The Cognitive Approach to treating depression

Question 1

What is cognitive behaviour therapy (CBT) ?

Answer 1

• a method for treating mental disorders like depression which is based on cognitive & behavioural techniques
• it begins with an assessment for the therapist & patient to identify the patient’s problems where they then collectively work towards a goal for the therapy and how to achieve it
• a main task it identifying negative & irrational thoughts which are worked towards challenging them & putting more effective behaviours into place

Question 2

What is Beck’s cognitive therapy?

Answer 2

• the idea is to identify the person’s negative triad which are then must be challenged
• cognitive therapy also aims to help patients test the reality of their negative beliefs by specific hw given to them from the therapists
• if this fails the therapist can provide evidence to the patient to prove that their statements about themselves, the world & the future are wrong

Question 3

What is Ellis’s rational emotive behaviour therapy (REBT) ?

Answer 3

• REBT extends the ABC model to ABCDE where D is dispute & E is effect
• the main effect of REBT is to identify & challenge the irrational thoughts
• e.g. patient may talk about how unfair the world is & the therapist would dispute these irrational beliefs by giving examples of utopianism - this involves a vigorous argument
• the intended effect is to change the irrational belief to break the link between negative events & depression

Question 4

What are the different methods of disputing identified by Ellis?

Answer 4

• empirical argument - involves disputing whether there is actual evidence supporting the negative belief
• logical argument - involves disputing whether the negative thought is factual when thought about logically

Question 5

What is behavioural activation?

Answer 5

• therapists encourage their patients suffering depression to be more active & engage in activities they enjoy alongside the cognitive aspects of CBT
• this aims to provide more evidence for the irrational nature of the patient’s beliefs

Question 6

Evaluation: It is effective

Answer 6

• lots of evidence supports the effectiveness of CBT for treating depression
• e.g. March et al. compared effects of CBT with antidepressants & both combined in 327 adolescents with depression
• after 36 weeks 81% of antidepressants group, 81% of CBT group & 86% of both combined group were significantly improved
• this is a strength as it proves CBT to be just as effective as medication & working alongside it
• this suggests there is a good case for making CBT the 1st choice for treating depression in public health care systems like the NHS

Question 7

Evaluation: CBT may not work for the most severe cases

Answer 7

• some cases of depression are so severe where patients can’t motivate themselves to participate in the work involved in CBT
• they may not be able to pay attention to what is happening in a session
• when this is a case antidepressants is a possible treatment - CBT can be involved when the patient is more motivated
• this is a limitation for CBT as it means it can’t be used alone for treatment of all cases of depression

Question 8

Evaluation: Success may be due to the therapist-patient relationship

Answer 8

• Rosenzweig suggested that the differences between methods of psychotherapy like CBT & systematic desensitisation might be small
• this is because all psychotherapies involve therapist-patient relationships
• it may be that the quality of the relationships determines the success of the therapy rather than the technique used
• many comparative reviews done find small differences between the therapies which supports the idea that having an opportunity to talk to someone who listens is what matters more than the technique used in trying to treat a patient

Question 9

Evaluation: Overemphasis on cognition

Answer 9

• there is a risk that due to the emphasis on the patients cognitions in CBT it may end up minimising the importance of the circumstances in which the patient is living in
• e.g. a patient living in poverty needs to change their circumstances - an emphasis more on what’s happening in the patient’s mind rather than their environment can prevent this
• this is a limitation for CBT because when used inappropriately it can demotivate people to change their situation