cognitive approach to treating depression

what approaches do we look at

- CBT

- Cognitive treatment -> Beck, Ellis

what is CBT

most used for psychological treatment for depression, based on behavioural and cognitive techniques

what does CBT aim to do

to make client aware of the relationship betweem thought, emotion, and action, it helps people change how they think and what they do

what is CBT a type of

talking/psychotherapy involving how you think about yourself, the world, and other people

what are the components of CBT

- initial assessment

- goal setting

- idenitfying negative/irrational thoughts

what is part of initial assessment

therapists and patient meet and review what brought the patient to CBT

what is part of goal setting

therapist and patient talk about what the patient wants to achieve and gain for CBT, setting small goals to achieve

what is part of idenitfying negative/irrational thoughts

identifying and challengng those thoughts using Ellis' REBT or Beck's approach

what is the main aim of CBT

to get the client to the point they can be independent and use strategies practicsed over the course of CBT to help themselves

how long is a course of CBT

generally 5-20 sessions with client/therapist meetings every week or fortnight with each session lasting 30-60 minuets

what does cognitive treatment aim to deal with

thinking, challenging negative thoughts or cognitive distortions (thinking traps)

name 4 thinking traps

- catastrophising

- overgeneralisation

- all or nothing

- rumination

define catastrophising

view or present a present situation considerably worse than it actually is

define overgeneralisation

single negative event is wrongly viewed as a universal unending pattern of faliure

define all or nothing

situations are viewed in extreme absolutes with no middle ground

define rumination

repetitive, passive, and unproductive dwelling on negative emotions, past events, or personal problems

what behavioural technique is used in CBT

behavioural activation

what is behavioural activation

encouraging patients to engage in activities they are avoiding

what do most therapists do when administering CBT

use a combination of ellis and beck

what may a therapist do following a session

therapist may set client homework, patient identifies own irrational beliefs and then proves them wrong leading to their beliefs to change

what may a therapist using becks approach do

help patient identify negative thoughts abput themselves, their world, and their future using necks negative triad, client/therapist work together to challenge the thoughts by discussing evidence for and against them = reality testing

what does REBT stand for

rational emotive behaviour therapy

what does REBT aim to do

aims to help clients identify and challenge irrational thoughts

what do therapists do as part of D,E (dispute, effective)

therapist disputes a patients irrational beliefs and replace them with more effective beliefs and attitudes

what is a logical dispute

where a therapist questions the logic of a persons thoughts

what is an empirical dispute

therapist seeks evidence for a persons thoughts

what des REBT aim to do

identify and dispute patients irrational thoughts

what is the therapists role in REBT

to break the link between negative life effects and depression by changing the clients irrational belief

what other study do we look at

Newark et al 1973

what was the aim of Newark 1973

to discocver if people with psychological problems had irrational attitudes

what was the method of Newark

two groups of participants were asked if they agreed with the following statements identified by ellis as irrational

- it is essential that one be loved or approved of by virtually everyone in the community

- one must be perfectly competent, adequate and achieving in order to consider oneself worthwhile

one group consisted of people who had been diagnosed with anxiety and the other group had no psychological problems

what was the results of Newark

- 65% of anxious participants agreed with statement a compared to 2% of non-anxious participants

- for statement b 80% of anxious participants agreed compared to 25% of non-anxious participants

what was the conclusion of Newark

people w/ emotional problems think in irrational ways

what are the strengths of cognitive treatments

- research support -> MARCH ET AL 2007

- soft determinism -> claims we may develop depression through cognitions the approach state that these aren't fixed and individuals can be empowered to heal or improve through CBT treatments

- free will -> CBT allows patients to develop at own pace with the therapist tailoring the sessions to suit every individual

what happened in March and what were the results

- examined 327 adolescents with a diagnosis of depression and looked at effectiveness of CBT, anti-depressants, and treatment with combination of CBT and antidepressants

- results = after 36 weeks; 81% of antidepressant group and 81% of CBT group significantly improved demonstrating the effectiveness of CBT in treating depression

what are the limitations of cognitive treatments

- too focused on cognitions -> some criticised CBT for not taking other factors into consideration (social circumstances -> DV)

- success is unclear -> success of CBT may not be due to specific techniques advocated by beck or ellis (ROSENZWEIG 1936)

- here-and-now emphasis -> may not be appropriate for all patients as some need to revisit their past events as part of their journey so may not be effective for all individuals

what happened in Rosenzweig

argued relationship between client/therapist which is of utmost importance in determining success

what are the economic implications of cognitive treatments

- treating mental disorders = effective treatment reduces sick days thus improving productivity

- if people are less likely to relapse after treatment then economical in long run as people would have less time off work