The Cognitive Approach to Treating Depression

Question 1

CBT aims to:

Answer 1

identify + alter negative and irrational beliefs and expectations (cognitive element) + to alter dysfunctional behaviours contributing to depression (behavioural element).

Question 2

CBT stands for:

Answer 2

Cognitive behavioural therapy

Question 3

What are the two parts of the treatment?

Answer 3

• Cognition
• Behaviour

Question 4

Who came up with CBT?

Answer 4

Beck

Question 5

What is the idea behind Beck’s CBT?

Answer 5

to identify the automatic thoughts about the world, self and future.

Question 6

What are the three COGNITION parts:

Answer 6

• Thought catching
• Challenging beliefs
• Cognitive restructuring

Question 7

Thought catching:

Answer 7

therapist helps client identify faulty negative beliefs through discussions about experiences and thoughts + hw assignments where client asked to record daily thoughts and events

Question 8

Challenging beliefs:

Answer 8

thoughts r challenged through discussion. therapist demonstrates negative effect of beliefs, uses evidence to dispell them. As hw, client may work as scientist by conducting reality testing to test validity of negative beliefs.

Question 9

Cognitive restructuring:

Answer 9

clients helped to replace negative thoughts w positive and constructive ones- helps reduce impact of negative automatic thoughts and replace them w positive which help alleviate symptoms of depression.

Question 10

What is the BEHAVIOURAL part:

Answer 10

• Behaviour activation

Question 11

Behaviour activation:

Answer 11

Depressed ppl dont ppt in activities they previously enjoyed. Client and therapist identify potentially pleasurable activities + how to overcome obstacles in carrying them out. Then given graded hw assignments which allow them to experiment w chosen activity + then engage in progressively more rewarding activities.

Question 12

What does REBT stand for:

Answer 12

Rational Emotive Behavioural Therapy

Question 13

Ellis’s explanation of depression is ABC. To treat depression:

Answer 13

Ellis adds on stages D and E

Question 14

The central technique of REBT is to:

Answer 14

identify and dispute irrational thoughts.

Question 15

D is for

Answer 15

Disputing

Question 16

What are three types of disputing:

Answer 16

• Empirical (scientific)
• Logical
• Pragmatic (functional)

Question 17

Empirical disputing:

Answer 17

irrational beliefs are not consistent w reality- no evidence for them in real life.

Question 18

Logical Disputing:

Answer 18

irrational beliefs do not follow logically from available info/ evidence- conclusions drawn r illogical

Question 19

Pragmatic (functional) Disputing:

Answer 19

irrational beliefs have no real use to client - have negative effect instead- should be dispenced

Question 20

E is for

Answer 20

Effect of disputing

Question 21

Effect of disputing:

Answer 21

successful disputing changes self-defeating, irrational beliefs into more rational beliefs-> client can move to more rational intepretations of events- healthier consequences. Helps depressed client feel better + become more self accepting.

Question 22

Strength- supporting research for effectiveness of CBT and REBT.

Answer 22

Numerous studies show CBT is effective in reducing symptoms of moderate + severe depression + preventing relapse- esp in those who only have depression.
Ellis- 90% success rate of REBT, taking avg of 27 sessions to complete treatment.
David et al (2008) found all REBT, Beck’s CBT and drug therapy to be effective at end of treatment. 6 month follow up- evidence that REBT more effective.
Shows that cognitive treatments r effective + REBT most in long term + should b seen as first choice treatment of depression.

Question 23

Ellis-

Answer 23

Ellis- 90% success rate of REBT, taking avg of 27 sessions to complete treatment.

Question 24

David et al (2008)-

Answer 24

David et al (2008) found all REBT, Beck’s CBT and drug therapy to be effective at end of treatment. 6 month follow up- evidence that REBT more effective.

Question 25

Strength of CBT- its techniques r appropriate for use in variety of situations.

Answer 25

Many modes of delivery for CBT e.g online therapy , interactive software programmes, face to face consultations. Also been used successfully w ppl of all ages with degrees of depression from mild to severe. SB: not restricted to certain groups of + can b adjusted to help ppl of diff lifestyles/ types of depression- wide variety of ppl can benefit from it. +CBT - no negative side effects like insomnia + weight loss found in SSRIs/other drugs. Easily accessible + offers to help wide range of ppl w depression.

Question 26

Weakness - competence of therapist in CBT has impact on treatment outcome + leads to variation in some outcomes.

Answer 26

Kuyken (2009)- 15% of variance in outcome may be attributed to therapist competence. Therapists assessed as most competent- better patient outcomes regardless of complexity of the case. Since quality of treatment may depend on ability of therapist + therapist and patient relationship- may not work as well for everyone. Reduces effectiveness of treatment.

Question 27

Kuyken (2009)-

Answer 27

Found 15% of variance in outcome may be attributed to therapist competence.

Question 28

Weakness of CBT- may not work for all personality types/ situations.

Answer 28

Simons (1995) - CBT not effective for ppl w rigid attitudes + resistant to change. Also not effective for ppl w high stress levels, due to long term problems in their lives (e.g disability or abusive marriage) - brief treatment like CBT cannot resolve. If cause of depression is external and out of person's control- may make client assume the problem is w their own thoughts and perspective - less motivated to remove themselves from hostile environment. Could further contribute to their illness + may limit appropriateness of CBT in situations.

Question 29

Simons (1995) -

Answer 29

Found CBT not effective for ppl w rigid attitudes + resistant to change. Also not effective for ppl w high stress levels, due to long term problems in their lives (e.g disability or abusive marriage) - brief treatment like CBT cannot resolve.