- research by terry et al found that people with high cognitive vunerability (they had experienced a negative thought process as suggested by beck) were more likely to suffer depression
Practical explanations for treatment of depression
- evident from its application in CBT by identifying negative thughts and challenging them
BUT
Blames the client rather than situational factors
-suggests the client is responsible for their disorder
- may lead to the client or therapist overlooking situational factors like life events or family problems might contriute to the disorder
-cognitive, therapist asks the client to become aware of thoughts which contribute to anxiety or depression, this enables the thoughts to be challenged. clients are often asked to find proof of their irrational thoughts
-behavioural, client and therapist develop coping strategies to deal with the thoughts, they are often set homework assignments and the client is continually set goals to progress to more rational thinking. this often tests irrational beliefs against reality
-behavioural activation, encourages depressed clients to become more active and engage in pleasurable activities- dealing with any cognative obstacles along the way
-unconditional positive regard, if the therapist provides respect and appreciation regardless of what the client says or does they feel valued and are more likely to change beliefs and attitude
Identify and challenge irrational thoughts by putting in place a disruptive intervention so that a negative consequence to a negative belief doesn't happen
march et al compared the effects of cbt to antidepressants and found it was just as effective
- this suggests that cbt should be a first choice treatment of depression
-however, combining cbt and antidepressants produced most significant improvement
downsides:
cbt appears to be more useful for some people than others, cant be used for all cases
-patients may not be able to engage with the hard cognitive work required
- in this case it may be more appropriate to treat with andtidepressant medication to manage symptoms and start cbt when they are more alert and able to focus
cbt effectiveness may be due to the relationship with the client and therapist
-there is not much difference in the effectiveness of psychological therapies, eg cbt vs counselling
-this may be because they share common factors such as being able to talk to a sympathetic person which suggests that cognitive strategies are not the active component of treatment
other treatments are available
-drug therapies have less effort on the part of the client and can be used in conjunction with another therapy eg a psycho therapy like cbt
-this may be useful as a distressed client may be unable to focus on the demands of cbt