Cognitive approach to treating depression

Cognitive behaviour therapy

Cognitive behaviour therapy (CBT) Is the most common psychological treatment for depression. It is an example for the cognitive approach to treatment but it also includes behaviour treatment

COGNITIVE ELEMENT - CBT begins with an assessment where the client and the cognitive behaviour therapist work together to clarify the client problems . They join the identify goals for the therapy and put together a plan to achieve them

BEHAVIOUR ELEMENT - CBT involves working to change negative and irrational thoughts and finally put more effective behaviours into place

Beck’s cognitive therapy

The idea behind cognitive therapy is to identify automatic thoughts about the world, The self and the future - This is the negative triad. Once identified these thoughts must be challenged, as well as challenging these thoughts, cognitive therapy aims to help clients test their negative beliefs

Ellis’s REBT

REBT Extends the ABC model to an ABCDE model - D Stands for dispute And E For Effect. The central technique of REBT is to identify and dispute (challenge) irrational thoughts . The intended effect is to change the irrational belief and so break the link between negative life events and depression . Empirical argument involves disputing whether there is actual evidence to support the negative belief . Logical argument involves disputing whether the negative thought logically follows the fact

Behavioural activation

The goal of behavioural activation is to work with depressed clients to gradually decrease their avoidance and isolation , and increase their engagement in activities that have been shows to improve mood

Evaluation

• one strength of the CBT is that there is a lot of evidence for its effectiveness- many studies show that CBT works. For example, March (2007) compared CBT to antidepressant drugs and also a combination of both treatments when treating 327 depressed adolescents. After 36 weeks he found that CBT was just as effective when used in its own, and more effective when used with antidepressants

• One limitation of CBT is that there’s a lack of effectiveness for cases with clients who have learning disabilities - in some cases , depression can be so severe that clients cannot motivate themselves to engage with the CBT or even pay attention to what is happening in the sessions. Also , the complex rational thinking involved makes it unsuitable for treating depression in clients with learning disabilities

• One limitation of CBT is its high relapse rates - although CBT is quite effective in tackling the symptoms in depression , there are some concerns of how long the benefits last. Some recent studies show that the long term outcomes of CBT are not as good as assumed. This means that the CBT may need to be repeated periodically