a cognitive behavioural therapy (CBT) for depression called rational emotive behavioural therapy (REBT)
• It aims to challenge automatic negative thoughts by replacing them with rational beliefs
• The therapist uses logical arguments to show patients that their self-defeating beliefs don’t logically follow from the information available (e.g: just because your friend doesn’t say hello to you doesn’t mean they hate you, it could just be that they didn’t see you)
• The therapist also uses empirical arguments to show patients that their self-defeating beliefs are not consistent with reality (e.g: it doesn’t make sense to believe everyone hates you when they keep inviting you out for dinner)
• Patients undertaking REBT are encouraged to engage in behavioural activation (becoming more active & taking part in pleasurable activities) as many depressed patients often don’t engage in activities they used to enjoy

Question 4

What is a strength of cognitive behavioural therapy (CBT)?

Answer 4

1. It has research support
   - March et al (2007) found that CBT was as effective as antidepressants in treating depression
   - They looked at the effectiveness of CBT, antidepressants, and a combination of the two
   - After 36 weeks, 81% of the antidepressant group and 81% of the CBT group significantly improved
   - 86% of the combination group had significantly improved
   - This suggests that a combination of CBT & antidepressants is the most effective treatment
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   - David (2008) found that CBT is a better treatment for depression in the long-term compared to antidepressants
   - He compared 170 patients with depression who had 14 weeks of CBT with patients who were treated with the drug fluoxetine
   - 6 months later, it was found that patients who had received CBT were less likely to have relapsed

Question 5

What are 3 weaknesses of cognitive behavioural therapy (CBT)?

Answer 5

1. It requires commitment & motivation
   - Patients with severe depression may not engage with CBT, or even attend the sessions, and therefore this treatment will be ineffective
   - Alternative treatments, such as antidepressants, do not require the same level of motivation and may be more effective in these cases
   - Therefore CBT cannot be used as the sole treatment for severely depressed patients
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2. CBT assumes that the root cause of depression is irrational thought processes and therefore ignores other factors or circumstances that might contribute to a person’s depression
   - For example, a patient who is suffering from domestic violence or abuse doesn’t need to change irrational thoughts, but instead needs to change their circumstances
   - Therefore, CBT would be ineffective in treating these patients until their circumstances have changed
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3. CBT relies on patients self-reporting their thoughts as thoughts cannot be objectively observed or measured
   - These self-reports could be unreliable and it is difficult to verify if they are accurate or not