The cognitive approach to explaining and treating depression

Question 1

What 2 reasons do the cognitive give for explaining depression?

Answer 1

Beck’s negative triad

Ellis’ ABC model

Question 2

What did Beck say?

Answer 2

In particular, it is a person’s cognitions that create vulnerability to depression (i.e. the way they think). Beck suggested 3 parts to this cognitive vulnerability.

Question 3

Name the 3 parts of Beck’s negative triad

Answer 3

1. Faulty information processing
2. Negative self-schemas
3. Negative triad

Question 4

What is faulty information processing?

Answer 4

Depressed people make fundamental errors in logic. This is when depressed people attend to the negative aspects of a situation and ignore positives. They blow small problems out of proportion, thinking in terms of black and white and ignoring the middle ground.

Question 5

What are negative self-schemas?

Answer 5

A self-schema is a package of ideas that we have about ourselves. Depressed people have developed negative self-schemas and therefore they interpret all the information about themselves in a negative way.

Question 6

Explain the negative triad

Answer 6

Depressives have a:
-negative view of the self e.g. i am a failure

• negative view of the world e.g. the world is a hard place (this creates the impression there is no hope anywhere)
• negative view of the future e.g. this will always be the case (such thoughts reduce any hopefulness and enhance depression)

Question 7

What did Ellis say?

Answer 7

He proposed that good mental health is the result of rational thinking, defined as thinking in ways that allow people to be happy and free from pain. Conditions like anxiety and depression (poor mental health) result from irrational thoughts.

Question 8

What did Ellis define irrational thoughts as?

Answer 8

Any thoughts that interfere with us being happy and free from pain.

Question 9

What does the ABC model explain?

Answer 9

How irrational thoughts affect our behaviour and emotional state.

Question 10

What does the A stand for in Ellis’ ABC model and what does it mean?

Answer 10

Activating event
Ellis focused on situations in which irrational beliefs are triggered by external situations. Ellis says we get depressed when we experience negative events e.g. failing a test or breaking up with someone and these trigger irrational beliefs.

Question 11

What does the B stand for in Ellis’ ABC model?

Answer 11

Beliefs

Irrational beliefs : musterbation (we must always succeed) and utopianism (the belief life is always meant to be fair)

Question 12

What does the C stand for in Ellis’ ABC model?

Answer 12

Consequences
When an activating event triggers irrational beliefs there are emotional and behavioural consequences. For example, if a person believes they must always succeed and then fails at something this can trigger depression.

Question 13

Give 2 examples of irrational beliefs

Answer 13

Musterbation

Utopianism

Question 14

What is musterbation?

Answer 14

We must always succeed

The belief that it is a major disaster whenever something does not go smoothly.

Question 15

What is utopianism?

Answer 15

The belief that life is always meant to be fair.

Question 16

Give a short summary of Ellis’ ABC model

Answer 16

If events are negative then the beliefs may be irrational and then the consequence can be depression.

Question 17

How does the cognitive approach treat depression?

Answer 17

Cognitive Behaviour Therapy including challenging irrational beliefs.

Question 18

What is CBT?

Answer 18

A method for treating mental disorders based on both cognitive and behavioural techniques. Aims to deal with thinking, such as challenging negative thoughts. It looks to improve the state of the mind now.
Patient meets with a therapist for between 5 and 20 weekly/fortnightly sessions lasting between 30 and 60 minutes.

Question 19

What are the 2 different types of CBT that the cognitive approach looks at to treat depression?

Answer 19

1. Beck’s Cognitive Therapy

2. Ellis’ Rational Emotive Behaviour Therapy

Question 20

What does Beck’s cognitive therapy do?

Answer 20

Challenges the negative triad (beliefs of the client)

Question 21

Describe what happens in Beck’s cognitive therapy

Answer 21

• First, the client will be assessed to discover the severity of their condition and therapist will establish a baseline (starting point), prior to treatment to help monitor improvement.
• The client is asked provide information about how they perceive themselves, the future and the world.
• Therapists use a process of reality testing e.g. if the client says “I’m useless and will always fail” they will be asked whether in reality they have been successful at something.
• May be given homework “Patient as scientist” where they gather evidence e.g. record when people have been nice to them as this can then be used as evidence against negative thoughts.
• Try to replace negative thinking with positive e.g. challenge them.

Question 22

What does Ellis’ REBT do?

Answer 22

Extends the ABC model to the ABCDE model.

Irrational beliefs challenged in a vigorous argument to break the link between negative life events and depression.

Question 23

What does the D stand for in Ellis’ ABCDE model?

Answer 23

Dispute (challenge the thoughts)

Question 24

What does the E stand for in Ellis’ ABCDE model?

Answer 24

Effect (See a more beneficial effect on thoughts and behaviour)

Question 25

Give an example of a situation where Ellis’ REBT is used

Answer 25

For example a client might want to talk about how unfair things seem - an REBT therapist would identify this as utopianism and challenge this as an irrational belief. This would involve a vigorous argument. The intended effect is to change the irrational belief and so break the link between negative life events and depression.

Question 26

What methods did Ellis identify to break the link between negative life events and depression a.k.a “disputing” ?

Answer 26

Empirical argument

Logical argument

Question 27

What is empirical argument?

Answer 27

Disputing whether there is actual evidence to support the negative belief.

Question 28

What is logical argument?

Answer 28

Disputing whether the negative thought logically follows from the facts.

Question 29

What is the aim of behavioural action?

Answer 29

To work with depressed individuals to gradually decrease their avoidance and isolation, and increase their engagement in activities that have been shown to improve mood e.g. exercising, going out for food. The therapist aims to reinforce such activity.