The cognitive approach to treating depression- CBT

what assumption is CBT based on?

depression is caused by the way the patient views themselves and the world

What is the aim of CBT?

identify irrational thought processes and beliefs and to replace them with more adaptive thoughts and beliefs to reduce emotional distress and depression

cognitive element of CBT

assessment in which the client and the cognitive behaviour therapist work together to clarify the client's problems.

They jointly identify goals for the therapy and put together a plan to achieve them.

behaviour element of CBT

working to change negative and irrational thoughts and put more effective behaviours into place

REBT

- Rational Emotive Behaviour Therapy

- type of CBT

- developed by Ellis

- extends ABC model to ABCDE model

ABCDE model

Activating Event

Belief

Emotional Consequence

Dispute

Effective New Belief

goal of REBT

identify and dispute irrational thoughts

what are the 3 types of disputing?

1. Logical disputing

2. Empirical disputing

3. Pragmatic disputing

Logical disputing

challenging irrational beliefs that do not follow logically from the information available

Empirical disputing

identifying when self-defeating beliefs are not consistent with the reality/evidence

Pragmatic disputing

Emphasising the lack of usefulness of self-defeating beliefs

Effects (E) in RBT

effective disputing challenges self-defeating beliefs into more rational ones so that the individual can move on from catastrophising to more rational interpretations of events

what does the client learn as therapy goes on?

to effectively identify, challenge and change their own irrational beliefs

What are the homework assignments?

- between therapy sessions

- designed to test irrational beliefs and put rational beliefs into practice

- often include behavioural activation

what is behavioural activation?

Therapist encourages patient to engage in enjoyable activities or exercise to provide more evidence that negative beliefs are irrational

strength of CBT- high effectiveness in treating depression compared to other approaches

- focus on identifying and challenging irrational thoughts and replace with adaptive, rational ones

- March et al. (2007)-m 81% out of 327 adolescents significantly improved when treated with CBT, comparable to success rate of antidepressant medication

- CBT highly effective alone- highest success rate (86%) when CBT + medication

- demonstrates significant impact on depressive symptoms- valuable therapeutic option within clinical psychology/ NHS

strength of CBT- empowers patients with lifelong coping strategies

- CBT prevents relapse as helps patients solve problems, unlike drug therapies which only alleviate symptoms

- patients less likely to become dependent n a therapist or medication overtime

- Kuyken et al. (2008)- patients who recieved CBT had lower relapse rates than those treated with medication alone

- skills developed in CBT promote autonomy and self-efficacy

- focus on skill development and relapse prevention adds considerable value to its use as a psychological treatment

weakness of CBT- high relapse rates

- effective at tackling symptoms of depression yet concerns over how long benefits last

- more recent studies suggest long-term outcomes not as effective as previously assumed

- Shehzad Ali (2017)- 42% of patients relapsed into depression within 6 months of ending CBT treatment, 53% within a year out of 439 clients

- success of CBT not due to specific techniques advocated by Beck or Ellis

weakness of CBT- overemphasis on thought patterns

- overlooks situational/environmental factors which contribute to depression

- e.g. ongoing abuse, poverty- encouraging some1 to change how they think about their situation may be insufficient/inappropriate

- may lead to blaming individual for their condition- approach suggests their thinking is the root of the problem

- effective but limited considerations of social and environmental influences- doesn't fully address root cause of individuals depression