Cognitive approach: treating depression

Question 1

What are the steps of cognitive behavioural therapy (CBT)?

Answer 1

1. Identifying negative thinking patterns in depression patients- Patient is encouraged to talk about difficulties and identify negative thoughts. Patient will then complete self report questionnaires: The Beck depression inventory (21 questions scored 0-3 giving a total of 63. Higher score= more depressed).
2. Therapist challenges the irrational thoughts of depressed patients and presents alternatives
3. Skill acquisition and application- Therapist works with patient on intervention techniques: new skills + ways to think about things (optimistic self statements/ relaxation techniques).
4. Follow up- Therapy undergoes final assessment using self reports (BDI) to compare before and after scores.

Question 2

If the point is:

A strength of CBT is that there’s evidence that supports using it with depression.

What is the evidence, example and link?

Answer 2

Evidence- For example, March et al compared CBT, antidepressants and a combination of CBT + antidepressants in 327 adolescents.

Explanation- After 36 weeks, 86% of the CBT + antidepressants group had significantly improved compared to 81% of other groups.

Link- This illustrates the effectiveness of CBT in treating depression.

Question 3

If the point is:

A weakness of CBT is that its success could lead to an etiological fallacy being made, whereby we assume the causes of depression are cognitive because the cognitive treatments are successful.

What is the evidence, explanation and link?

Answer 3

Evidence- For example, just because some symptoms can be removed in CBT, it doesn’t necessarily mean the causes can be solely cognitive in origin.

Explanation- Subsequently, negative thinking can also develop after depression.

Link- Therefore, it’s important to keep an open mind to the causes of depression and not have this view narrowed by the success of certain treatments.

Question 4

If the point is:

A strength of CBT is that it tackles the root problem of depression, unlike biological treatments such as antidepressants.

What is the evidence, explanation and link?

Answer 4

Explanation- This improves the chances that the depressive episode will be short lived and reduces the chances of relapses further down the line.

Evidence- This could be because of the skill acquisition component of CBT, it helps to inoculate depressed patients against further depressive episodes.

Link- Therefore, it could be argued that the effects of CBT are more effective and longer lasting than alternatives.

Question 5

If the point is:

A weakness of CBT is that some psychologists argue that improvements with CBT are actually rooted in the therapist- patient relationship.

What is the evidence, explanation and link?

Answer 5

Explanation- It may be the quality of this therapeutic relationship that determines any improvement, and not the techniques used in CBT.

Evidence + link- Luborsky found very little differences between therapies, which supports the view that having someone to talk to who will listen matters the most in recovery from depression.

Question 6

What are the evaluation points for CBT in treating depression?

Answer 6

+ Research to support
— Could lead to an etiological fallacy being made, whereby we assume the causes of depression are cognitive because the cognitive treatments are successful
+ It tackles the root problem of depression, unlike biological treatments such as antidepressants
— Some psychologists argue that improvements with CBT are actually rooted in the therapist-patient relationship