Cognitive approach to treating depression

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Cognitive behavioural therapy (CBT) involves both cognitive and behavioural emelemts and typically starts with an initial assessment in which the patient and therapist identify the patients problems.

thereafter, the patient and therapist agree on a set of goals and a plan of action to achieve these goals. While there are different forms of CBT (based on Beck and Ellis’s theories) the aim to identify the negative and irrational thoughts remains the same, depsite the fact their approaches differ

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ellis developed his ABC model to include D (dispute) and E (effective). the idea here is that the therapist will dispute the patients irrational beliefs, to replace them with more effective beliefs and attitudes

there are different types of dispute which can be used, including empirical dispute - where the therapist seeks evidence for a persons thoughts “where is the evidence that your beliefs are true”

following a session, the therapist may set their patient homework. The idea is that the patient identifies their own irrational beliefs and then proves them wrong - as a result their beliefs begin to change.

AO3 - strength of CBT

comes from research evidence which demonstrates its effectiveness in treating depression.

Research by March et al. (2007) found that CBT was as effective as antidepressants in treating depression. The researchers examined 327 adolescents with a diagnosis of depression and looked at the effectiveness of CBT, antidepressants, and treatment with a combination of CBT and antidepressants.

After 36 weeks, 81% of the antidepressant group and 81% of the CBT group had significantly improved, demonstrating the effectiveness of CBT in treating depression. However, 86% of the CBT with antidepressant group had significantly improved. This suggests that a combination of both treatments may be more effective.

While March et al. provide some support for cognitive treatments of depression, their research demonstrates that a combination of cognitive and biological treatments is more effective. This suggests that cognitive treatments and explanations do not provide a complete explanation of depression and other factors (mainly biological ones) should also be considered.

AO3 - issue is that it requires motivation

One issue with CBT is that it requires motivation. Patients with severe depression may not engage with CBT, or even attend the sessions and therefore this treatment will be ineffective in treating these patients.

Alternative treatments,such as antidepressants, do not require the same level of motivation and may be more effective in these cases. This poses a problem for CBT, as CBT cannot always be used as the sole treatment for severely depressed patients, who often lack the motivation to attend therapy and to speak about their depression.

AO3 - emphasis on the role of cognitions as primary cause of depression

CBT has been criticised for its overemphasis on the role of cognitions as the primary cause of depression. Some psychologists have criticised CBT for not considering other factors such as social circumstances which might contribute to a person’s depression.

For example, a patient who is suffering from domestic violence or abuse does not need to change their negative/irrational beliefs, but in fact needs to change their circumstances. Therefore, CBT would be ineffective in treating these patients until their circumstances have changed.