Psychological Treatment for Unipolar Depression - CBT

Question 1

What is CBT?

Answer 1

Cognitive behavioural therapy

Question 2

What does CBT work on changing?

Answer 2

Works on changing negative thoughts into positive thoughts and behaviour will change in line with this

Question 3

What does CBT focus on?

Answer 3

Focuses on current issues/current situation

CBT on its own is used for mild depression

Question 4

How many CBT sessions are needed?

Answer 4

Initially, six sessions of CBT, each session is around 50 minutes

Question 5

How can CBT be accessed?

Answer 5

Available on NHS for free, but private sessions of CBR are available

Question 6

How are CBT sessions carried out?

Answer 6

One-to-one sessions with a therapist is the norm

Group therapy sessions for some issues - also access CBT online

Question 7

What is the involvement of the client like in CBT?

Answer 7

Patient has active involvement during the session - they drive what they want to talk about

Question 8

What is the role of the therapist during CBT?

Answer 8

One of the main roles of the therapist is to identify any triggers for their negative thoughts

Question 9

What will the therapist provide the patients with in CBT?

Answer 9

Provide strategies for the patient to help with overcoming their negative thinking

Help with stress management - relaxation techniques, hypnosis, medication

Problem-solving strategies provided by the therapist to the patient - e.g. assertiveness training and learning that catastrophic thoughts are unlikely to happen

Question 10

What is expected of clients between CBT sessions?

Answer 10

Patient records any negative thoughts and alternative thoughts in a thought diary

Will help them identify individual thoughts and emotions

Question 11

How does CBT take an eclectic approach?

Answer 11

Combine medication e.g. SSRIs and CBT

Particularly if the depression is moderate to severe

Question 12

What is the supporting evidence/strengths of CBT as a psychological treatment for unipolar depression?

Answer 12

Beck et al (1978)

Elkin (1989)

Hollon et al (2005)

Psychology in society

Social control

Question 13

What is the refuting evidence/weaknesses of CBT as a psychological treatment for unipolar depression?

Answer 13

Sandahl (1998)

Elkin (1989)

Pinquart (2006)

Self-report data

Low adherence

Question 14

Why is Beck et al (1978) supporting evidence of CBT as a psychological treatment for unipolar depression?

Answer 14

Beck et al demonstrated that CBT is far more effective than drug therapy and had the added benefit of lower attrition rates than drug therapy.

This is a strength because it provides evidence for the effectiveness of CBT when used on its own as a treatment for unipolar depression.

Furthermore, compared to drug therapies, CBT produces no unpleasant side effects for the client’s mental and physical health therefore supporting the use of CBT.

Question 15

Why is Elkin (1989) supporting evidence of CBT as a psychological treatment for unipolar depression?

Answer 15

Elkin (1989) randomly allocated 239 participants diagnosed with depression to one of four treatment groups (CBT, interpersonal therapy, anti-depressants, or a placebo pill) and found that CBT was as effective in reducing symptoms of depression, even after 18 months.

This is a strength because it shows that CBT is an equally effectiveness treatment for depression.

Question 16

Why is Hollon et al (2005) supporting evidence of CBT as a psychological treatment for unipolar depression?

Answer 16

Hollon et al. (2005) compared relapse rates for CBT and antidepressants and found that only 31% of CBT patients suffered a relapse compared to 76% of those treated with drugs.

This is a strength because it shows that CBT offers a better cure for depression whereas drug therapy is only palliative.

Question 17

Why is psychology in society a strength of CBT as a psychological treatment for unipolar depression?

Answer 17

CBT is backed by government funding in the UK and is a large part of the initiative to improve access to psychological therapies.

This is a strength because CBT provides results quickly and is relatively cheap compared to other therapies therefore supporting the usefulness of CBT and demonstrating the use of psychological knowledge in society.

Question 18

Why is social control a strength of CBT as a psychological treatment for unipolar depression?

Answer 18

The patient is more actively involved in planning their treatment program and has more autonomy regarding their treatment regime.

This is a strength because CBT may be viewed as a more ethical treatment for depression than anti-depressants as it is not a form of social control.

Question 19

Why is Elkin (1989) refuting evidence of CBT as a psychological treatment for unipolar depression?

Answer 19

Elkin (1989) also found that for severely depressed people antidepressants were significantly more effective and that after 18 months, 36% of CBT clients relapsed.

This is a weakness because it showed that CBT was not a very useful therapy for severely depressed people and that it is not especially effective in preventing a relapse.

Question 20

Why is Pinquart (2006) refuting evidence of CBT as a psychological treatment for unipolar depression?

Answer 20

Pinquart (2006) reviewed studies of anti-depressants and psychological therapies used to treat depression and found that whilst psychological therapies were more effective, drugs were cheaper and can be provided immediately whereas there is a waiting list for psychological therapies.

This is a weakness because whilst the client is on a waiting list their mental health may deteriorate, relationships may become problematic and may break down and people may have to take time off work or interrupt schooling.

Question 21

Why is low adherence a weakness of CBT as a psychological treatment for unipolar depression?

Answer 21

Some severely depressed clients find CBT challenging. Some find it hard to have well-established negative thoughts challenged, whilst others may struggle to keep up the commitment to attend the therapy sessions and complete homework tasks, such as the thought diary.

This is a weakness because low adherence to treatment results in high dropout rates, which are both costly for the NHS and make it difficult to assess the true effectiveness of CBT.

Furthermore, CBT may only be of benefit to severely depressed clients who are also using anti-depressants (medicated), thus CBT may not be effective when used on its own.