cognitive approach treating depression

• cbt

  cognitive behavioural therapy
• cognitive part of cbt

  identify irrational or negative thoughts that cause depression , aim is to replace these with positive thoughts
• behavioural part of cbt

  encourages patients to test their beliefs through behavioural experiments and homework
• aim of cbt

  turn irrational beliefs into rational ones
• ellis extended abc model into abcdef model

  d-disputing irrational thoughts/feelings

  e-effects of disputing and effective attitude to life

  f-new feelings that are produced
• challenge irrational thoughts through

  logical disputing

  empirical disputing

  pragmatic disputing
• logical disputing

  self-defeating beliefs do not follow logically from information available

  e.g-does thinking in this way make sense?
• empirical disputing

  self-defeating beliefs may not be consistent with reality

  e.g-where is the proof that this belief is accurate?
• pragmatic disputing

  emphasises lack of usefulness of self-defeating beliefs

  e.g-how is this belief likely to help me?
• homework from cbt

  clients given assignments

  e.g-ask someone on a date with a fear of rejection

  this tests irrational beliefs against reality and puts new rational beliefs into practice
• behavioural activation

  encourage depressed clients to be active and engage in pleasurable activities

  based on idea that being active leads to rewards that act as an antidote to depression
• more on behavioural activation

  many depressed people no longer participate in activities they enjoyed so therapists and client identify potentially pleasurable activities and deal with cognitive obstacles
• unconditional positive regard in cbt

  ellis 1994 said successful therapy needed a client to be convinced of their value

  if therapist provides respect and appreciation regardless of what client does and says, this will facilitate a change in beliefs and attitudes
• strength-research support

  ellis 1957 claimed 90% success rate for REBT, average of 27 sessions to complete treatment

  cbt done well in outcome studies of depression for example, cuijpers et al 2013 reviewed 75 studies and found cbt superior to no treatment

  rebt effective but factors relating to client and therapist may limit effectiveness
• outcome studies of depression

  studies designed to measure the outcome of treatment
• limitation-cbt more suitable for some individuals than others

  less suitable for people with high levels of irrational beliefs that are resistant to change-elkin et al 1985

  so individual differences affect its effectiveness
• strength-belief that changing behaviour can ease depression supported by study on beneficial effects of exercise

  babyak et al 2000 studies 156 adult volunteers with major depressive disorder, randomly assigned to 4 month course of aerobic exercise , drug treatment or both,all improved by end

  6 months after exercise group had lower relapse rates than drug group

  so change in behaviour can help treat depression
• limitation-alternative treatments

  antidepressants-SSRIs

  need less effort from client as cbt average 27 sessions which is lots of commitment

  can be used with cbt as client may be unable to focus on cbt demands so could enable them to cope

  using cbt and drugs may be best option
• limitation-dodo bird effect

  all treatments may be equally effective

  research found small differences in success rates-Luborsky et al 1975 and 2002 reviewed over 100 studies and found this
• why might the treatments be equally effective?

  common factors in the psychotherapies