Treating Depression - CBT Flashcards
How CBT helps treat depression
- main psychological treatment for depression
- helps identify irrational/maladaptive thought + alter them
How therapists carry out CBT
(1) begins w/ assessment where patient + therapist clarify the problem
(2) Identify goals for the therapy => where negative thoughts would benefit from challenge
(3) involves behaviours put in place to change them
Beck’s Cognitive Therapy
=> aims to identify thoughts about world self and future (negative triad) and challenge them
=> Patients test the reality of these through tasks e.g recalling enjoying an event / hw to see a friend
=> in future sessions where patient says no one is nice to them therapist can provide evidence as a retort
what is REBT
= Rational Emotive Behaviour Therapy
- developed by Ellis’ ABC model which extended to ABCDEF
- ABC = Activating event => Beliefs => Consequences
- DEF (what occurs in therapy) = Dispute => Effect => Feelings that are now produced
Disputing in REBT
- Vigourous argument which aims to change irrational belief and break the link between negative life events + depression
e. g patient says they’ve been unlucky => REBT therapist would identify this as utopianism and challenge this
Logical disputing in REBT
- Arguing against self-defeating belief that don’t follow logically from the information
=> “Does thinking this way make sense?”
Empirical disputing in REBT
- Arguing against self-defeating may not be consistent with reality
=> “Where’s the proof that this belief is accurate?”
Pragmatic disputing in REBT
- Highlights the lack of usefulness of self defeating beliefs
=> “Does this belief help me?”
Evidence for effectiveness - Strength
-March et al’s (2007) study of 327 depressed adolescents - compared effect of CBT vs antidepressants vs combination
Found - 81% of drug + CBT group and 86% of combo improved
Suggests CBT is effective alone and more when used w/ meds
=> brief (6-12 sessions) => cost effective => 1st choice in public healthcare
Suitability for Diverse Clients - Limitation
Depression can be so severe that clients cant self motivate to engage/pay attention to the cognitive work
Strumey (2005) suggest talking therapies like CBT arents suitable for those w/ learning disabilities
=> SUGGESTS that CBT is only suitable to a specific range of ppl
Counter to Suitability for Diverse Clients
New evidence by Lewis and Lewis (2016)
=> Concluded CBT as effective as antidepressants and behavioural therapies for severe depression
Also, Taylor et al (2008) found when used appropriately, CBT is effective to those w/ learning disabilities
SUGGESTS it’s suitable for a wider range than what was thought
Relapse Rates for CBT are high - Limitation
More recent studies suggest long term outcomes w/ CBT isn’t good as assumed
e.g. Ali et al (2007) assessed depression in 439 clients monthly for 1yr after CBT
Found: 42% relapsed in 6 months, 53% in a year
=> SUGGESTS CBT has to be repeated periodically to be effective
Client Preferences = not suiting some patients - Limitation
- Some want symptoms gone as quick + easy as possible => prefer medication
- Others e.g. trauma survivors want to explore orgins of their symptoms = prefer psychotherapy
Evident in Yrondi et al’s (2015) study of preference found depressed ppl rated CBT as least preferred psychological therapy
Is it the therapy or the relationship?
Rosenzwig suggested the difference between methods of psychotherapy such as CBT and SD may be small
=> All include the therapist-patient relationship => its quality may determine success rather than anything else
CBT’s overall focussed on cognitions (L)
- focused on thought processes and may ignore situational factors that cause :( like poverty or abuse
- Since some may need to change circumstances rather than just thinking - may overly blame patient for illness - UNFAIR
