The cognitive approach to treating depression

Question 1

What is the main treatment for depression?

Answer 1

Cognitive Behavioural Therapy (CBT)- the broad aim is to change negative/irrational thinking to positive thinking. The negative/irrational thinking is challenged and strategies put in place to change this. However, there are elements of the therapy that also tackles behaviour to make this more effective in achieving goals.

Question 2

What is Beck’s CBT?

Answer 2

Based on his theory of the negative triad. The therapy works by identifying these negative thoughts about the self, world and future and challenging these. This is when the client tests the reality of these negative beliefs.

Question 3

What are the 4 stages of Beck’s CBT?

Answer 3

1.Thought catching- where the negative beliefs are identified
2. Patient as scientist- the patient generates hypotheses to test the validity of their negative thoughts
3. Homework tasks- the patient tests their hypotheses and records their findings
4. Cognitive restructuring- the patient has now gathered evidence to dispute their negative hypothesis so can be used as evidence by the therapist in future sessions to dispute these negative thoughts to change them to more positive ones

Question 4

What is Ellis rational emotive behaviour therapy (REBT)?

Answer 4

Ellis noticed that many patients had irrational beliefs characterised by the words ‘must’ and ‘should’. The client is helped to both recognise and challenge these irrational beliefs by extending the ABC model covered previously to add a ‘D’ and ‘E’ stage

Question 5

What is the ‘D’ stage?

Answer 5

D- dispute the beliefs- once the irrational beliefs have been identified, the therapist will challenge these beliefs. This can be done through logical dispute where the therapist questions the logic of a person’s thoughts or empirical dispute can be used where the therapist seeks actual evidence for a person’s thoughts. This dispute will help to change these irrational beliefs to break the ABC cycle

Question 6

What is the ‘E’ cycle?

Answer 6

E-effect- this’s where irrational beliefs have now been replaced by effective new beliefs. This is where symptoms of depression should start to be relieved

Question 7

What are the strengths of CBT?

Answer 7

1. Research to support- March et al (2007)- used 327 adolescents diagnosed with depression and allocated them to either antidepressant treatment (drugs), CBT treatment or a combination. After 36 weeks, 81% of the antidepressant group and 81% of the CBT group had significantly improved their symptoms- can be just as effective as drugs- However, CBT plus antidepressants has 86% improvement rate- combination is better than CBT alone
2. More ethical than drug therapy- more empowering for patients- CBT only works if they put in effort- they can feel good about improvements- no side-effects- help raise self-esteem and tackle negative cognitions

Question 8

What are the limitations of CBT?

Answer 8

1. Relies on efforts from patients- loss of energy (behavioural characteristic)may cause low effort in participating- drug treatments don’t require the same motivation-limits effectiveness of CBT in treating depression if they’re not accessing sessions to change negative thinking
2. Relapse rates are quite high- effective short-term treatment- many people experience negative thoughts again several months after treatment- Paykel at al (2005)- after 3 years, the benefits of CBT decayed and relapse rates began to rise- may treat depression but not necessarily cure it if symptoms reoccur following treatment