The cognitive approach to treating depression

Question 1

describe cognitive behavioural therapy

Answer 1

the most commonly used psychological treatment for depression
cognitive elements include an assessment of the client’s problems and a plan to achieve goals
a central task is to identify where there might be irrational thoughts that might benefit from challenge
behaviour elements include working to change negative and irrational thoughts with more effective behaviours

Question 2

describe beck’s cognitive therapy

Answer 2

identifies automatic thoughts about the world, self and future - negative triad
these thoughts must be challenged
aims to help clients challenge the reality of their negative beliefs
‘client as scientist’
therapist can use evidence from client that their negative thoughts and statements are incorrect

Question 3

describe ellis’ rational emotive behaviour therapy

Answer 3

extends the ABC model to an ABCDE model
D is dispute and E for effect
central technique of REBT is to identify and challenge irrational thoughts
involves vigorous argument
the intended effect is to break the link between negative life events and depression
empirical and logical arguments are methods of disputing

Question 4

describe behavioural activation

Answer 4

the aim is 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
the therapist aims to reinforce such activity

Question 5

what is the evidence for the effectiveness of CBT (STRENGTH)

Answer 5

march et al 2007 compared CBT to antidepressant drugs when treating 327 depressed adolescents
after 36 weeks, 81% of the CBT group symptoms significantly improved
CBT is also cost-effective as it requires a fairly brief amount of sessions
therefore, CBT is widely the first choice of treatment in health care systems

Question 6

why isn’t CBT suitable for diverse clients (LIMITATION)

Answer 6

in some cases depression can be so severe that clients cannot motivate themselves to engage with the cognitive work of CBT, they may not even pay attention in the session
the complex rational thought in CBT also means it is unlikely to suit clients with learning disabilities
therefore, CBT may only be appropriate for a specific range of people with depression

Question 7

what evidence challenges the diversity concerns (COUNTERPOINT)

Answer 7

a review by lewis and lewis (2016) concluded that CBT was as effective as antidepressant drugs and behavioural therapies for severe depression
when used appropriately, CBT is effective for people with learning disabilities
therefore, CBT may be suitable for a wider range of people than once thought

Question 8

how does CBT for the treatment of depression have high relapse rates (LIMITATION)

Answer 8

CBT is effective in tackling the symptoms of depression, but these benefits may not be long-term
relatively few early studies of CBT looked at long-term effectiveness
ali et al. (2017) found 42% of clients relapsed into depression within 6 months of CBT
therefore, CBT may need to be repeated periodically