Treatments for Depression

• What does CBT stand for?


  Cognitive Behavioural Therapy
• What is the central aim of CBT?


  Identify and work to change & challenge irrational beliefs
• Who is CBT between?

  Therapist & client
• What is the cognitive element of CBT?


  Assess/Clarify problems client faces

  Identify the goals of the therapy

  Plan to achieve goals
• What is the behavioural element of CBT?


  Work to put in effective behaviours in place
• What treatment is derived from Beck‘s negative triad explanation?

  Cognitive therapy
• What treatment was derived from Ellis’s ABC Model?

  REBT
• What is Ellis’s ABCDE stand for?

  Activating event

  Beliefs

  Consequences

  Dispute

  Effect
• What is a key element of CBT & REBT?

  Engaging in vigorous argument to challenge & dispute irrational beliefs/thought.
• What types of vigorous argument are used?


  Empirical & Logical
• How can irrational thoughts be challenged?

  Direct argument.

  Client collects their own evidence to test reality.

  Using proof.
• What is Behavioural Activation?


  The aim to work with patients to gradually reduce their practice of avoidance & isolating behaviours.

  Increasing engagement in mood improving activities.
• Who should reinforce/encourage behavioural activation?


  Therapist
• How is CBT limited as a talking therapy?


  Lacks effectiveness with clients with learning disabilities or severe depression as the cannot engage in hard cognitive work or levels of motivation needed to be successful
• What did Sturmey 2005 suggest?


  Any talking therapies are unsuitable for people with learning disabilities always
• What does CBT being a talking therapy mean for the diversity of clients?

  Limited to a specific range of individuals it is a suitable & useful treatment
• What did Ali et al show?


  42% of patients relapsed after 6 months of finishing CBT treatment

  53% of patients relapsed within the year of finishing CBT treatment
• What does high relapse rates mean for CBT as a treatment?


  Lacks long-term effectiveness

  Necessary to repeat periodically so not a true treatment.

  More like symptom management
• What did March et al 2007 do?


  Compared antidepressants & CBT.

  327 Ps over 36 weeks were monitored
• What did March et al find?


  81% effective for either CBT alone or Antidepressants alone

  86% effective when both CBT & Antidepressants are used
• How is CBT cost effective?

  When compared to alternative therapies it is briefer from 6 to 12 sessions.

  So more affordable & convenient for NHS