treatment of depression

Question 1

Cognitive behaviour therapy

Answer 1

A psychological therapy for treating mental disorders - both cognitive and behavioural techniques

Question 2

Cognitive element

Answer 2

Client undergoes assessment - identify goals for therapy and put together a plan
- Helps to identify negative or irrational thoughts

Question 3

Irrational thoughts

Answer 3

Dysfunctional thoughts
- Defined as thoughts that likely interfere with happiness - lead to mental disorders such as depression

Question 4

Behaviour element

Answer 4

Working to change negative and irrational thoughts and put more effective behaviours into place

Question 5

Beck’s cognitive therapy

Answer 5

Challenges negative triad
- Aims to help client test reality of negative beliefs - set homework - can use to help patient in future

Question 6

Homework

Answer 6

Record positive experiences to use in therapy to demonstrate reality
- Client as scientist

Question 7

Ellis’ rational emotive behaviour therapy

Answer 7

Rational emotive behaviour therapy - ABCDE - identify and dispute irrational thoughts
- Identify causes such as utopianism - vigorous argument
- Different methods of disputing

Question 8

D + E

Answer 8

Disputing of irrational beliefs (empirical and logical disputing) produces effect

Question 9

Behavioural activation

Answer 9

As become depressed - avoid difficult situations and become isolated - maintains or worsen symptoms

Behavioural activation - gradually decrease avoidance and isolation - increase engagement - aims to reinforce this activity

Question 10

Evidence for effectiveness

Answer 10

• Strength - evidence for CBT
• March et al
• 81% CBT group, 81% of antidepressant group, 86% of both group significantly improved
• Just as effective as drug treatments
• More effective when combined
• Brief therapy - cost-effective
• CBT is widely seen as first choice of treatment in public health care systems

Question 11

Suitability for diverse clients

Answer 11

• Limitation - lack of effectiveness for severe cases and learning disabilities
• clients cannot motivate themselves to engage with cognitive work of CBT - may not be able to pay attention
• Sturmey - any form of psychotherapy is not suitable for people with learning disabilities - CBT
• CBT may only be appropriate for a specific range of people with depression

Question 12

Diverse clients counterpoint

Answer 12

• Recent evidence that challenges this
• Lewis and Lewis - CBT as effective as antidepressant drugs and behavioural therapies for severe depression
• Taylor et al - when use appropriately CBT is effective for people with learning disabilities
• Suitable for a wider range of people than once thought

Question 13

Relapse rate

Answer 13

• Limitation - high relapse rate
• Recent studies show long-term outcomes not as good
• Shehzad Ali et al - assessed depression in 439 clients every month for 12 months following a course of CBT
• 42% of clients relapsed into depression within 6 months of ending treatment and 53% within a year
• CBT may need to be repeated periodically

Question 14

Client preference

Answer 14

• CBT for depression focuses on identifying and changing unhelpful patterns of thinking and behaviour
• Evidence to say it is highly effective - atleast in short term
• Some people want symptoms gone quickly
• Yrondi et al - depressed people rated CBT as their least preferred psychological therapy