Psychological Therapies of Depression

Question 1

What are 2 psychological treatments of depression?

Answer 1

1. Cognitive behavioural therapy (CBT)

2. Psychodynamic interpersonal therapy (PIT)

Question 2

Who developed cognitive behavioural therapy (CBT) and what is its aim?

Answer 2

Beck

Aim - identify and challenge maladaptive cognitions and dysfunctional behaviours.

Question 3

What are the 3 phases of CBT?

Answer 3

1. Challenging the clients negative thoughts - asking them to prove the accuracy of their irrational beliefs - thinking of alternative explanations for these beliefs.
2. Teaching self-talking to block the negative beliefs.
3. Testing faulty hypotheses through homework tasks.

Question 4

What are the 2 most important techniques involved in CBT?

Answer 4

1. Thought catching

2. Behavioural activation

Question 5

What does thought catching involve?

Answer 5

Helps the client recognise the link between thoughts and feelings.
They may be asked to keep a diary of emotion arousing events and thoughts, then their negative thoughts will be challenged by the therapist.

Question 6

What does behavioural activation involve?

Answer 6

Being active can lead to rewards that act as an anecdote for depression so therapist and P identify potentially pleasurable activities and anticipate and deal with any cognitive obstacles and maladaptive thoughts.

Question 7

What support did Babyak find, relating to behavioural action? (Method, findings).

Answer 7

156 adult volunteers w/ MDD randomly allocated to a exercise, drug or combo group.
Found - all improved after 6 months but 6 months after study, exercise group had lower relapse rates - link between exercise and improvement in thoughts.

Question 8

What did Robinson use to assess the effectiveness of CBT, what did he find and what does this suggest?

Answer 8

Meta-analysis
Found- CBT was superior to no treatment at all but wasn’t more effective when compared to a placebo group - suggests a psychological element to the successfulness of CBT.

Question 9

What does the outcome of CBT also rely on?

Answer 9

The competence of the therapist.

Question 10

What did Rush et al find, relating to the effectiveness of CBT, and what did Hollon find that supported this, and what does this suggest?

Answer 10

CBT was more effective in reducing a low mood than tricylics.
Hollon - 60% success rate for CBT - comparable to drug therapies - lower relapse rate for CBT.
Suggests - CBT deals with the cause of depression and equips people w/ strategies to cope in case of relapse.

Question 11

What has been found about the appropriateness of CBT?

Answer 11

Has been successfully applied to many age groups - elderly, adolescents, etc.

Question 12

What has been found about phone and computer based CBT?

Answer 12

Phone and computer based CBT has also been found to be successful and has lower rates of attrition.

Question 13

What did Mohr find, relating to phone based CBT vs. face to face CBT?

Answer 13

Only 8% of p’s dropped out of phone based CBT compared to 47% of face to face CBT.

Question 14

Why may phone or computer based CBT be more appropriate in some situations and have lower rates of attrition?

Answer 14

Not face to face and can take away some anxiety, intimidation and embarrassment. Depressed people may also not have the motivation to actually go out.

Question 15

In what situation is CBT less suitable?

Answer 15

When the person is exposed to stressors in their life which they can’t control - changing negative thoughts won’t help them deal w/ uncontrollable stressors.

Question 16

What are 3 factors that can make CBT less effective and appropriate?

Answer 16

1. Individual differences.
2. The environment in which someone is in.
3. Severity of depression.

Question 17

Who developed psychodynamic interpersonal therapy (PIT) and what is its aim?

Answer 17

Robert Hobson
Aim - uncover disturbances in interpersonal relationships which have caused depression by modifying them in the therapeutic relationship - so it looks at difficulties in relationships which may be causing depression.

Question 18

What are the 4 things that PIT is designed to help with and how does PIT aim to help with them?

Answer 18

1. Unresolved grief - facilitating mourning.
2. Role disputes - when there are different expectations about relationships between the people involved - PIT recognises and resolves these disputes.
3. Role transitions - depression caused by life events - PIT helps give up old role and views new role as an opportunity.
4. Interpersonal deficits - individual feels they have a lack of support resulting in low self esteem - PIT helps reduce social isolation.

Question 19

What did Paley et al find, relating to the effectiveness of PIT?

Answer 19

Found it to be as successful as CBT when assessed over 52 months.

Question 20

What did Gurthrie argue about the appropriateness of PIT?

Answer 20

PIT is important in the treatment of depression when the causes lie in dysfunctional relationships, but the quality of the client/therapist relationship determines the outcome so having an experienced therapist is essential.

Question 21

What was found when NHS psychotherapy patients received PIT?

Answer 21

NHS psychotherapy patients who received 12 weeks of PIT found that even brief treatment was effective, even w/ inexperienced therapists.

Question 22

Why is attrition a problem?

Answer 22

Can make the results less valid - p’s dropping out means that recorded outcomes can be artificially positive or negative, meaning we can’t always rely on results because of attrition as the validity of the research is lowered.

Question 23

What did Hunt and Andrews find, relating to attrition in psychotherapies?

Answer 23

Assessed 5 meta-analysis.

Drop out rate for psychotherapies was 8%.

Question 24

When compared to biological therapies, why may psychological therapies be more suitable?

Answer 24

1. Don’t produce side effects
2. Can be used on adolescents - if their neurological development is incomplete, they may not respond well to drugs.
3. They help deal with the cause of depression, not just the symptoms like many biological treatments - indicated through lower relapse rates.

Question 25

What may be most suitable for severely depressed patients?

Answer 25

Biological therapies at first to treat the symptoms as quickly as possible, and the psychological therapy later on alongside bioligcal to treat the cause