Cognitive Approach to Explaining and Treating Depression

Question 1

Describe Ellis’ ABC Model

Answer 1

• Ellis though that irrational thinking was the cause, defined as having thoughts that interfere with being happy. He argued irrational beliefs result from ‘musturbatory thinking’. The assumption something ‘must’ be true. An individual that holds these ideas is bound to be disappointed at times and so it leads to depression, the ‘musts’ are challenged in therapy.
• A: activating event. B: rational or irrational belief, C: consequences of belief

Question 2

Describe Beck’s cognitive vulnerability

Answer 2

• He believed the cause was errors in logic, focusing on certain (negative) aspects of a situation while ignoring equally relevant (possibly positive) information. These illogical thought patterns are self-defeating and cause great anxiety. These include:
• Magnification and Minimisation: they make the problem bigger than it is and the solution they make it smaller
• Personalisation: negative events are interpreted as their fault
• Negative automatic thoughts: stream of automatic negative thoughts that persist even with contrary evidence

Question 3

Describe the negative self schema

Answer 3

• Possessing a set of beliefs and expectations about themselves that are pessimistic, may be acquired in childhood.
• Predisposes the person to depression but a stressful life event is required to activate this later in life.

Question 4

Describe the cognitive triad

Answer 4

A pessimistic and irrational view of three key elements in a person’s belief system: the negative view of self, negative view of the world, negative view of the future.
- They tend to see themselves as worthless. Interpret events in an unrealistically negative and see the world as posing obstacles that can’t be handled. They see the future as hopeless.

Question 5

Give evaluation of the cognitive approach in explaining depression

Answer 5

• Supporting evidence. Clark and Beck found that cognitive vulnerabilities were common in depressed people and these preceded the depression. Shows negative thinking is linked with depression. However that’s only one correlation and so it cannot establish cause and effect as thinking was assessed in those who were already depressed. It’s possible that depression causes negative thoughts
• Practical application. Cohen et al concluded that assessing cognitive vulnerability allows psychologists to screen young people, identifying those most at risk of developing depression in the future and monitoring them, can be applied in CBT that challenges negative thoughts. However, it doesn’t affect the cause e.g. simply reducing negative thoughts. The cause could be an imbalance of neurotransmitters instead.

Question 6

Outline CBT

Answer 6

CBT: Cognitive behaviour therapy includes a cognitive behaviour therapist and client identify negative or irrational thoughts (cognitive). And changing irrational thoughts and putting more effective behaviours (behaviourist)

Question 7

Describe cognitive therapy (CT)

Answer 7

• It identifies the negative triad and challenges it
• Aims to help clients test the reality of their negative beliefs
• Beck used various techniques to challenge the negative thinking of people with depression e.g. dysfunction thought diary. Where clients records when someone is nice or they’ve enjoyed an event, this is used as evidence if they think irrationally. The rating of original irrational belief should reduce after rationalising thought.

Question 8

Describe rational emotive behaviour therapy (REBT)

Answer 8

• REBT works on identifying and challenging
• Ellis extended his ABC model to ABCDEF: D (Disputing irrational thoughts), E (Effects of disputing) and F (new Feelings)
• Disputing can be done through empirical arguments (disputing whether there is actual evidence to support the negative belief) and logical arguments (disputing where the negative thought logically follows from the facts)
• Effective disputing leads to more rational beliefs, helping the client to feel better.

Question 9

Give evaluation of CBT as a treatment for depression (effectiveness)

Answer 9

Evidence for effectiveness. March et al compared the effectiveness of CBT and drugs and a combination of the two as treatments for depression for 327 clients. After 36 weeks of treatment, there were similar effectiveness in each, 81% improved for CBT and drugs and 86% for the combination group. Suggests CBT is widely seen as the first choice of treatment.

Question 10

Give evaluation of CBT as a treatment for depression (diversity + counter)

Answer 10

• Lack of suitability for diverse clients. Those with severe depression can’t motivate themselves to engage with CBT as they may not be able to pay attention. Complex rational thinking is needed which may be difficult for those with learning disabilities. Sturmey suggested that psychotherapies, including CBT weren’t suitable for those with learning disabilities. Suggests CBT may only be appropriate for a specific group of people.
• However, recent research by Lewis and Lewis concluded CBT was as effective as drugs and behavioural therapies for severe depression. Taylor et al found when used properly, CBT is effective for those with learning abilities. Means CBT may be suitable for a wider range of people than what was thought

Question 11

Give evaluation of CBT as a treatment of depression (relapse)

Answer 11

High relapse rates. Ali et al found after a course of CBT, 42% of 439 patients relapsed at the 6 month follow up and 53% relapsed within the year. Suggests CBT may need to be repeated periodically