Treatments of Depression

Question 1

Cognitive Behavioural Therapy

Answer 1

The therapist works to make the patient aware of the relationship between thought, emotion, and actions. Tackles negative thought processes - changes the way a client thinks to lead to a change in behaviour.

Question 2

Who’s explanation of depression does CBT link to?

Answer 2

Beck’s Cognitive Triad, as it focuses on the negative triad, challenging negative thoughts on the self, the world, and the future.

Question 3

CBT Assessment

Answer 3

The client is first assessed to monitor any improvement. The therapist explores current thoughts, emotions, and behaviours with the patient, building a trusting relationship.

Question 4

Dysfunctional Thought Diary

Answer 4

Patient keeps a diary of their thoughts and feelings towards negative events. For each thought, they then rate how much they believe it. They then give a rational response, and rate their belief in that, then finally, re-rate their belief in the irrational thought.

Question 5

Challenging Dysfunctional Thoughts

Answer 5

The patient is taught how to challenge thoughts outside of CBT sessions by asking themselves questions, such as considering if there is any evidence. This allows the negative thought to become positive.

Question 6

Rational Emotional Behavioural Therapy

Answer 6

Disputing and challenging irrational thoughts to create positive effects.

Question 7

Who’s explanation of depression does REBT link to?

Answer 7

Ellis’ ABC Model

Question 8

Disputing

Answer 8

Challenging irrational thoughts and beliefs. The therapist encourages the patient to think of alternative explanations, involving a vigorous discussion.

Question 9

Empirical Disputing

Answer 9

Disputing whether there is actual evidence to support their negative belief.

Question 10

Logical Disputing

Answer 10

Involves disputing whether the negative thought logically follows from the facts.

Question 11

Pragmatic Disputing

Answer 11

Involving disputing how the negative thought is going to help them.

Question 12

Effect

Answer 12

The new beliefs and attitudes that emerge, generally positive thoughts.

Question 13

Homework Tasks

Answer 13

Therapists may set patients homework to put themselves into situations they have previously avoided, or telling people how they feel.

Question 14

Behavioural Activation

Answer 14

The patient is encouraged to become more active and take part in pleasurable activities.

Question 15

Strengths of Cognitive Treatments

Answer 15

• Supporting evidence from Lincoln et al. (1997) - used a questionnaire to identify stroke victims who had developed depression. 19 patients were given CBT for 4 months, resulting in reduced symptoms.
• Cognitive therapies attempt to get to the root of the problem (like negative thoughts) rather than just targetting the symptoms like drug therapies do.
• Supporting evidence from March et al. (2007) - studied 327 patients of major depressive disorder. Patients were given either CBT, drugs, or both. After 12 weeks, drugs improved depression by 62% and only 48% by CBT. However, after 36 weeks, drug’s improvement was 81% while CBT’s was 86%, showing the longer-lasting effects of CBT.
• Does not involve any side effects or issues with dosage that drug treatments might find.
• CBT is more empowering for the patient than drug treatments, with patients taking an active role in their recovery process.
• Supporting evidence from Hollon et al. (2006) - found that 40% of depressed patients relapsed within 12 months after 16 weeks of CBT, 45% relapsed on drug treatments, and 80% relapsed on a placebo.

Question 16

Limitations of Cognitive Treatments

Answer 16

• CBT and REBT are both very expensive, and have long waiting lists on the NHS. This limits their usefulness as some patients may be in desperate need of immeadiate help.
• Therapies only work if the patients engage with the homework. This may be difficult for patients of depression as they are likely to have lowered motivation, and this could cause them to feel even more negative about themselves.
• Therapies may take a while to take effect, especially compared to drug therapies (as seen in March et al. 2007). This may be an issue in severe, desperate cases of depression.
• Patients will have individual differences - CBT may not be most suitable for all patients, especially due tp the motivation required.