A03 Cognitive Approach to treating Depression

• Evaluation of Cognitive Approach to Treating Depression?

  +CBT is effective (March et al 2007)

  -CBT not work for severe cases

  -Success due to therapist-patient relationship (Rosenzweig 1936)

  -Some patients want to explore past

  -Overemphasis on cognition (reductionist) (McCusker 2014)
• Supporting evidence - CAtTDA03

  P: There lots of CBT for depression. E: Study by March et al (2007) compared effects of CBT with antidepressant drugs & a combination of the two in 327 adolescents with a main diagnosis of depression. After 36 weeks 81% of CBT group, 81% of antidepressant group & 86% of CBT & antidepressants group were significantly improved.

  E: Thus CBT emerged as just as effective as medication & helpful alongside medication.

  L: Suggests there good case for making CBT first choice for public health care systems like NHS. Thus CBT strengthened
• Overemphasis on cognition - CAtTD A03

  P: CBT may end up minimising the importance of the circumstances in which the patient is living (McCusker 2014). E: A patient living in poverty or suffering abuse needs to change their circumstances and any approach that emphasised what is in the patients mind rather than their environment can prevent this.

  L: CBT techniques use inappropriately can demotivate people to change their situation
• Success due to therapist-patient relationship - CAtTD A03 - PART 1

  P: Rosenzweig (1936) suggested that differences between different methods of psychotherapy e.g CBT & Systemic desensitisation might actually be quite small
• Success due to therapist-patient relationship - CAtTD A03 - PART 2


  E: All psychotherapies have one essential ingredient - the relationship between therapist and patient. It may be the quality of this relationship that determines success rather than the particular technique that is it.

  L: Many comparative reviews (e.g. Luborsky et al 2002) find small differences (between therapies, suggesting that they share a common basis) which supports view that simply having opportunity to talk to someone who listen could be what matters most.

  TB&BOOKLET
• Not good for severe cases - CAtTD A03


  P: Some cases depression so severe that CBT not work for patients. So severe patients cant motivate themselves to engage in the hard cognitive work required for CBT.

  E: They may not able to pay attention to what happening in session. Where this is the case it is possible to treat patients with antidepressant medication & commence CBT when they more alert & motivated.

  L: Although, possible to work around this using medication, this limitation of CBT coz means CBT can't be used as sole treatment for all cases of depression.
• Patients want to explore past - CAtTD A03


  P: One of the basic principles of CBT is that the focus of CBT is that the focus of the therapy is on the patient's present and future, rather than their past.

  E: Some patients want to explore past (CBT doesn't do). This contrasts to some other forms of psychotherapy.

  E: Some patients aware of link between current depression & childhood experiences & may want to talk about their experience.

  L: They can find this 'present-focus' very frustrating. The focus of CBT may ignore an important aspect of the depressed patient's experience.