Psychopathology : Cognitive Approach to Depression (treating)

Question 1

Whats cognitive behavioural therapy?

Answer 1

most commonly used treatment in the NHS for depression
- based on Beck’s Negative Traid
- involves cognitive and behavioural elements
- cognitive elements aim to identify irrational and negative thoughts and replace negative thoughts with more positive ones
- behavioural elements encourage patients to test their beliefs through behavioural experiments and homework

Question 2

Advs of cognitive behavioural therapy

Answer 2

• Large body of evidence to support its effectiveness (especially in combination with antidepressants) → March et al. (2007) examined 327 adolescents with a diagnosis of depression and looked at the effectiveness of CBT, antidepressants and a combination. After 36 weeks, 81% of the antidepressants group and 81% of the CBT group had significantly improved (demonstrating its effectiveness). 86% of CBT + antidepressants improved.
• Lewis + Lewis (2016) found that efficiency of CBT was equal to antidepressants and Taylor et al. (2008) found CBT could be used for patients with learning difficulties

Question 3

Disadvs of cognitive behavioural therapy

Answer 3

• may not be suitable for all patients → Sturney (2005) proposed those with learning disabilities may not be able to access the complex rational thinking of any form of talking therapy’. Similarly those with severe depression may not be motivated to engage in CBT.
• high relapse rates → Ali et al (2017) assessed depression in 439 patients every month for 123 months completing CBT. 42% relapsed into depression within 6 months, and 58% in the year. People with severe depression may not be engaged.
• efficiency may not depend on Beck’s triad or Ellis’ ABC model, but the relationship between therapist and patient → Resenzweig et al (1986) argued relationship is most important, suggesting having someone to talk to is the crucial component in overcoming depression. This is supported by Luborsky et al (2002) that showed little difference between methods of psychotherapy.

Question 4

Whats the central premise of CBT?

Answer 4

thoughts, feelings + behaviour impact each other, so if an irrational thought can be identified it can also change peoples emotions and behaviour

Question 5

Whats an initial assessment?

Answer 5

CBT therapist works with patient to identify problems

Question 6

Whats goal setting?

Answer 6

patient and therapist agree on a set of goals and a plan of action to achieve them

Question 7

Whats identifying automatic and relative irrational thoughts?

Answer 7

in relation to themselves, their world and their future (Becks negative triad) or activating events and beliefs (Ellis’ ABC Model)

Question 8

Whats ‘patient as scientist’?

Answer 8

therapist and patient challenge negative thoughts against reality and/or puts new rational beliefs into practice by…
- discussing evidence for/against
- homework outside of the sessions (eg. thought diaries)

Generating and testing hypothesis about the validity of their irrational thoughts. When they realise their thoughts don’t match reality, this’ll change their schemas, the irrational thoughts will be discarded, leading to cognitive restructuring - finally leading to change in feelings and behaviours

Question 9

Whats thought catching?

Answer 9

identifying irrational thoughts coming from the negative triad of schemas

Question 10

Whats behavioural activation?

Answer 10

engaging in more active and enjoyable activities (important to combat depressive symptoms of isolation and loss of interest)

Question 11

Whats Ellis’ ABCDE model?

Answer 11

Dispute → the therapist asks the client to dispute/ challenge their irrational thoughts and beliefs as utopianism
Effective new responses → therapist asks client to think of more rational responses

Question 12

Types of disputing - empirical

Answer 12

Assessing whether there’s evidence for the thought

Question 13

Types of disputing - logical

Answer 13

Assessing whether the thoughts follow from the facts

Question 14

Types of disputing - pragmatic

Answer 14

Assessing if the thought is helpful