Cognitive approaches to depression

• How do we use cognitive approaches to try and treat depression?

  Cognitive treatments try to help patients change their way of thinking. Irrational and negative thinking needs to be replaced with rational and positive thinking.
• How does cognitive behavioural therapy (CBT) work?

  • Patient & therapist work together: identify problems, set goals, build a relationship
  • Patients receive homework where they have to write down their thoughts throughout the week. Called thought catching. (Identification of faulty beliefs/cognitive biases)
  • When patient sees therapist, they challenge these negative thoughts (cognitive restructuring)
  • Then may get more homework to practice more rational/adoptive behaviours
  • Behavioural activation: encouraging patients to identify activities that they enjoy and go out and do them
• What is the ABCDE model?

  Developed by Ellis - adaption to his previous ABC model. Involves challenging negative and irrational assumptions.

  A = Activating event

  B = Beliefs

  C = Consequences

  D = Dispute

  E = Effect
• What is logical disputing?

  Showing that self defeating beliefs do not follow logically from the available information.
• What is empirical disputing?

  Explaining how self defeating beliefs may not be consistent with reality.
• What is pragmatic disputing?


  Emphasis on lack of usefulness of self-deprecating beliefs.
• Positive evaluation:

  • Effectiveness - David et al studied 170 patients suffering from a major depressive disorder, and those that had 14 weeks of REBT (rational emotive behaviour therapy) had better treatment outcomes than those who were treated with drug therapies
  • Economical implications - CBT may be more expensive than drug therapy, however individual is less likely to relapse than those on drug therapies, thus saving money for NHS long term & ensures person can get back to work and aid economy
• Negative evaluation:

  • Not suitable for all - Ellis believed some people who claimed to be following REBT principles weren't always doing this e.g. due to difficulty focusing in session or lack of motivation. Combination of CBT and drug therapies may be better.
  • Irrational environments - If irrational beliefs are stemming from toxic environments/places then REBT will be ineffective or could make person believe that the suffering they are enduring is rational and okay.