The cognitive approach to treating depression

• what is the cognitive element of using CBT to treat depression?

  ->it begins with an assessment which the client and the cognitive behaviour therapist works together to clarify the client's problems

  ->they jointly identify goals for therapy and put together a plan to achieve them

  ->on of the central tasks is to identify where there might be negative or irrational thoughts that will benefit from challenge
• what is the behavioural element of using CBT to treat depression?

  -> CBT then involves working to change negative and irrational thoughts and finally put more effective behaviours in place
• describe and explain Beck's CBT

  ->the therapist helps to identify negative thoughts in relation to themselves, their world, their future, using Beck's cognitive triad

  ->the patient & therapist will then work together to challenge these irrational thoughts by discussing evidence for & against these (reality testing)

  ->the patient will then be encouraged to test the validity of their negative thoughts and may be set homework to challenge & test their negative thoughts
• describe and explain Ellis' Rational Emotive Behaviour Therapy (REBT)

  ->Ellis developed his ABC model to include D (dispute) and E (effective)

  ->the main idea is to challenge irrational thoughts however with Ellis' theory & this is achieved through dispute (argument)

  ->the therapist disputes the patient's irrational beliefs, to replace their irrational beliefs with more effective belief & attitudes
• what are the two types of dispute in Ellis' REBT?

  ->logical dispute: where the therapist questions the logic of a person's thoughts e.g 'does the way you think of the situation makes any sense?'

  ->empirical dispute: where the therapist seeks evidence for a person's thoughts e.g 'where is the evidence that your beliefs are true?'
• what happens following a REBT/CBT session?

  ->the therapist may set their patient homework

  ->the idea is that patient identifies their own irrational beliefs and proves them wrong

  ->as a result, their beliefs begins to change
• what is a strength of using CBT in treating depression?

  ->there's a large body of supporting evidence supporting it's effectiveness for treating depression

  ->E.g, March (2007) compared the effects of CBT with antidepressants drugs and a combination of the two in 327 adolescents with main diagnosis of depression

  ->after 36 weeks, 81% of the CBT group, 81% of the antidepressants group & 86% of the CBT plus antidepressant group were significantly improved
• why is it that the use of CBT in treating depression having a large body of supporting evidence a strength?

  ->it implies that it's just as effective when used and more so alongside antidepressants

  ->it also means that CBT is widely seen as the first choice of treatment in public health care systems such as the NHS
• what is a limitation of the use of CBT a s a treatment of depression?

  ->it has high relapse rates

  ->although CBT is quite effective tackling the symptoms of depression, there are some concerns over how long the benefits last

  ->some recent studies implies that the long term outcomes are not so impressive as had been assumed

  ->Ali (2007) assessed depression in 439 clients every month for 12 months following a course of CBT

  ->42% of the clients relapsed into depression within six months of ending treatments and 53% relapsed within a year
• why is the relapse rates being high after using CBT a limitation?


  it means that CBT may need to be repeated periodically
• what's another limitation for depression of using CBT as a treatment of depression?

  ->the lack of effectiveness for severe cases and for it's clients with learning disabilities

  ->in some cases, depression can be severe that clients cannot motivate themselves to engage with the cognitive works of CBT

  ->they may not be even be able to pay attention to what's happening in a session

  ->it also seems likely that hard cognitive work involved in CBT makes it unsuitable for treating depression in clients with learning disabilities
• what does the ineffectiveness of using CBT as a method of treating depression a limitation?


  ->it it implies that CBT may only be appropriate for a specific range of people with depression
• counterpoint


  ->although more recent evidence challenges the fact that CBT is only appropriate of a specific range of people

  ->Lewis and Lewis (2016) concluded that CBT was effective as antidepressants drugs and behavioural therapies for severe depression

  ->Taylor (2008) concluded that, when appropriately, CBT is effective for people with learning disabilities- this means that CBT may be suitable for a wider range of people than was once thought