Cognitive Treatments Of Depression Flashcards
Cognitive behavioural therapy (CBT) - Beck: Patient and therapist work together
In CBT - the patient and therapist work together to clarify the patient’s problems and to identify where there might be negative or irrational thoughts that will benefit from being challenged.
CBT - Challenging negative thoughts relating to the negative triad.
The patient identifies the aspects of the negative triad and takes an active role in challenging these thoughts.
CBT - ‘patient as scientist’
In CBT patients are encouraged to test the reality of their own irrational beliefs.
Patients are set ‘homework’ e.g they may record if they experienced an event which they enjoyed or when someone was nice to them.
The therapist will use this homework in future sessions to provide evidence against beliefs such as ‘no one is nice to me’, ‘there is no point in going on’. This evidence directly refutes the patient’s irrational beliefs and can help them to move away from the negative triad.
Ellis’s rational emotive behaviour therapy - (REBT)
REBT provides an extension to the ABC model into an ABCDE model.
D - dispute irrational beliefs
E - effect
REBT - disputing irrational beliefs
If a patent would talk about how life is unfair and how unlucky they are - the therapist would identify this as utopianism and challenge the irrationality of his belief.
Empirical argument - the therapist will dispute whether there is evidence to support the irrational belief.
Logical argument- disputing whether the negative thought actually follows from the facts.
REBT - Behavioural activation
As depression occurs - sufferers will tend to avoid difficult situations and isolate themselves - which will maintain or worsen the depressive symptoms.
Therefore the treatment aims to gradually work with depressives to decrease this avoidance and isolation and increase activities that have been seen to improve mood, e.g. exercising, going out to dinner
✅AO3- CBT is effective
Much evidence to support effectiveness of CBT for depression.
March et al (2007)
Compared CBT and antidepressants’ effectiveness in 327 depressed teenagers. After 36 weeks - 81% of both separate groups and 86% of the combination therapy group had significantly reduced symptoms.
Shows CBT is just as effective as medication - provides strong case for CBT as first choice n public healthcare systems.
❌AO3 - CBT may be ineffective in severe cases of depression
Some cases of depression can be of such severity that patients lack the motivation to even begin the CBT process or take part in the hard cognitive work it entails.
These patients can be treated by antidepressants and then begin CBT if their motivation improves
However this is a weakness as it means CBT cannot be used as a sole treatment for all cases of depression
❌AO3- therapies’ successes may be due to therapist-patient relationship
Rozenwieg (1936)
Suggested there are not big differences between various therapies, and that the one factor that is present in all successful therapies is a good quality of relationship between the therapist and their patient - and that the quality of this relationship is what determines success rather than any particular technique.
Loborsky et al’s 2002 comparative review found very little difference between therapies
❌AO3- CBT doesn’t acknowledge the past
Although some patients want to explore their pasts, a basic principle of CBT is that the therapy focuses on the present and the future rather than their past.
Some other forms of psychotherapy acknowledge the possibility of links between childhood experiences and the later development of depression
This is a weakness as CBT may be ignoring an important aspect of the depressive’s experience.
❌AO3 - overemphasis on cognition
CBT may seriously minimise the importance of a patient’s environment
A patient who is living in poverty or suffering domestic abuse needs to change their environment - and CBT’s emphasis on cognition may prevent this - as the patient may too place this emphasis on cognition and fail to recognise that their environment needs to change.
Incorrect application of CBT can demotivate people to change their situation
