Treating depression

Question 1

What does treatment of depression look to do?

Answer 1

Treatment and therapies look to identify and change the negative/irrational beliefs that may lead to certain behaviours

Question 2

What are the two types of CBT?

Answer 2

• Beck’s cognitive therapy
• Ellis REBT

Question 3

What does REBT mean?

Answer 3

rational emotive behavioural therapy

Question 4

How does Beck’s cognitive therapy work?

Answer 4

• focuses on identifying irrational beliefs related to negative triad
• one identified they are challenged
• conducted through a process called ‘patient as scientist’

Question 5

How does ‘patient as scientist’ work?

Answer 5

• Patient (sometimes as homework) will set up experiments to test their beliefs
• Allows patient to collect evidence that will refute those negative beliefs

Question 6

What is added to Ellis’ ABC model

Answer 6

Dispute and Effect

Question 7

What are the three types of disputes

Answer 7

• Logical dispute: irrational beliefs do not follow logically from the information available. ‘does thinking this way make sense’
• Empirical disputing: may not be consistent with reality, ‘Where is the proof that this belief is accurate’
• Pragmatic disputing: emphases the lack of usefulness of irrational beliefs, ‘How is this belief likely to help me’

Question 8

A03 -Effective in treating depression

Answer 8

• There is a large body of evidence to support the effectiveness of CBT for depression
• For example, study by March et al compared the effects of CBT with antidepressant drugs and a combination of the two in 327 adolescents with a main diagnosis of depression
• After 6 weeks, 81% of the CBT group, 81% of the antidepressant group and 86% of the combination group were significantly improved
• Therefore, CBT emerged as just as effective as medication and helpful alongside medication
• Suggests making CBT the first choice of treatment in public health care systems like the NHS

Question 9

A03 - However, it may not be effective in for more severe cases

Answer 9

• CBT requires motivation to attend, something that many patients with depression lack
• As many as 27 sessions of REBT may be required for it to be effective
• Instead other treatments like drug therapies require less effort on part of the client
• Drug therapies are used in conjunction to CBT as they can help with some of the symptoms of depression, like lethargy, that help the patient focus on their CBT sessions
• Suggests CBT may not be effective treatment for all patients with depression and may be useful when used with other techniques like drug therapy

Question 10

A03 - CBT may be due to therapist-patient relationship

Answer 10

• Rosenzwig suggested that the differences between the different methods of psychotherapy, such as CBT and systematic desensitization might actually be quite small
• Psychotherapies share one essential ingredient, therapist-patient relationship
• it may be the quality of this relationship that determines success rather than the technique
• Many comparative reviews (e.g. Lurborsky et al) find very small differences, which supports the view that having the opportunity to talk to someone matters the most
• This suggests that the key cognitive principle that underpins CBT (identifying and challenging irrational health) may bear little importance when treating depression

Question 11

A03 - May be an overemphasis on cognition within CBT

Answer 11

• There is a risk that because of its emphasis on what is going on in the mind of the individual patient CBT may end up minimsing the importance of the circumstances in which the patient is living in (McCusker)
• A patient living in poverty or suffering from abuse needs to change their circumstances, and any therapy that focuses on the patients mind rather than environment can prevent this from happening
• CBT used inappropriately can demotivate people to change their situation
• This suggests that CBT may not be appropriate treatment for all individual suffering from depression