The cognitive approach to treating depression

Question 1

What is CBT?

Answer 1

most commonly used psychological treatment for depression. a method for treating mental disorders based on cognitive and behavioural techniques.
Cognitive element - identify irrational thoughts
Behaviour element - change irrational thoughts and put more effective behaviours into place

Question 2

What is the cognitive element of CBT?

Answer 2

Assessment where the client and CBT therapist work together to clarify clients problem. Identify goals for therapy and put together a plan to achieve them. Identify negative or irrational thoughts is central.

Question 3

What is the behavioural element of CBT?

Answer 3

Working to change negative and irrational thoughts, put more effective behaviours into play.

Question 4

What is Becks Cognitive Therapy?

Answer 4

idea behind cognitive therapy is to identify automatic thoughts about self, world and future - this is the negative triad. These thoughts must be challenged once identified. Cognitive therapy helps test the reality of negative thoughts, set homework to record when they enjoyed an event or when people were nice to them. This is used as evidence to prove clients statements incorrect.

Question 5

What is Ellis’s REBT?

Answer 5

Rational Emotive Behaviour Therapy (REBT).
Extends ABC model to include D and E, (dispute and effect). The central technique of REBT is to challenge irrational thoughts. A client may talk about how unfair things seem and a therapist would identify these as utopianism and challenge as an irrational belief. The intended effect of this is to change the irrational belief to break the link between negative life effects and depression. Ellis identified different methods of disputing; empirical argument and logical argument.
empirical - is there evidence to support the negative belief?
logical - does the negative thought logically follow from the facts?

Question 6

What is behavioural activation?

Answer 6

As individuals become depressed they avoid difficult situations which maintains or worsens their symptoms. Goal of behavioural activation is to gradually decrease avoidance and isolation and increase their engagement in activities to improve mood. the therapist aims to reinforce such activity

Question 7

evaluation of cognitive approach (brief)

Answer 7

strength - evidence supporting effectiveness, March et al
weakness - lack of effectiveness for severe cases HOWEVER evidence contradicts this (Taylor et al + Lewis and Lewis)
weakness - high relapse rates

Question 8

strength of CBT for treating depression

Answer 8

one strength of CBT is that there is large amounts of evidence supporting its effectiveness for treating depression. March et al compared CBT to antidepressant drugs and also to a combination of both treatments when treating 327 depressed adolescents. It was found that CBT was just as effective when used on its own and more so when used alongside antidepressants. CBT is usually a fairly brief therapy requiring 6-12 sessions so it is also a cost-effective method. Therefore, CBT is widely seen as the first choice of treatment in public health care systems.

Question 9

limitations of CBT for treating depression

Answer 9

one weakness of CBT for depression is the lack of effectiveness for severe cases and clients with learning disabilities. Depression can be so severe that clients cannot motivate themselves to engage with the cognitive work of CBT and may not be able to pay attention during a session. it also seems likely that the complex rational thinking involved in CBT makes it unsuitable for those with learning disabilities. Sturmey suggests that any form of psychotherapy is not suitable for people with learning disabilities. This suggests that CBT may only be appropriate for a specific range of people with depression. However, there is more recent evidence to challenge these beliefs. A review by Taylor et al concluded that when used appropriately CBT is effective for people with learning disabilities. This means that CBT may be suitable for a wider range of people than was once thought.

A further weakness is that CBT has high relapse rates. There are some concerns over how long the benefits of CBT last. Some recent studies suggest that long-term outcomes of CBT are not as good as had been assumed. Ali et al assessed depression in 439 clients every month for 12 months following a course of CBT. 53% of clients had relapsed into depression within a year. therefore, this means that CBT may need to repeated periodically