Treating depression notes

Outline for Cognitive Behaviour Therapy

• Introduction to CBT

  • Most commonly used psychological treatment for depression and other mental health issues

  • Cognitive approach with behavioural elements

• Cognitive Element

  • Assessment process with therapist to clarify problems and set therapy goals

  • Identifying negative or irrational thoughts for challenge

• Behaviour Element

  • Changing negative thoughts and implementing effective behaviours

• Beck's Cognitive Therapy

  • Application of Beck's cognitive theory of depression

  • Identifying automatic negative thoughts and challenging them

  • Testing reality of negative beliefs through homework assignments

• Ellis's Rational Emotive Behaviour Therapy (REBT)

  • Extends ABC model to ABCDE model (Dispute and Effect)

  • Identifying and disputing irrational thoughts

  • Different methods of disputing: empirical and logical arguments

• Behavioural Activation

  • Goal to decrease avoidance and isolation in depressed individuals

  • Increase engagement in mood-improving activities like exercise and social outings

  • Therapist reinforces positive activities to combat depression maintaining behaviors

Evaluation Evidence for Effectiveness of CBT

• Strengths of CBT

  • Large body of evidence supporting effectiveness for treating depression

  • Studies showing effectiveness:

    • John March et al. (2007) study on 327 depressed adolescents

    • 81% improvement in CBT group, antidepressants group, and CBT plus antidepressants group

  • Cost-effective and widely used in public health care systems

• Suitability for Diverse Clients

  • Limitation: Lack of effectiveness for severe cases and clients with learning disabilities

  • Severe depression may hinder engagement with cognitive work in CBT

  • Complex rational thinking in CBT may not be suitable for clients with learning disabilities

  • Peter Sturmey (2005) suggests psychotherapy, including CBT, may not be suitable for clients with learning disabilities

• Counterpoint

  • Recent evidence challenging conventional wisdom:

    • Gemma Lewis and Glyn Lewis (2016) review: CBT as effective as antidepressant drugs for severe depression

    • John Taylor et al. (2008) review: CBT effective for people with learning disabilities

  • Suggests CBT may be suitable for a wider range of people than previously thought

• Relapse Rates

  • Limitation: High relapse rates in CBT for depression

  • Concerns over long-term effectiveness:

    • Few early studies on long-term outcomes

    • Shehzad Ali et al. (2017) study: 42% relapsed within six months, 53% within a year

  • Indicates the need for periodic repetition of CBT.

Evaluation of Client Preference in Cognitive Behavioral Therapy (CBT) for Depression

• Focus of CBT for Depression

  • Identifying and changing unhelpful patterns of thinking and behavior

  • Highly effective in tackling symptoms of depression in the short term

• Client Preferences in Depression Treatment

  • Not all clients prefer CBT for depression

  • Some prefer quick symptom relief through medication

  • Others, like trauma survivors, prefer exploring the origins of their symptoms

• Study on Client Preference

  • Antoine Yrondi et al. (2015) study

  • Depressed individuals rated CBT as their least preferred psychological therapy

• Discussion on Client Preference vs. Effectiveness

  • Does client preference matter if CBT is effective?

  • Consideration of client autonomy and individual needs in therapy

  • Importance of aligning treatment approach with client preferences for long-term success

• Conclusion

  • Balancing effectiveness of CBT with client preferences

  • Importance of considering individual client needs and autonomy in therapy decisions