The Cognitive Approach to Depression

Question 1

What is Beck’s negative triad?

Answer 1

The idea that people with depression became trapped in a cycle of negative thoughts, depressed people tend to focus on the negative and ignore the positive.

1. Negative view of the self
2. Negative view of the future
3. Negative view of the world

Question 2

Depression stems from negative schemas… what are these? (Beck’s)

Answer 2

A self schema is a package of ideas we have about ourselves, those that are depressed have negative versions of these. Usually this is an ineptness schema or a self blame schema.

Question 3

What is an ineptness schema? (Beck’s)

Answer 3

An expectation of failure

Question 4

What is a self-blame schema? (Beck’s)

Answer 4

A feeling of responsibility for all misfortunes

Question 5

Depression is maintained by cognitive biases… what are these? (Beck’s)

Answer 5

• Arbitrary interference
• Minimisation
• Magnification
• Overgeneralisation

Question 6

What is arbitrary interference? (Beck’s)

Answer 6

Conclusions drawn without sufficient evidence

Question 7

What is minimisation? (Beck’s)

Answer 7

Minimalising any positive life events

Question 8

What is magnification? (Beck’s)

Answer 8

Exaggerating negative elements

Question 9

What is overgeneralisation? (Beck’s)

Answer 9

Sweeping conclusions drawn on the basis of a single event

Question 10

What is Ellis’s ABC model?

Answer 10

Ellis proposed that depression was mainly the result of irrational thoughts about external events. To explain this he proposed a simple concept known as the ABC model. Ellis claimed depression was not really the result of the activating event, but more based on the accompanying beliefs about the events

Question 11

What does the A stand for in the ABC model?

Answer 11

A = The activation event

Question 12

What does the B stand for in the ABC model?

Answer 12

B = Beliefs about A. According to Ellis, these beliefs are the crucial difference between individuals who become depressed and those who do not. These are undesirable emotions and thoughts

Question 13

What does the C stand for in the ABC model?

Answer 13

C = Consequences of undesirable thoughts and emotions which would lead to undesirable behaviour

Question 14

What is polarised thinking (Ellis)?

Answer 14

Seeing everything in black or white

Question 15

What is over-generalisation (Ellis)?

Answer 15

Sweeping generalisations

Question 16

What is catastrophising (Ellis)?

Answer 16

Making a mountain out of a molehill

Question 17

What are the general basic principles surrounding CBT?

Answer 17

• Simultaneously tackling cognition and behaviour
• Weekly or fortnightly sessions (30 mins to an hour) for 6 weeks to 6 months
• Therapy focuses on the present but may ask about the past
• The client and therapist agree about what to discuss at a session
• Problems are broken down into parts to identify thoughts, emotions and actions

Question 18

What is the aim of CBT?

Answer 18

To help rationalise and challenge depressed patients irrational thinking as this can help remove the depressive states patients find themselves in. Simultaneously challenges the thinking and behaviour of depressed patients

Question 19

What are the 4 key features of CBT?

Answer 19

1. Identifying negative thinking patterns in depressed patients
2. Challenging irrational thoughts of depressed patients
3. Skill acquisition and application
4. Follow-up

Question 20

What is identifying negative thinking patterns in depressed patients (CBT)?

Answer 20

Encouraging depressed patients to talk about the specific difficulties and identify any negative automatic thoughts. Beck’s depression inventory consists of 21 questions scored from 0 to 3 giving a total score between 0 and 63. Each question is a different symptom and this gives a good indicator of mood

Question 21

What is challenging irrational thoughts of depressed patients (CBT)?

Answer 21

Challenging negative thoughts and providing alternatives. Sometimes called cognitive reframing as it shows events in a more optimistic fashion

Question 22

What is skill acquisition and application (CBT)?

Answer 22

The therapist introduces intervention techniques including new skills and ways of thinking of things. Relaxation techniques and optimistic self-statements can be used alongside setting homework