The cognitive approach to treating depression Flashcards
(8 cards)
What is the initial cognitive behavioural therapy?
Method for treating mental disorders
Initial assessment
Goal setting
Identify irrational thoughts and challenge them using becks CBT and Ellis’ REBT
Backs CBT and REBT are both examples of cognitive therapy
What is Becks cognitive therapy?
Identify automatic thoughts about the world, self and future - negative triad
Once identified thoughts are challenged
Helps clients test reality of their negative beliefs
Set goals together
Therapists set the patient homework
‘patient as scientist’
Therapists challenge patients irrational thoughts
Therapist and client discuss evidence against those irrational thoughts using patients homework as evidence
What is Ellis’s rationale emotive behaviour therapy?
ABCDE model
D - Dispute
E - Effect
Identify and dispute irrational thoughts
Dispute - vigorous argument
Logical dispute - question the logic of persons thoughts
Empirical dispute - therapist seeks whether there is any evidence to support these irrational beliefs
What is behavioural activation?
When become depressed tend to increasingly avoid difficult situations and become isolated - maintains or worsens symptoms
Aim to gradually decrease their avoidance and isolation
Increase engagement in activities that have been shown to improve mood
Therapist aims to reinforce such activity
What is an evaluation for CBT?
Evidence for effectiveness
March et al
Compared CBT to antidepressant drugs
Combination of both
Treating 327 depressed adolecents
After 36 qwwks
81% of CBT
81% antidepressants group
86% CBT + antidepressants
Were significantly improved
CBT was just as effective when used on its own and more alongside antidepressants
CBT is usually a fairly brief therapy 6-12 sessions
Cost effective
Meaning CBT is widely seen as the first choice of treatment in public health care system such as the national health service
What is an evaluation for CBT?
Suitability for diverse clients
Lack of effectiveness for severe cases and for clients with learning difficulties
Some cases client cannot motivate themselves to engage with cognitive work of CBT
May not be able to pay attention to what happens in session
Seems likely that the complex rational thinking makes it unsuitable for learning difficulties
Suggesting CBT may only be appropriate for a specific range of people with depression
What is an evaluation for CBT?
Relapse rates
High relapse rates
Concerns over how long benefits last
Rarely few studies looked at long term effectiveness
Ali et al
Assed depression in 439 clients
Every month for 12 months following course of CBT
42% clients relapsed within six months of treatments
53% relapsed within a year
Meaning CBT may need to be repeated periodically
What is an evaluation for CBT?
Counterpoint to suitability for diverse clients
Some evidence that challenges this
Lewis and Lewis
CBT was as effective as antidepressant drugs and behavioural therapies for severe depression
Taylor et al
When used appropriately CBT is effective for people with learning difficulties
Meaning CBT may be suitable for a wider range of people than was once thought
