4- cognitive treatments for depression

How does CBT begin?

Starts with an assessment in which the patient and therapist work together to clarify the patient’s problems. They jointly identify goals for the therapy and put together a plan to achieve them.

What is the central task of CBT?

To identify where there may have been irrational thoughts and how these will be challenged.

What two types of cognitive treatment for depression exist?

CBT and REBT

Who developed CBT?

Beck

What types of thoughts does Beck’s CBT try to challenge?

The negative triad/irrational beliefs/negative self-schemas

In Beck’s CBT, how does the patient test the reality of their irrational beliefs?

Using a ‘patient as scientist’ approach

What is an example of a ‘patient as scientist approach’?

Setting homework to record when they enjoyed an event or people were nice to them.

How does the therapist use this evidence in later sessions?

To challenge negative thoughts.

Who developed REBT?

Ellis

What does REBT stand for?

Rational emotive behavioural therapy

What letters would you associate with REBT?

ABCDE

What do the letters D and E stand for?

Dispute and Effect

What is the purpose of dispute?

To challenge irrational thoughts e.g. utopianism using vigorous argument which breaks the link between negative life events and depression.

What two arguments are used to dispute irrational beliefs?

Empirical argument and logical argument

What is the empirical argument based on?

Whether there is actual evidence to support the negative belief

What is the logical argument based on?

Whether the negative thought logically follows facts.

CBT also involves behavioural activation to provide evidence for beliefs being irrational.

What is behavioural activation?

Where the patient engages in enjoyable activities.

CBT is even more successful when combined with which other treatment for depression such as?

Drug therapy

Who found that CBT was just as effective as anti-depressants and even more successful when combined with antidepressants?

March

Approximately what percentage of adults have been found to benefit from Beck’s CBT?

80

What is a benefit of CBT over drug therapy?

Lower relapse rates

Give one example of a condition where CBT may not be effective for treating depression.

Where depression is so severe that the patient can’t motivate themselves to engage with CBT or pay attention during sessions.

What might CBT’s success rate actually be the result of?

Simply talking to someone i.e. the therapist-patient relationship.

On what timescale is CBT based?

Present and future

Why might some people be frustrated by CBT given its focus on the present and future?

Unable to explore the past e.g. where childhood events are involved in the source of their depression.

What else might cause depression besides cognitions?

Biology and the environment

Give an example where the environment could contribute to depression.

Where the patient is suffering abuse.

What could be a potential flaw of CBT, if used inappropriately?

It could demotivate people to change their situation (i.e. their environment).