The Cognitive Approach to Treating Depression Flashcards
What is CBT?
The most commonly used treatment for depression. The cognitive element comes from an assessment in which the client and therapist work together to clarify the issues. They jointly identify goals and put together a plan to achieve them. The behavioural element is how CBT then involves working to change negative and irrational thoughts and put more effective behaviours into place.
What is Beck’s CBT?
Identify automatic thoughts about the world, self and future. Once identified these must be challenged. As well as challenging these beliefs, it aims to help clients test their own beliefs. They set homework for the client to record when they enjoyed an event, so in future these can be used to disprove irrational beliefs.
What is Ellis’ REBT?
REBT extends the ABC model, with Dispute and Effect. A client may talk about how unfair life is, which the therapist will argue is an example of utopianism. This would break into a vigorous argument where the intent is to break the link between negative lift events and depression.
Logical argument involves disputing whether negative thought logically follows the facts and empirical argument is whether the beliefs follow real facts.
What is the strength - evidence for effectiveness?
There is a large body of evidence supporting it. March compared CBT to antidepressants and also to a combination of both when treating adolescents. After 36 weeks, 81% of the CBT group, 81% of the antidepressants group and 86% of the joint group were improved. CBT is widely seen as the first choice of treatment in the NHS.
What is the limitation - suitability for diverse clients?
It is ineffective for severe cases or those with learning disabilities. In some cases depression can be so severe the clients cannot engage with CBT, and the complex cognitive thought involved in CBT makes it unlikely that it is suitable for treating those with learning disabilities.
What is the strength - Lewis and Lewis?
They concluded CBT was as effective as antidepressant drugs and behavioural therapies for severe depression. Another review concluded that CBT is effective for those with learning disabilities if applied correctly.
What is the limitation - relapse rates?
Although CBT is effective in tackling the symptoms of depression, there are concerns over how long the benefits last. Ali assessed depression in 439 clients over a year after they stopped CBT. 42% relapsed into depression within 6 months and 53% after a year.
