The Cognitive approach to treating depression

Question 1

What is the main form of therapy in the cognitive approach to treating depression?

Answer 1

CBT cognitive behaviour therapy

Question 2

What happens in CBT?

Answer 2

A therapist identifies the maladaptive thoughts and behavioural elements of the issue and then uses the cognitive model to help patients change the way they think about the world and themselves.

Question 3

What is the aim of CBT?

Answer 3

Aims to tackle the beliefs a person holds (B in Ellis’ ABC model ) so that the consequences and outcomes of the belief can be changed to become more optimistic and positive ( C in Ellis’ ABC model)

Question 4

In REBT, Ellis extended his ABC model to ABCDEF.
What does the DEF stand for?

Answer 4

Disputing
Effect
Feelings

Question 5

Explain the DEF in Ellis’ Extended model.

Answer 5

The patient’s beliefs are disputed (challenged) by providing evidence or reasons to why it is wrong. The disputing can be Empirical, Logical or Pragmatic.
Effects of disputing on the patient’s beliefs are examined and new feelings are encouraged.

Question 6

Define reframing

Answer 6

When the therapist helps the patient rehabilitate their understanding of their beliefs, challenging their negative/ irrational thoughts to turn them into positive and rational ones.

Question 7

What is Logical Disputing?

Answer 7

questioning ‘ Does thinking in this way make sense?’

Question 8

What is Empirical Disputing?

Answer 8

Asking ‘Are these beliefs consistent with reality?’
- ‘Where is the proof that this belief is accurate?’

Question 9

What is Pragmatic Disputing?

Answer 9

Emphasising the lack of usefulness of self-defeating beliefs
– ‘How is this belief likely to help me?’

Question 10

How can a therapist influence reframing?

Answer 10

Setting the patient tasks (homework) to complete each week, aiming to help the patient build up a body of evidence that will challenge their faulty beliefs.

Question 11

What did Ellis conclude (1957) from his evaluation on CBT?

Answer 11

Reported a 90% success rate for REBT.
Found it took on average 27 sessions to complete REBT, suggesting it’s effectivity.

Question 12

What are the two issues with Ellis’ evaluation on CBT? (1957)

Answer 12

In places like England, it’s rare for a patient to receive 27 sessions of therapy due to expense and availability with NHS.
This evaluation could be biased as he conducted it himself with very few other studies finding the same results.

Question 13

What did Whitfield and Williams (2003) evaluate with CBT?

Answer 13

found that it had an extensive number of studies supporting its use as therapy.

Question 14

What did Whitfield and Williams (2003) find out with CBT?
(issue and proposition)

Answer 14

found that NHS was struggling to deliver all of the face-to-face sessions needed.
proposed the idea of self-help courses where the patient would need less of these sessions.

Question 15

What did March et al. (2007) compare CBT with and tested?

Answer 15

Compared it with the use of antidepressants and tested a combination of them both with treating 327 depressed teenagers.

Question 16

What were March et al.’s findings (2007) with their test regarding 327 depressed teenagers?

Answer 16

After 36 weeks, 81% of the CBT group, 81% of the antidepressant group + 86% of the combination group had significantly improved.
The combination group having the largest improvement suggests that depression may have both cognitive and biological causes.

Question 17

From March et al. ‘s findings (2007) what can the National Institute for Health Care Excellence (NICE) do?

Answer 17

They can use the findings to decide which treatment to offer through the NHS.

Question 18

What did Lincoln et al. (1997) find with CBT that supports it?

Answer 18

They found that it helped improve the symptoms of stroke patients who had developed depression. (comorbid disorders)
Suggests it can be used for different types of depression with different causes.

Question 19

What did Sturmey (2005) refute against CBT?

Answer 19

Found that CBT has limitations when used with patients who have learning disabilities as they may struggle to understand the treatment and make effective progress.

Question 20

In contrast to Sturmey (2005) what did Taylor et al. conclude regarding CBT?

Answer 20

Concluded that CBT can be effective for patients with learning difficulties when used in an appropriate way. This means that more research is needed to help refine CBT to make it more effective when working with different groups of patients.

Question 21

What did Shehzad et al. (2017) find out that refutes against CBT?

Answer 21

Found that of 439 clients, 42% had relapsed within 6 months and 53% had relapsed within one year, means that repeated sessions of CBT may be needed, but isn’t common for repeated dosage of antidepressants.

Question 22

What is the alternative treatment to treating depression?

Answer 22

Antidepressants/ SSRIs

Question 23

What does SSRI stand for?

Answer 23

Serial Serotonin Reuptake Inhibition

Question 24

What are SSRIs used for and what has been shown to support their use?

Answer 24

To increase the levels of serotonin in the brain, and have been shown to reduce some of the negative thoughts associated with depression as well as the thoughts going around someone’s head.

Question 25

What are the two common SSRIs?

Answer 25

Fluoxetine
Prozac

Question 26

Why must SSRI’s be monitored with teenagers?

Answer 26

It has been linked to an increased risk of suicidal thoughts/ ideation.

Question 27

Define unresponsive depression

Answer 27

A patient who hasn’t improved despite CBT and SSRIs

Question 28

What are the steps to Electroconvulsive Therapy (ECT) ?

Answer 28

A patient who has untreatable depression is administrated a sedative and muscle relaxant
A small current is passed through the brain
The current causes a seizure that is thought to help some of the networks in the brain which can help with some of symptoms causing depression.