Cognitive approach to treating

• Cognitive behaviour therapy (CBT)


  • CBT is the most commonly used psychological treatment for depression and a range of other mental health issues
  • Cognitive element - client and therapist assess the client's problems and identify goals and plans for therapy. One of the central tasks is to identify where there might be negative or irrational thoughts
  • Behaviour element - working to change negative and irrational thoughts and finally put more effective behaviours into place
• Beck's cognitive therapy


  • The idea is to identify automatic thoughts about the world, the self and the future. Once identified these thoughts must be challenged
  • Cognitive therapy also aims to help clients test the reality of their negative beliefs by setting homework, such as recording when they enjoyed an event
  • In future sessions if the client says that they don't enjoy anything the therapist can produce this as evidence to prove that they are being irrational
• Ellis' REBT


  • REBT extends the ABC model to an ABCDE model - d for dispute and e for effect
  • E.g. a client might talk about how unfair things seem. An REBT therapist would identify this as utopianism - an irrational belief - and challenge this
  • This would involve a vigorous argument with the intent to change the irrational belief and break the link between negative life events and depression
  • Ellis identified different methods of disputing;
  • Empirical argument - disputing whether there is evidence to support the belief
  • Logical argument - disputing whether the negative thought is logical
• Behavioural activation


  • As individuals become depressed they tend to increasingly avoid difficult situations and become isolated, which worsens symptoms
  • Behavioural activation aims to work with depressed clients to gradually decrease their avoidance and isolation, and increase their engagement in activities that have been shown to improve mood
  • E.g. exercising, going out to dinner etc