Evaluation

• Evidence for effectiveness 


  One strength of CBT is the large body of evidence supporting its effectiveness for treating depression:

  • March et al. compared CBT to antidepressant drugs and also to a combination of both when treating 327 depressed adolescents and found that after 36 weeks, 81% of the CBT group, 81% of the antidepressant group and 86% of the combination group were significantly improved
  • CBT is also cost-effective
  • Therefore, CBT is widely seen as the first choice of treatment in the NHS
• Suitability for diverse clients

  One limitation of CBT for depression is the lack of effectiveness for severe cases and for clients with learning disabilities:

  • In some cases depression can be so severe that clients cannot motivate themselves to engage with the cognitive work of CBT
  • The complex rational thinking involved makes it unsuitable for treating clients with learning disabilities
  • Sturmey suggests that any form of psychotherapy is not suitable for people with learning disabilities
  • Therefore, CBT may only be appropriate fora a specific range of people with depression
• Counterpoint to suitability for diverse clients

  There is evidence that challenges this:

  • Lewis and Lewis concluded that CBT was as effective as antidepressant drugs and behavioural therapies for severe depression
  • Taylor et al. concluded that when used appropriately, CBT is effective for people with learning difficulties
  • Therefore, CBT may be suitable for a wider range of people than was once thought
• Relapse rates

  One limitation of CBT for the treatment of depression is its high relapse rates:

  • Relatively few early studies of CBT for depression looked at long-term effectiveness. Some more recent studies suggest that long-term outcomes are not as good as had been assumed
  • Ali et al. assessed depression in 439 clients every month for 12 months following a course for CBT and found that 42% of the clients relapsed into depression within six months of ending treatment and 53% relapsed within a year
  • Therefore, CBT may need to be repeated periodically